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Central/Peripheral fat mass ratio is associated with increased risk of hypertension in HIV-infected patients

Paula Freitas1, Davide Carvalho, Ana Cristina Santos

  • 1Department of Endocrinology, Hospital de São João and University of Porto Medical School, Porto, Portugal. paula_freitas@sapo.pt

Journal of Clinical Hypertension (Greenwich, Conn.)
|September 6, 2012
PubMed

Insights

Hypertension risk in HIV patients with lipodystrophy is debated. This study found hypertension is linked to central fat accumulation, not just lipodystrophy, in HIV-infected adults on antiretroviral therapy.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Endocrinology

Background:

  • Hypertension risk in human immunodeficiency virus (HIV)-infected patients, especially those with lipodystrophy, remains unclear.
  • Combination antiretroviral therapy (cART) is standard for HIV management but can influence body composition and metabolic health.
  • Lipodystrophy, a condition characterized by abnormal fat distribution, is a known complication of cART.

Purpose of the Study:

  • To assess the impact of lipodystrophy on hypertension prevalence in HIV-infected adults on cART.
  • To investigate the association between specific fat distribution patterns and hypertension.
  • To identify body composition factors associated with hypertension in this population.

Main Methods:

  • Cross-sectional study of 368 HIV-infected adults receiving cART.
  • Lipodystrophy assessed clinically and by fat mass ratio (FMR).
  • Body composition evaluated using dual-energy x-ray absorptiometry and computed tomography; blood pressure measured.

Main Results:

  • Overall hypertension prevalence was similar in patients with and without clinically or FMR-defined lipodystrophy.
  • Patients with isolated central fat accumulation and mixed lipodystrophy showed a significantly higher hypertension prevalence.
  • Hypertensive patients had higher total, central, and central/peripheral fat mass ratios.
  • Adjusted analysis confirmed hypertension significantly associated with central/peripheral fat mass ratio (OR, 1.258; 95% CI, 1.008-1.569).

Conclusions:

  • Hypertension is not more prevalent in HIV patients with lipodystrophy overall.
  • Central fat accumulation and mixed lipodystrophy patterns are significantly associated with higher hypertension risk.
  • Central/peripheral fat mass ratio is an independent predictor of hypertension in HIV-infected adults on cART.

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