Ngatchou William, Lemogoum Daniel, Ndobo Pierre, Yiagnigni Euloge, Tiogou Emiline, Nga Elisabeth, Kouanfack Charles, Nde Francis, Degaute Jean-Paul, van de Borne Philippe, Leeman Marc
Hypertension Clinic Department, Erasme University Hospital, Brussels, Belgium.
Blood Press Monit. 2013 Oct;18(5):247-51. doi: 10.1097/MBP.0b013e328363ee43.
HIV infection increases cardiovascular risk and highly active antiretroviral therapy may further augment it. We hypothesized that an increase in large artery stiffness may be a mechanism of enhanced cardiovascular risk in treated HIV-infected (HIV-T) patients.
Pulse wave velocity (PWV) and augmentation index (AI) were measured in 108 Cameroonian untreated HIV-infected (HIV-UT) patients and in 130 HIV-T patients.
Brachial and aortic systolic blood pressure (BP), diastolic BP, and pulse pressure were higher in HIV-T patients than in HIV-UT patients (all, P < 0.01). PWV was comparable in HIV-T and HIV-UT patients (7.2 ± 1.5 vs. 7.46 ± 2.2 m/s, respectively, P = 0.3), whereas AI was higher in HIV-T patients than in HIV-UT patients (7.9 ± 5 vs. 5.76 ± 4%, respectively, P = 0.003). AI was associated independently with age, brachial systolic BP, brachial diastolic BP, and height in HIV patients (R = 0.75, P < 0.01).
This study shows that pulse pressure and AI were increased in HIV-T patients, compared with matched HIV-UT patients, suggesting that highly active antiretroviral therapy could increase cardiovascular risk. However, PWV was not accelerated in HIV-T patients.
HIV感染会增加心血管疾病风险，而高效抗逆转录病毒疗法可能会进一步加剧这种风险。我们推测大动脉僵硬度增加可能是接受治疗的HIV感染（HIV-T）患者心血管疾病风险增加的一种机制。
对108名喀麦隆未接受治疗的HIV感染（HIV-UT）患者和130名HIV-T患者测量了脉搏波速度（PWV）和增强指数（AI）。
HIV-T患者的肱动脉和主动脉收缩压（BP）、舒张压和脉压均高于HIV-UT患者（均P<0.01）。HIV-T患者和HIV-UT患者的PWV相当（分别为7.2±1.5与7.46±2.2米/秒，P = 0.3），而HIV-T患者的AI高于HIV-UT患者（分别为7.9±5与5.76±4%，P = 0.003）。在HIV患者中，AI独立与年龄、肱动脉收缩压、肱动脉舒张压和身高相关（R = 0.75，P<0.01）。
本研究表明，与匹配的HIV-UT患者相比，HIV-T患者的脉压和AI升高，提示高效抗逆转录病毒疗法可能会增加心血管疾病风险。然而，HIV-T患者的PWV并未加快。
