Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine.
Department of Internal Medicine, Ochsner Health System, New Orleans, Louisiana, USA.
Curr Opin Cardiol. 2023 Jul 1;38(4):297-303. doi: 10.1097/HCO.0000000000001050. Epub 2023 Mar 29.
The aim of this study was to provide an overview of the burden, pathogenesis, and recent recommendations for treating hypertension among people living with HIV (PLWH). This review is relevant because of the increase in the prevalence of HIV as a chronic disease and the intersection of the increasing prevalence of hypertension.
The contribution of HIV to the pathogenesis of hypertension is complex and still incompletely understood. Evidence suggests that chronic inflammation from HIV, antiretroviral treatment (ART), and comorbidities such as renal disease and insulin resistance contribute to developing hypertension in PLWH. Treatment is not distinct from guidelines for HIV-noninfected people. Nonpharmacological guidelines such as decreasing blood pressure by promoting a healthy lifestyle emphasizing exercise, weight loss, and smoking cessation are still recommended in the literature. The pharmacological management of hypertension in PLWH is similar, but special attention must be given to specific drugs with potential interaction with ART regimens. Further research is needed to investigate the pathways and effects of hypertension on HIV.
There are different pathways to the pathogenesis of hypertension in PLWH. Clinicians should take it into consideration to provide more precise management of hypertension in PLWH. Further research into the subject is still required.
本研究旨在概述 HIV 感染者(PLWH)的高血压负担、发病机制和最新治疗建议。鉴于 HIV 作为慢性病的患病率增加,以及高血压患病率不断上升的交集,本综述具有相关性。
HIV 对高血压发病机制的影响是复杂的,目前仍不完全清楚。有证据表明,HIV 引起的慢性炎症、抗逆转录病毒治疗(ART)以及合并症(如肾病和胰岛素抵抗)导致 PLWH 发生高血压。其治疗方法与 HIV 未感染者的指南并无区别。文献中仍推荐通过促进健康的生活方式来降低血压,强调运动、减肥和戒烟等非药物性指南。PLWH 高血压的药物治疗相似,但必须特别注意与 ART 方案有潜在相互作用的特定药物。需要进一步研究以调查高血压对 HIV 的作用途径和影响。
PLWH 高血压的发病机制有不同途径。临床医生应考虑这一点,以提供更精确的 PLWH 高血压管理。仍需要对此主题进行进一步研究。