THE 10-YEAR RELATIONSHIP BETWEEN SUPAR AND CENTRAL SYSTOLIC BLOOD PRESSURE IN AN HIV INFECTED POPULATION

Abstract

Objective: Inflammation plays a role in vascular wall changes which may lead to aortic stiffening. Soluble urokinase plasminogen activator receptor (suPAR), a low-grade inflammatory marker, is predictive of cardiovascular disease and mortality in the general and HIV infected populations. We determined the 10-year relationship between suPAR and central SBP in the HIV infected. Design and method: HIV uninfected and infected participants from the PURE study, conducted in the North West province, South Africa, were matched by age and sex and followed for a median of 9.87 years (HIV uninfected: baseline = 211 and follow-up = 159; HIV infected: baseline = 92 and follow-up = 144 of which 69% initiated antiretroviral treatment (ART)). We obtained demographic and cardiometabolic data and measured EDTA plasma suPAR with suPARnostic® ELISA kits at baseline and follow-up and measured central SBP at follow-up. Results: Median suPAR was higher in HIV infected (ART-naive) compared to uninfected participants at baseline (3.61 vs 3.26 ng/ml; p = 0.038) but not at follow-up (p = 0.45). Cox-regression analyses (Figure 1) showed that, in the HIV infected group only and independent of ART, suPAR predicted a higher central SBP (> = 118 mmHg) after 10 years, but only when lipids, glomerular filtration rate or gamma-glutamyl transferase were added to the model. Conclusions: The initiation of ART may contribute to lower inflammation (as measured with suPAR) in HIV infected compared to uninfected individuals. SuPAR associated with central SBP over 10 years, but only when metabolic markers or renal function were taken into account. This may suggest a significant mediating effect between inflammation and cardiometabolic risk markers in increasing central aortic pressure and therefore future cardiovascular risk in the HIV infected.