Introduction
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.
Methods
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.
Results
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.
Conclusions
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: http://goo.gl/aJH5Gj
By:
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
More at: https://twitter.com/hiv insight
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