ISH NIA PS 03-05 Masked hypertension in patients infected with human inmunodeficiency virus (HIV)

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Abstract

Objective:

HIV-infected patients have higher rates of cardiovascular events than general population. We hypothesized that the prevalence of hypertension in HIV-infected patient is underestimate due to a high rate of masked hypertension (MH).

Design and method:

HIV-infected patients (n = 63) underwent to clinical and laboratory examination, and 24 h Ambulatory Blood Pressure Monitoring (ABPM). Patients were classified as sustained normotension (NT) [normal blood pressure (BP) in clinic and ABPM], sustained hypertension (HTN) (high BP in clinic and ABPM), MH (normal BP in clinic and high BP on ABPM) and white coat hypertension (WCH) (high BP in clinic and normal BP on ABPM).

Results:

The prevalence of hypertension in office was 33.5%, increasing up to 44% after the 24 h ABPM. MH was present in 25% (11/44) of the non-elevated clinic BP and 6 clinic hypertensive patients present WCH. MH patients had higher clinic systolic (SBP) and diastolic (DBP) BP (p < 0.04 and p < 0.005, respectively), higher levels of plasma uric acid (p < 0.04) and higher waist circumference (p < 0.03) than the NT group. In a multivariable model, clinic DBP and smoking were associated to the presence of MH. The presence of clinic DBP equal or higher than 80 mmHg predict MH with a sensitivity and specificity of 90.9% and 71% respectively.

Conclusions:

High rate of masked hypertension is present in HIV infected patients. Clinic DBP higher than 80 mmHg and smoking predict the presence of MH between HIV infected patients with non-elevated clinic BP.

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