Presented in part at the 21st European Meeting on Hypertension and Cardiovascular Prevention, Milan, June 17-20, 2011 (Abstract N. 462).
Low Nadir CD4 Cell Count Predicts Sustained Hypertension in HIV-Infected Individuals
Article first published online: 26 OCT 2012
© 2012 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 15, Issue 2, pages 101–106, February 2013
How to Cite
Manner, I. W., Trøseid, M., Oektedalen, O., Baekken, M. and Os, I. (2013), Low Nadir CD4 Cell Count Predicts Sustained Hypertension in HIV-Infected Individuals. The Journal of Clinical Hypertension, 15: 101–106. doi: 10.1111/jch.12029
- Issue published online: 22 JAN 2013
- Article first published online: 26 OCT 2012
- Manuscript received: July 13, 2012; revised: September 5, 2012; accepted: September 7, 2012
Hypertension is associated with cardiovascular disease in the human immunodeficiency virus (HIV)–infected population. The authors aimed to test the hypothesis whether advanced immunosuppression with low nadir CD4 lymphocyte cell count is a predictor of sustained hypertension in HIV-infected individuals. In a longitudinal study of an HIV cohort of 434 patients (43±11 years, 72% men, 71% Caucasians), standardized blood pressure was measured in duplicate during 3 clinical visits both at baseline and after 3.4±0.8 years. The lowest CD4 cell count in the individual history was recorded as nadir CD4. Both nadir CD4 cell count <50 cells/μL and duration of antiretroviral therapy (ART) were associated with sustained hypertension, and the highest proportion of hypertensive patients was observed in those who had both nadir CD4 cell count <50 cells/μL and prolonged ART duration. Nadir CD4 cellcount <50 cells/μL was an independent predictor of hypertension (adjusted odds ratio [OR], 2.48; 95% confidence interval [CI], 1.27–4.83), as was ART duration (adjusted OR, 1.13; 95% CI, 1.03–1.24). The predictive power of ART duration was more pronounced in patients with nadir CD4 cell count <50 cells/μL. Delaying ART initiation until a state of advanced immunosuppression might add to and even fuel the cardiovascular risk associated with ART. J Clin Hypertens (Greenwich). 2012; 00:00–00 ©2012 Wiley Periodicals, Inc.