Elevated blood pressure in subjects with lipodystrophy

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 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 tive controls. 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 HIV. 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.