Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Am J Hypertens. 2024 Sep 16;37(10):759-768. doi: 10.1093/ajh/hpae078.
Integrase strand transfer inhibitors (INSTIs) are a commonly used antiretroviral therapy (ART) class in people with human immunodeficiency virus (HIV) and associated with weight gain. We studied the association of INSTI-based ART with systolic and diastolic blood pressure (SBP and DBP).
We recruited 50 people taking INSTI-based ART and 40 people taking non-INSTI-based ART with HIV and hypertension from the University of Alabama at Birmingham HIV clinic. Office BP was measured unattended using an automated (AOBP) device. Awake, asleep, and 24-hour BP were measured through ambulatory BP monitoring. Among participants with SBP ≥130 mm Hg or DBP ≥80 mm Hg on AOBP, sustained hypertension was defined as awake SBP ≥130 mm Hg or DBP ≥80 mm Hg.
Mean SBP and DBP were higher among participants taking INSTI- vs. non-INSTI-based ART (AOBP-SBP/DBP: 144.7/83.8 vs. 135.3/79.3 mm Hg; awake-SBP/DBP: 143.2/80.9 vs. 133.4/76.3 mm Hg; asleep-SBP/DBP: 133.3/72.9 vs. 120.3/65.4 mm Hg; 24-hour-SBP/DBP: 140.4/78.7 vs. 130.0/73.7 mm Hg). After multivariable adjustment, AOBP, awake, asleep, and 24-hour SBP were 12.5 (95% confidence interval [CI] 5.0-20.1), 9.8 (95% CI 3.6-16.0), 10.4 (95% CI 2.0-18.9), and 9.8 (95% CI 4.2-15.4) mm Hg higher among those taking INSTI- vs. non-INSTI-based ART, respectively. AOBP, awake, asleep, and 24-hour DBP were 7.5 (95% CI 0.3-14.6), 6.1 (95% CI 0.3-11.8), 7.5 (95% CI 1.4-13.6), and 6.1 (95% CI 0.9-11.3) mm Hg higher among those taking INSTI- vs. non-INSTI-based ART after multivariable adjustment. All participants had SBP ≥130 mm Hg or DBP ≥80 mm Hg on AOBP and 97.9% and 65.7% of participants taking INSTI- and non-INSTI-based ART had sustained hypertension, respectively.
INSTI-based ART was associated with higher SBP and DBP than non-INSTI-based ART.
整合酶链转移抑制剂（INSTIs）是一种常用于人类免疫缺陷病毒（HIV）感染者的抗逆转录病毒疗法（ART）类别，与体重增加有关。我们研究了基于 INSTI 的 ART 与收缩压和舒张压（SBP 和 DBP）之间的关联。
我们从阿拉巴马大学伯明翰分校的 HIV 诊所招募了 50 名正在服用基于 INSTI 的 ART 和 40 名正在服用非 INSTI 基于 ART 且患有高血压的 HIV 感染者。使用自动（AOBP）设备进行无人值守的办公室血压测量。通过动态血压监测测量清醒、睡眠和 24 小时血压。在 AOBP 上 SBP≥130mmHg 或 DBP≥80mmHg 的参与者中，定义持续性高血压为清醒时 SBP≥130mmHg 或 DBP≥80mmHg。
与服用非 INSTI 基于 ART 的参与者相比，服用 INSTI 基于 ART 的参与者的 SBP 和 DBP 更高（AOBP-SBP/DBP：144.7/83.8 与 135.3/79.3mmHg；清醒-SBP/DBP：143.2/80.9 与 133.4/76.3mmHg；睡眠-SBP/DBP：133.3/72.9 与 120.3/65.4mmHg；24 小时-SBP/DBP：140.4/78.7 与 130.0/73.7mmHg）。在多变量调整后，服用 INSTI 与非 INSTI 基于 ART 的参与者之间的 AOBP、清醒、睡眠和 24 小时 SBP 分别高出 12.5mmHg（95%置信区间 [CI] 5.0-20.1）、9.8mmHg（95% CI 3.6-16.0）、10.4mmHg（95% CI 2.0-18.9）和 9.8mmHg（95% CI 4.2-15.4）。服用 INSTI 与非 INSTI 基于 ART 的参与者之间的 AOBP、清醒、睡眠和 24 小时 DBP 分别高出 7.5mmHg（95% CI 0.3-14.6）、6.1mmHg（95% CI 0.3-11.8）、7.5mmHg（95% CI 1.4-13.6）和 6.1mmHg（95% CI 0.9-11.3）。在多变量调整后，所有参与者的 AOBP 上 SBP≥130mmHg 或 DBP≥80mmHg，服用 INSTI 与非 INSTI 基于 ART 的参与者中，分别有 97.9%和 65.7%的参与者患有持续性高血压。
与非 INSTI 基于 ART 相比，INSTI 基于 ART 与更高的 SBP 和 DBP 相关。
