Hypertension is a common condition among people living with HIV and is associated with an increased risk for cardiovascular disease and chronic kidney disease. However, there is limited information on the relationship between the development of hypertension in people living with HIV who recently started taking HIV medications.
To address this gap, DR 021 assessed hypertension one year after starting HIV medications among people living with HIV who were enrolled in ACTG studies between 1999 and 2011. Hypertension was defined as blood pressure ≥ 130/80 mmHg and these participants did not previously have hypertension and were not taking antihypertensive medications.
Researchers found that one-third (32%) of participants were diagnosed with hypertension after starting HIV medications. Specifically, people who started taking HIV medications containing a non-nucleoside reverse transcriptase inhibitor, notably efavirenz, and stavudine were more likely to receive a diagnosis of hypertension, while hypertension was diagnosed less frequently among those starting protease inhibitors, tenofovir disoproxil fumarate, darunavir/ritonavir, and atazanavir/ritonavir. Additionally, older age, higher body mass index, and having hepatitis C were associated with an increased likelihood of being diagnosed with hypertension, while females and participants with higher baseline CD4 counts were less likely to receive a hypertension diagnosis.
The take-home message from this study for providers is to regularly monitor blood pressure in HIV patients after starting on HIV medications for early diagnosis and management of hypertension. The providers may consider risk factors to prescribe HIV medications that have less risk of development of hypertension.
Future research should investigate the role of specific causes such as inflammation and lipids in the development of hypertension in people living with HIV who have recently started taking HIV medications. It should also evaluate the risk of development of hypertension in people living with HIV who recently started newer HIV medications like integrase strand transfer inhibitors.
Siddiqui, M., et al. (2022). “Risk Factors for Incident Hypertension Within 1 Year of Initiating Antiretroviral Therapy Among People with HIV.” AIDS Res Hum Retroviruses 38(9): 735-742.