Elevated blood pressure in HIV-infected individuals receiving highly active antiretroviral therapy.

OBJECTIVE

We examined the effects of antiretroviral regimens on blood pressure (BP).

METHODS

This retrospective study examined systolic and diastolic BP (SBP and DBP) measurements among participants of a State of Hawaii Department of Health program from January 1995 to July 2001. The change in BP during four consecutive 6-month visits was estimated using linear regression and was interpreted as the change in BP per year. BP changes among the antiretroviral treatment groups were compared to untreated controls.

RESULTS

Of 1,601 patients identified, 286 met the criteria for inclusion. After adjustment for baseline age, BP, and CD4+ count, there was an increase in SBP by 4.71 mmHg/year (p =.005) and DBP by 2.26 mmHg/year (p =.076) among patients initiating HAART. Among these patients, an increase of 4.75 mmHg/year in SBP (p =.002) and 1.96 mmHg/year in DBP (p =.042) was seen with HAART regimens containing a protease inhibitor (PI) but no nonnucleoside reverse transcriptase inhibitor (NNRTI). In NNRTI-containing HAART regimens without PIs, an increase of 3.21 mmHg/year in SBP (p =.011) and 2.62 mmHg/year in DBP (p =.050) was observed. No significant BP changes were noted with patients on regimens containing only nucleoside reverse transcriptase inhibitors (NRTIs).

CONCLUSIONS

The use of NNRTI- or PI-containing HAART is associated with elevation of both SBP and DBP in HIV-infected individuals.