Wednesday, February 17, 2016

Ambulatory Blood Pressure Monitoring in Individuals with HIV: A Systematic Review and Meta-Analysis

Abnormal diurnal blood pressure (BP) rhythms may contribute to the high cardiovascular disease risk in HIV-positive (HIV+) individuals. To synthesize the current literature on ambulatory BP monitoring (ABPM) in HIV+ individuals, a systematic literature review and meta-analysis were performed.

Medical databases were searched through November 11, 2015 for studies that reported ABPM results in HIV+ individuals. Data were extracted by 2 reviewers and pooled differences between HIV+ and HIV-negative (HIV-) individuals in clinic BP and ABPM measures were calculated using random-effects inverse variance weighted models.

Of 597 abstracts reviewed, 8 studies with HIV+ cohorts met the inclusion criteria. The 420 HIV+ and 714 HIV- individuals in 7 studies with HIV- comparison groups were pooled for analyses. The pooled absolute nocturnal systolic and diastolic BP declines were 3.16% (95% confidence interval [CI]: 1.13%, 5.20%) and 2.92% (95% CI: 1.64%, 4.19%) less, respectively, in HIV+ versus HIV- individuals. The pooled odds ratio for non-dipping systolic BP (nocturnal systolic BP decline <10%) in HIV+ versus HIV- individuals was 2.72 (95% CI: 1.92, 3.85). Differences in mean clinic, 24-hour, daytime, or nighttime BP were not statistically significant. I2 and heterogeneity chi-squared statistics indicated the presence of high heterogeneity for all outcomes except percent DBP dipping and non-dipping SBP pattern.

An abnormal diurnal BP pattern may be more common among HIV+ versus HIV- individuals. However, results were heterogeneous for most BP measures, suggesting more research in this area is needed.

Full article at:

Shia T. Kent, Samantha G. Bromfield, Paul Muntner
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America

Greer A. Burkholder, Edgar T. Overton, Michael J. Mugavero
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America

Louise Falzon, Joseph E. Schwartz, Daichi Shimbo
Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America

Suzanne Oparil
Department of Medicine, Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama, United States of America

Joseph E. Schwartz
Applied Behavioral Medicine Research Institute, Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, United States of America

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