FACTORS AFFECTING CAROTID-FEMORAL PULSE WAVE VELOCITY IN HIV-INFECTED INDIVIDUALS

Abstract

Objective: Carotid-femoral PWV (cfPWV) is considered as the ‘gold-standard’ measurement of arterial stiffness. According to 2013 ESH/ESC Guidelines for the management of arterial hypertension, cfPWV > 10m/s is indicative of asymptomatic organ damage. The aim of this study is to determine possible correlation between cfPWV and HIV infection and by extension the effect of HIV infection in arterial stiffness. Design and method: We studied 69 male HIV-infected individuals over 50 years old (mean: 54.44 ± 3.5 years) without hypertension, diabetes mellitus and no known history of cardiovascular disease. HIV history, including time of first positive HIV test and years of antiretroviral therapy, smoking (pack years), alcohol abuse, body mass index (BMI) and physical activity described as metabolic equivalents (METS) were recorded. Furthermore, blood pressure and heart rate were measured and blood tests were performed for the calculation of eGFR using MDRD formula and lipid analysis (total, HDL, LDL cholesterol and triglycerides). cfPWV and central aortic blood pressure were determined by applanation tonometry using the Sphygmocor (Atcor, Australia) device in each patient. Simple and multiple linear regression analysis were performed to predict independent variables of cfPWV. Results: In simple linear regression analysis, cfPWV was associated with the years of HIV infection and antiretroviral therapy, age, heart rate, peripheral diastolic blood pressure and central diastolic aortic blood pressure (p < 0.05). In multiple linear regression analysis, years of HIV infection (b = 0.298, p = 0.009), pack-years (b = −0.242, p = 0.029) and age (b = 0.234, p = 0.034) were determined as the three independent variables of cfPWV predicting 32.3% of the variance of cfPWV (R2 = 0.323). Conclusions: Our study showed that duration of HIV infection, as well as smoking and age, are strongly associated with cfPWV in male HIV infected individuals over 50 years old without hypertension or diabetes mellitus. Therefore, HIV infection increases total cardiovascular risk through increasing arterial stiffness.