Objectives: To assess the prevalence of elevated blood pressure in patients
Design: Case-control study.
Participants: Forty-two patients with abnormal body fat (100%) and serum li
pids (86%) (HIV-positive cohort) were matched by age and sex to 42 HIV-posi
tive controls without previously diagnosed lipodystrophy and to 13 HIV-nega
Setting: Tertiary care, university-based, fully dedicated HIV clinic.
Main outcome measures: Frequency and magnitude of elevated blood pressure d
uring highly active antiretroviral therapy.
Results: There were 23 +/- 16 and 22 +/- 12 blood pressure measurements rec
orded per subject over 21 +/- 11 and 22 +/- 11 months for the HIV-positive
cohort and HIV-positive controls, respectively. Three or more elevated read
ings occurred in 74% of the cohort and in 48% of the HIV-positive controls
(P = 0.01) and accounted for 38 +/- 25% versus 22 +/- 26% (P = 0.01) of the
total readings, respectively. The average of the three highest systolic re
adings (153 +/- 17 versus 144 +/- 15 mmHg; P = 0.01) and diastolic readings
(92 +/- 10 versus 87 +/- 9 mmHg; P = 0.01) was greater for the cohort than
for the HIV-positive controls. Family history of hypertension was more com
mon in the cohort than in the controls but accounted for only 13% of the lo
g odds ratio value for elevated blood pressure in the cohort. Systolic bloo
d pressure was correlated with waist-to-hip ratios in the cohort (r = 0.45;
P = 0.003) but not in the HIV controls (r = 0.06; P = 0.68) and tended to
be related to fasting triglycerides (r = 0.34; P = 0.052) in subjects with
Conclusions: Elevated blood pressure may be linked to the metabolic disorde
rs occurring in patients with HIV, as in the dysmetabolic syndrome. (C) 200
1 Lippincott Williams & Wilkins.