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Elevated blood pressure in subjects with lipodystrophy

Sattler, Fred R.; Qian, Dajuna; Louie, Stanb; Johnson, Debra; Briggs, William; DeQuattro, Vincentc*; Dube, Michael P.d

Clinical Science

Objectives: To assess the prevalence of elevated blood pressure in patients with lipodystrophy.

Design: Case–control study.

Participants: Forty-two patients with abnormal body fat (100%) and serum lipids (86%) (HIV-positive cohort) were matched by age and sex to 42 HIV-positive controls without previously diagnosed lipodystrophy and to 13 HIV-negative controls.

Setting: Tertiary care, university-based, fully dedicated HIV clinic.

Main outcome measures: Frequency and magnitude of elevated blood pressure during highly active antiretroviral therapy.

Results: There were 23 ± 16 and 22 ± 12 blood pressure measurements recorded per subject over 21 ± 11 and 22 ± 11 months for the HIV-positive cohort and HIV-positive controls, respectively. Three or more elevated readings 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 readings (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 common in the cohort than in the controls but accounted for only 13% of the log odds ratio value for elevated blood pressure in the cohort. Systolic blood 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 HIV.

Conclusions: Elevated blood pressure may be linked to the metabolic disorders occurring in patients with HIV, as in the dysmetabolic syndrome.

From the Division of Infectious Diseases, Department of Medicine, the aDivision of Biometry, Department of Preventive Medicine, Keck School of Medicine, the bSchool of Pharmacy and Department of Pharmacy, University of Southern California, the cDivision of Cardiology, Department of Medicine, Keck School of Medicine, Los Angeles, California, USA, and the Division of Infectious Diseases, Department of Medicine, Indiana University, Indianapolis, IN, USA. *Deceased.

Requests for reprints to: F. R. Sattler, LAC-USC Medical Center, Rand Schrader Clinic, Room 351, 1300 North Mission Road, Los Angeles, California 90033, USA.

Received: 26 January 2001;

revised: 8 June 2001; accepted: 13 June 2001.

Sponsorship: Supported by grants from the National Institutes of Health (DK-49308 and NCRR GCRC MOI RR-43).

© 2001 Lippincott Williams & Wilkins, Inc.