PP.31.25

Abstract

Objective: This study aimed to assess the 24-hour blood pressure pattern of hypertensive (HTN) individuals living with HIV and quantify the major contributive risk factors of non-dipping. Although hypertensive cardiovascular complications are closely related to 24-hour blood pressure pattern, major gaps in current knowledge exist regarding this subject in HIV+ populations. Design and method: Data analysed was from the Register of cardiovascular Complications among people living with HIV (RECOVIH) which included 174 known hypertensive HIV+ individuals with 1 or more CV risk factors who underwent 24-hour Ambulatory Blood Pressure Monitoring (ABPM) in our cardiac centre. Multiple logistic regression with non-dipping as outcome quantified risk factors and their impact. Diagnostic criteria: Hypertension on ABPM: at or above 130/80 mmHg, systolic and/or diastolic Dipping: day to night systolic blood pressure decline at or above 10% Non-dipping: day to night systolic blood pressure decline less than 10% Results: The cohort had a mean age of 52 ± 7.5 years, was predominantly male (90%), and had a long duration of HIV and antiretroviral (ARV) exposure (14 ± 6 and 10 ± 4.5 years respectively). The cohort had a mean BMI of 24.5 ± 4, 27% were current smokers, 24% had clinical lipodystrophy (60% atrophic), 13% had diabetes, and 71% were under antihypertensive therapy (72% under renin angiotensin antagonists, 35% under beta-blockers, 24% under diuretics and 16% under calcium channel blockers). Non-dipping hypertension prevalence was 48% in RECOVIH. No statistically significant differences between dippers and non-dippers were observed for demographic, clinical and biologic parameters. No statistically significant differences between the two groups were detected for nocturnal heart rate decrease or duration of known HIV status, ART exposure, and HIV-related biologic parameters. Non-dipping was associated with age (p = 0.049; OR 1.04; 95%CI 1.0002–1.08), use of diuretics (p = 0.03; OR 0.36; 95%CI 0.14–0.88), known hepatitis B virus (p = 0.049; OR 4.09; 95%CI 1.005–16.64), and HTN on the ABPM (p = 0.04; OR 2.02; 95%CI 1.05–3.88). Conclusions: Non-dipping hypertension prevalence is high among RECOVIH's middle age subjects at moderate to high risk of cardiovascular disease. If and how this high frequency of non-dipping pattern is associated with worse cardiovascular prognosis needs further study.