TY - JOUR

T1 - Blood pressure and body composition during first year of antiretroviral therapy in people with HIV compared to HIV-uninfected community controls

AU - Kavishe, Bazil Baltazar

AU - Olsen, Mette Frahm

AU - Filteau, Suzanne

AU - Kitilya, Brenda Wilfred

AU - Jeremiah, K

AU - Krogh-Madsen, Rikke

AU - Todd, J

AU - Friis, Henrik

AU - Faurholt-Jepsen, Daniel

AU - PrayGod, G

AU - Peck, Robert

N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2022

Y1 - 2022

N2 - Background: Body composition changes may explain the rapid increase in blood pressure (BP) in people with HIV (PWH) during the first year of antiretroviral therapy.Methods: We analyzed data from a cohort of PWH and HIV-uninfected adults from the same communities in Mwanza, Tanzania. Blood pressure (BP, mmHg) and body composition data were collected at baseline and 12 months follow-up. We used multivariable linear regression to compare BP changes in PWH and HIV-uninfected adults, and the relationship between changes in body composition and changes in BP.Results: BP data was available for 640 PWH and 299 HIV-uninfected adults. Sixty-four percent were women and the mean age was 38 years. In PWH, systolic BP (SBP) increased (114 to 118) whereas SBP decreased (125 to 123) in HIV-uninfected participants. Fat mass increased by 1.6 kilogram on average in PWH and was strongly associated with change in BP (P < 0.001). The greater increase in SBP in PWH was partly explained by the lower baseline SBP but PWH still experienced a 2.2 (95% CI: 0.3-4.2) greater increase in SBP after adjustment. Weight gain partially mediated the relationship between HIV and SBP increase in PWH; a one kilogram increase in fat mass accounted for 0.8 (95% CI: 0.6-1.1) increase in SBP.Conclusions: Weight and fat mass increase rapidly in PWH during the first 12 months of antiretroviral therapy and contribute to a rapid increase in SBP. Interventions to prevent excessive increase in fat mass are needed for PWH.

AB - Background: Body composition changes may explain the rapid increase in blood pressure (BP) in people with HIV (PWH) during the first year of antiretroviral therapy.Methods: We analyzed data from a cohort of PWH and HIV-uninfected adults from the same communities in Mwanza, Tanzania. Blood pressure (BP, mmHg) and body composition data were collected at baseline and 12 months follow-up. We used multivariable linear regression to compare BP changes in PWH and HIV-uninfected adults, and the relationship between changes in body composition and changes in BP.Results: BP data was available for 640 PWH and 299 HIV-uninfected adults. Sixty-four percent were women and the mean age was 38 years. In PWH, systolic BP (SBP) increased (114 to 118) whereas SBP decreased (125 to 123) in HIV-uninfected participants. Fat mass increased by 1.6 kilogram on average in PWH and was strongly associated with change in BP (P < 0.001). The greater increase in SBP in PWH was partly explained by the lower baseline SBP but PWH still experienced a 2.2 (95% CI: 0.3-4.2) greater increase in SBP after adjustment. Weight gain partially mediated the relationship between HIV and SBP increase in PWH; a one kilogram increase in fat mass accounted for 0.8 (95% CI: 0.6-1.1) increase in SBP.Conclusions: Weight and fat mass increase rapidly in PWH during the first 12 months of antiretroviral therapy and contribute to a rapid increase in SBP. Interventions to prevent excessive increase in fat mass are needed for PWH.

KW - Faculty of Science

KW - Blood pressure

KW - Body composition

KW - Fat mass

KW - Fat-free mass

KW - Body weight

KW - People with HIV

U2 - 10.1093/ajh/hpac085

DO - 10.1093/ajh/hpac085

M3 - Journal article

C2 - 35881168

VL - 35

SP - 929

EP - 937

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 11

ER -