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

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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.

TidsskriftAmerican Journal of Hypertension
Udgave nummer11
Sider (fra-til)929-937
Antal sider9
StatusUdgivet - 2022

Bibliografisk note

CURIS 2022 NEXS 214

© 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:

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