Association of Highly Active Antiretroviral Therapy with Increased Arterial Stiffness in Patients Infected with Human Immunodeficiency Virus

Abstract

BackgroundMetabolic disorders associated with atherosclerosis and cardiovascular disease have been described in HIV-infected individuals. We investigated (i) whether normotensive HIV-infected individuals and hypertensive patients have similarities regarding their arterial elastic properties and (ii) the effect of highly active antiretroviral therapy (HAART) and metabolic factors on arterial stiffness.MethodsIn a case-control study, we compared measurements of pulse wave velocity (PWV), arterial blood pressure, and markers of metabolic profile in 56 normotensive, HIV-infected patients (mean age 40 13 years) to 28 age- and sex-matched newly diagnosed untreated patients with hypertension and 28 healthy individuals.ResultsHIV-infected patients had higher PWV than healthy controls but lower PWV than hypertensives (8.1 1.4 m/s vs. 6.7 1.1 m/s vs. 9.0 1.0 m/s, P = 0.003 and 0.01, respectively). However, patients on HAART had similar PWV with hypertensives (8.4 1.4 vs. 9.0 1.0 m/s P = 0.25). Patients on HAART had higher PWV than patients without (8.4 1.4 m/s vs. 7.5 1.3 m/s, P = 0.03). Patients on HAART had higher total cholesterol, triglycerides, and diastolic blood pressure than patient's naive to HAART (P 0.05). In multivariate analysis, the independent determinants of increased PWV were HAART duration (unstandardized coefficient b v = 0.007, P = 0.04), serum cholesterol (b = 0.007, P = 0.04), mean or diastolic blood pressure (b = 0.049 and b = 0.060, P 0.01).ConclusionsHIV-infected individuals have increased arterial stiffness compared to healthy controls. Patients on antiretroviral therapy have similarities regarding their arterial elastic properties with patients with untreated hypertension. There is an independent association between duration of antiretroviral therapy, cholesterol levels, and blood pressure with increased arterial stiffness in HIV-infected patients. © 2009 American Journal of Hypertension, Ltd.