Central/Peripheral fat mass ratio is associated with increased risk of hypertension in HIV-infected patients.

The data on the risk of hypertension in human immunodeficiency virus (HIV)-infected patients, particularly in those with lipodystrophy, are controversial. The authors assessed the impact of lipodystrophy on hypertension in a cohort of HIV-infected adults receiving combination antiretroviral therapy. This was a cross-sectional study in which lipodystrophy (clinically and fat mass ratio [FMR]-defined), blood pressure, and body composition (dual-energy x-ray absorptiometry and computed tomography) were evaluated in 368 HIV adults. The prevalence of hypertension in HIV patients with or without clinically or FMR-defined lipodystrophy was similar (with clinical lipodystrophy 35.3% vs without 32.9%, not significant; with FMR lipodystrophy 41.7% vs without 32.2%, not significant). When HIV-infected patients were classified into 4 categories of fat distribution (based on the presence or absence of lipoatrophy and abdominal prominence), isolated lipoatrophy was not significantly associated with hypertension, but patients with isolated central fat accumulation and mixed forms of lipodystrophy had a significantly higher prevalence of hypertension. Hypertensive HIV patients had significantly higher total fat, central, and central/peripheral fat mass ratio than normotensive ones. After adjustment for age, sex, smoking, and body mass index, hypertension remains significantly associated with central/peripheral fat mass ratio (odds ratio, 1.258; 95% confidence interval, 1.008-1.569). Hypertension was not more prevalent in lipodystrophic HIV-infected patients, but was significantly associated with central/peripheral fat mass ratio.