aDepartment of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development, Amsterdam Health Technology Center bDepartment of Internal Medicine, Division of Vascular Medicine cDepartment of Internal Medicine, Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Academic Medical Center dHIV Monitoring Foundation, Amsterdam, The Netherlands.
Curr Opin HIV AIDS. 2017 Nov;12(6):513-522. doi: 10.1097/COH.0000000000000406.
This review describes what is known concerning the burden of hypertension among people living with HIV (PLHIV), and also addresses relevant topics with respect to its risk factors and clinical management.
Hypertension is highly prevalent in HIV-positive populations, and may be more common than in HIV-negative populations. Risk factors contributing to the development of hypertension in PLHIV include demographic factors, genetic predisposition, lifestyle, comorbidities such as obesity, antiretroviral therapy-related changes in body composition, and potentially also immunodeficiency, immune activation and inflammation, as well as effects from antiretroviral therapy itself. Clinical management of hypertension in PLHIV requires awareness for drug-drug interactions between antiretroviral drugs and antihypertensive drugs. Awareness, treatment, and control of hypertension in PLHIV is currently suboptimal and should be improved.
The burden of hypertension among PLHIV is high and its pathophysiology most likely multifactorial. Elucidating the exact pathophysiology of hypertension in PLHIV is vital as this may provide new targets to impact and improve clinical management. In the meantime, efforts should be made to improve hypertension management as per existing clinical guidelines in order to safeguard cardiovascular health and quality of life in PLHIV.
本文描述了 HIV 感染者(PLHIV)中高血压的负担情况,还讨论了相关主题,包括其危险因素和临床管理。
高血压在 HIV 阳性人群中高度流行,可能比在 HIV 阴性人群中更为常见。导致 PLHIV 高血压发展的危险因素包括人口统计学因素、遗传易感性、生活方式、肥胖等合并症、抗逆转录病毒治疗引起的身体成分变化,以及潜在的免疫缺陷、免疫激活和炎症,以及抗逆转录病毒治疗本身的影响。PLHIV 高血压的临床管理需要注意抗逆转录病毒药物和降压药物之间的药物相互作用。目前,PLHIV 高血压的知晓率、治疗率和控制率均不理想,应加以改善。
PLHIV 高血压负担沉重,其病理生理学可能是多因素的。阐明 PLHIV 高血压的确切病理生理学至关重要,因为这可能为影响和改善临床管理提供新的靶点。与此同时,应按照现有的临床指南努力改善高血压管理,以维护 PLHIV 的心血管健康和生活质量。