Association of Integrase Strand Transfer Inhibitor-Based Antiretroviral Therapy With Blood Pressure and Sustained Hypertension in People With Human Immunodeficiency Virus.
Mohammed Siddiqui, Greer A Burkholder, Eric Judd, Zhixin Wang, Lisandro D Colantonio, Lama Ghazi, Daichi Shimbo, Amanda L Willig, Edgar T Overton, Suzanne Oparil, Emily B Levitan, Sonya L Heath, Paul Muntner
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引用次数: 0
Abstract
Background: Integrase strand transfer inhibitors (INSTIs) are a commonly used antiretroviral therapy (ART) class in people with human immunodeficiency virus (HIV) and associated with weight gain. We studied the association of INSTI-based ART with systolic and diastolic blood pressure (SBP and DBP).
Methods: We recruited 50 people taking INSTI-based ART and 40 people taking non-INSTI-based ART with HIV and hypertension from the University of Alabama at Birmingham HIV clinic. Office BP was measured unattended using an automated (AOBP) device. Awake, asleep, and 24-hour BP were measured through ambulatory BP monitoring. Among participants with SBP ≥130 mm Hg or DBP ≥80 mm Hg on AOBP, sustained hypertension was defined as awake SBP ≥130 mm Hg or DBP ≥80 mm Hg.
Results: Mean SBP and DBP were higher among participants taking INSTI- vs. non-INSTI-based ART (AOBP-SBP/DBP: 144.7/83.8 vs. 135.3/79.3 mm Hg; awake-SBP/DBP: 143.2/80.9 vs. 133.4/76.3 mm Hg; asleep-SBP/DBP: 133.3/72.9 vs. 120.3/65.4 mm Hg; 24-hour-SBP/DBP: 140.4/78.7 vs. 130.0/73.7 mm Hg). After multivariable adjustment, AOBP, awake, asleep, and 24-hour SBP were 12.5 (95% confidence interval [CI] 5.0-20.1), 9.8 (95% CI 3.6-16.0), 10.4 (95% CI 2.0-18.9), and 9.8 (95% CI 4.2-15.4) mm Hg higher among those taking INSTI- vs. non-INSTI-based ART, respectively. AOBP, awake, asleep, and 24-hour DBP were 7.5 (95% CI 0.3-14.6), 6.1 (95% CI 0.3-11.8), 7.5 (95% CI 1.4-13.6), and 6.1 (95% CI 0.9-11.3) mm Hg higher among those taking INSTI- vs. non-INSTI-based ART after multivariable adjustment. All participants had SBP ≥130 mm Hg or DBP ≥80 mm Hg on AOBP and 97.9% and 65.7% of participants taking INSTI- and non-INSTI-based ART had sustained hypertension, respectively.
Conclusions: INSTI-based ART was associated with higher SBP and DBP than non-INSTI-based ART.
期刊介绍:
The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.