Document Detail


Lipoatrophy and lipohypertrophy are independently associated with hypertension.
MedLine Citation:
PMID:  19486188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Lipoatrophy and lipohypertrophy are associated with metabolic abnormalities, but little is known about their impact on hypertension. We conducted this study to determine the associations of lipoatrophy and lipohypertrophy with hypertension.
METHODS: A cross-sectional study of HIV-infected patients who completed a self-report body morphology assessment was performed. We defined hypertension as a clinical diagnosis, or a mean systolic blood pressure (BP) > 140 mmHg or diastolic BP > 90 mmHg in the previous 6 months. We used logistic regression to examine the association between hypertension and body morphology.
RESULTS: Among 347 patients, there were 2278 BP readings in 6 months. In adjusted analyses, patients with moderate lipoatrophy [odds ratio (OR) 4.3; P = 0.03] or moderate lipohypertrophy (OR 4.3; P = 0.006) had four times the odds, and patients with mild lipohypertrophy (OR 2.3; P = 0.03) had twice the odds of having hypertension compared with patients without changes. We hypothesized that the impact of lipohypertrophy on hypertension was mediated, in part, through body mass index (BMI). When BMI was included in the analysis, increased BMI was significantly associated with hypertension (OR = 1.1; P < 0.001 per kg/m(2)), and the association between lipohypertrophy and hypertension was no longer present. However, the association between moderate lipoatrophy and hypertension was strengthened (OR = 5.5; P = 0.01).
CONCLUSIONS: Lipoatrophy and lipohypertrophy are independently associated with hypertension and there is a dose-response effect with more severe lipoatrophy and lipohypertrophy. The association between lipohypertrophy (but not lipoatrophy) and hypertension appears to be mediated by BMI. Our results suggest that patient-based body morphology assessments are related to hypertension and may have potential implications for cardiovascular disease.
Authors:
Heidi M Crane; C Grunfeld; R D Harrington; M M Kitahata
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-05-20
Journal Detail:
Title:  HIV medicine     Volume:  10     ISSN:  1468-1293     ISO Abbreviation:  HIV Med.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-19     Completed Date:  2010-07-21     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  100897392     Medline TA:  HIV Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  496-503     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Antiretroviral Therapy, Highly Active*
Blood Pressure / physiology
Body Fat Distribution*
Body Mass Index
CD4 Lymphocyte Count
Epidemiologic Methods
Female
HIV Infections / drug therapy
HIV-Associated Lipodystrophy Syndrome / complications*
Humans
Hypertension / complications*
Male
Middle Aged
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
AI-27757/AI/NIAID NIH HHS; AI-60464/AI/NIAID NIH HHS; K23 AI060464/AI/NIAID NIH HHS; K23 AI060464-01A1/AI/NIAID NIH HHS; K23 AI060464-02/AI/NIAID NIH HHS; K23 AI060464-03/AI/NIAID NIH HHS; K23 AI060464-04/AI/NIAID NIH HHS; K23 AI060464-05/AI/NIAID NIH HHS; P30 AI027757/AI/NIAID NIH HHS; P30 AI027757-19/AI/NIAID NIH HHS; P30 AI027757-20/AI/NIAID NIH HHS; P30 AI027757-21/AI/NIAID NIH HHS; R01 DK 57508/DK/NIDDK NIH HHS; R01 DK057508/DK/NIDDK NIH HHS; R01 DK057508-01/DK/NIDDK NIH HHS; R01 DK057508-01S1/DK/NIDDK NIH HHS; R01 DK057508-02/DK/NIDDK NIH HHS; R01 DK057508-03/DK/NIDDK NIH HHS; R01 DK057508-03S1/DK/NIDDK NIH HHS; R01 DK057508-03S2/DK/NIDDK NIH HHS; R24 AI-067039/AI/NIAID NIH HHS; R24 AI067039/AI/NIAID NIH HHS; R24 AI067039-01A1/AI/NIAID NIH HHS; R24 AI067039-02/AI/NIAID NIH HHS; R24 AI067039-03/AI/NIAID NIH HHS
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