The Università di Perugia and Struttura Complessa di Medicina Interna, Ospedale S. Maria, Terni, Italy.
J Hypertens. 2013 Mar;31(3):560-7; discussion 567. doi: 10.1097/HJH.0b013e32835ca949.
HIV infection has been associated with increased cardiovascular risk. Twenty-four-hour ambulatory blood pressure (BP) is a more accurate and prognostically relevant measure of an individual's BP load than office BP, and the ambulatory BP-derived ambulatory arterial stiffness index (AASI) and symmetric AASI (s-AASI) are established cardiovascular risk factors.
In the setting of the HIV and HYpertension (HIV-HY) study, an Italian nationwide survey on high BP in HIV infection, 100 HIV-infected patients with high-normal BP or untreated hypertension (72% men, age 48 ± 10 years, BP 142/91 ± 12/7 mmHg) and 325 HIV-negative individuals with comparable age, sex distribution, and office BP (68% men, age 48 ± 10 years, BP 141/90 ± 11/8 mmHg) underwent 24-h ambulatory BP monitoring.
Despite having similar office BP, HIV-infected individuals had higher 24-h SBP (130.6 ± 14 vs. 126.4 ± 10 mmHg) and pulse pressure (49.1 ± 9 vs. 45.9 ± 7 mmHg, both P < 0.001), and a lower day-night reduction of mean arterial pressure (14.3 ± 9 vs. 16.3 ± 7%, P = 0.025). Both s-AASI and AASI were significantly higher in HIV patients (s-AASI, 0.22 ± 0.18 vs. 0.11 ± 0.15; AASI, 0.46 ± 0.22 vs. 0.29 ± 0.17; both P <0.001). In a multivariate regression, s-AASI was independently predicted by HIV infection (β = 0.252, P <0.001), age, female sex, and 24-h SBP. In HIV patients, s-AASI had an inverse relation with CD4 cell count (Spearman's ρ -0.24, P = 0.027).
Individuals with HIV infection and borderline or definite hypertension have higher symmetric AASI and 24-h systolic and pulse pressures than HIV-uninfected controls matched by office BP. High ambulatory BP may play a role in the HIV-related increase in cardiovascular risk.
HIV 感染与心血管风险增加有关。24 小时动态血压（BP）是个体 BP 负荷的更准确和预后相关的测量指标，而动态血压衍生的动脉僵硬度指数（AASI）和对称 AASI（s-AASI）是既定的心血管危险因素。
在 HIV 和高血压（HIV-HY）研究中，这是一项意大利全国范围内针对 HIV 感染中高血压的研究，100 名 HIV 感染的高正常血压或未经治疗的高血压患者（72%为男性，年龄 48±10 岁，BP 142/91±12/7mmHg）和 325 名年龄、性别分布和诊室 BP 相匹配的 HIV 阴性个体（68%为男性，年龄 48±10 岁，BP 141/90±11/8mmHg）接受了 24 小时动态血压监测。
尽管诊室 BP 相似，但 HIV 感染个体的 24 小时收缩压（130.6±14 比 126.4±10mmHg）和脉压（49.1±9 比 45.9±7mmHg，均 P<0.001）更高，且平均动脉压的昼夜下降幅度更低（14.3±9 比 16.3±7%，P=0.025）。s-AASI 和 AASI 在 HIV 患者中均显著升高（s-AASI，0.22±0.18 比 0.11±0.15；AASI，0.46±0.22 比 0.29±0.17；均 P<0.001）。在多变量回归中，s-AASI 独立于 HIV 感染预测（β=0.252，P<0.001）、年龄、女性性别和 24 小时收缩压。在 HIV 患者中，s-AASI 与 CD4 细胞计数呈负相关（Spearman's ρ -0.24，P=0.027）。
有边界或明确高血压的 HIV 感染个体的对称 AASI 和 24 小时收缩压和脉压高于匹配诊室 BP 的 HIV 未感染对照者。高动态血压可能在 HIV 相关心血管风险增加中发挥作用。
