Health Science Department, Milano-Bicocca University, Milan, Italy.
Infectious Disease Department, San Gerardo Hospital, Monza, Italy.
Hypertens Res. 2015 Jun;38(6):405-12. doi: 10.1038/hr.2015.25. Epub 2015 Mar 5.
HIV infected subjects present an unfavorable cardiovascular (CV) risk profile that is determined by the infection itself, highly active anti-retroviral therapy (HAART) and other factors, such as chronic kidney disease (CKD). Information is scant and contradictory on whether these factors are associated with arterial stiffness and blood pressure (BP) alteration. Our study aimed to evaluate those parameters in HIV-positive subjects both with and without HAART and with and without CKD, which was defined as the presence of microalbuminuria with a normal glomerular filtration rate. We enrolled 94 HIV-infected subjects without known CV risk factors and compared them with 37 control subjects. We recorded brachial and central BP (pulse wave analysis) and pulse wave velocity ( SphygmoCor). HIV-positive subjects of similar ages and with similar BP values showed central pulse pressure values that were significantly greater than those of controls; this was also the case for the Aix value. Central systolic and pulse pressure values and Aix were significantly greater in HIV-positive subjects with HAART and CKD than in the other HIV-positive subgroups and control subjects. PWV was also superimposable between groups when the data were analyzed relative to the presence of HAART and CKD. Our study shows that the unfavorable CV risk profile associated with HIV infection includes an increase in both central BP and Aix. The central BP increase seems to be favored by renal damage, which apparently has a role in the early stages of the disease.
HIV 感染患者的心血管（CV）风险状况不佳，这是由感染本身、高效抗逆转录病毒治疗（HAART）和其他因素决定的，如慢性肾脏病（CKD）。关于这些因素是否与动脉僵硬和血压（BP）变化有关的信息很少且相互矛盾。我们的研究旨在评估 HIV 阳性患者中有无 HAART 和 CKD 的这些参数，CKD 的定义为肾小球滤过率正常伴微量白蛋白尿。我们招募了 94 名无已知 CV 危险因素的 HIV 感染患者，并将其与 37 名对照患者进行比较。我们记录了肱动脉和中心血压（脉搏波分析）和脉搏波速度（ SphygmoCor）。年龄相似且血压值相似的 HIV 阳性患者的中心脉搏压值明显大于对照组；Aix 值也是如此。与其他 HIV 阳性亚组和对照组相比，接受 HAART 和 CKD 的 HIV 阳性患者的中心收缩压和脉搏压值以及 Aix 值明显更高。当根据是否存在 HAART 和 CKD 分析数据时，PWV 在各组之间也是可叠加的。我们的研究表明，与 HIV 感染相关的不良 CV 风险状况包括中心 BP 和 Aix 的增加。中央 BP 的增加似乎受到肾脏损害的影响，肾脏损害在疾病的早期阶段显然起着作用。
