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High prevalence of "non-dipping" blood pressure and vascular stiffness in HIV-infected South Africans on antiretrovirals

Borkum, M S ; Heckmann, J M ; Manning, K ; Dave, J A ; Levitt, N S ; Rayner, B L ; Wearne, N Winston, Alan

PloS one, 2017-09, Vol.12 (9), p.e0185003 [Periódico revisado por pares]

United States: Public Library of Science

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High prevalence of "non-dipping" blood pressure and vascular stiffness in HIV-infected South Africans on antiretrovirals
Autor: Borkum, M S ; Heckmann, J M ; Manning, K ; Dave, J A ; Levitt, N S ; Rayner, B L ; Wearne, N
Winston, Alan
Assuntos: Acquired immune deficiency syndrome ; Adult ; Aging ; Aging - drug effects ; AIDS ; Analysis ; Anthropometry ; Anti-Retroviral Agents - adverse effects ; Antiretroviral drugs ; Antiviral agents ; Aorta ; Biology and Life Sciences ; Blood ; Blood circulation disorders ; Blood pressure ; Blood Pressure - drug effects ; Body weight ; C-reactive protein ; Cardiovascular diseases ; Cardiovascular Diseases - chemically induced ; Cardiovascular Diseases - epidemiology ; CD4 antigen ; Cerebrovascular system ; Complications and side effects ; Cross-Sectional Studies ; Diabetes ; Diabetic neuropathy ; Dipping ; Diurnal ; Drug therapy ; Endocrinology ; Female ; Glucose tolerance ; Health risk assessment ; Health risks ; Heart ; HIV ; HIV infection ; HIV infections ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - virology ; HIV-1 - drug effects ; Hospitals ; Human immunodeficiency virus ; Humans ; Hypertension ; Infections ; Internet ; Male ; Medical electronics ; Medicine and health sciences ; Metabolism ; Nephrology ; Obesity ; Overweight ; Patients ; People and Places ; Physical Sciences ; Physiological aspects ; Prevalence ; Pulse Wave Analysis ; Risk analysis ; Risk Factors ; Risk reduction ; South Africa - epidemiology ; Stiffness ; Studies ; Systolic pressure ; Vascular diseases ; Vascular Stiffness - drug effects ; Velocity ; Wave velocity
É parte de: PloS one, 2017-09, Vol.12 (9), p.e0185003
Notas: Competing Interests: Some research funding awarded from a commercial source: Astra Zeneca. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Descrição: HIV-infected individuals are at increased risk of tissue inflammation and accelerated vascular aging ('inflamm-aging'). Abnormal diurnal blood pressure (BP) rhythms such as non-dipping may contribute to an increased risk of cardiovascular and cerebrovascular events in HIV infected individuals. However, little data exists on ambulatory blood pressure (ABP) and measures of vascular stiffness in the black African HIV infected population. This is a cross-sectional analysis of otherwise well, HIV infected outpatients on ART for >5 years. Study assessments included: 24hr ABP monitoring, pulse wave velocity (PWV) and central aortic systolic pressure (CASP) using a AtCor Medical Sphygmocor device, fasting lipogram, oral glucose tolerance test, high-sensitivity C-reactive protein (hsCRP) and anthropometric data. Patients completed a questionnaire of autonomic symptoms. CD4+ counts and viral loads were obtained from the National Laboratory results system. Sixty seven black participants were included in the analysis of whom 91% (n = 61) were female with a mean age of 42.2 ± 8.6 years. The median duration on ART was 7.5 years (IQR = 6-10), 84% were virally supressed and the median CD4 count was 529.5cells/mm3 (IQR = 372.0-686.5). The majority (67%) were classified as overweight and 76% had an increased waist circumference, yet only 88% of participants were normotensive. A hsCRP level in the high cardiovascular risk category was found in 68% of participants. The prevalence of non-dipping BP was 65%. Interestingly, there was no association on multivariable analysis between dipping status and traditional risk factors for non-dipping BP, such as: obesity, autonomic dysfunction and older age. This relatively young cross-sectional sample of predominantly normotensive, but overweight black women on effective ART >5 years showed: a high prevalence of non-dipping BP, inflammation and vascular stiffness. Causality cannot be inferred but cardiovascular risk reduction should be emphasized in these patients.
Editor: United States: Public Library of Science
Idioma: Inglês

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High prevalence of "non-dipping" blood pressure and vascular stiffness in HIV-infected South Africans on antiretrovirals

Borkum, M S ; Heckmann, J M ; Manning, K ; Dave, J A ; Levitt, N S ; Rayner, B L ; Wearne, N Winston, Alan

United States: Public Library of Science

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