The purpose of the cohort observation study by H.M. Crane et al. (USA), was to study the effect of taking various antiretroviral drugs, as well as clinical factors, on the level of blood pressure (BP) in people infected with HIV.

Patients starting the first cycle of highly active antiretroviral therapy (HAART) assessed average blood pressure before and during the treatment period, taking into account their antiretroviral drugs and prescribed drug classes, as well as demographic and clinical characteristics, including including changes in body mass index. The factors associated with an increase in blood pressure (more than 10 mm Hg for systolic, diastolic blood pressure or the first diagnosis of hypertension) were identified using the logistic regression method.

In 444 patients, 4,592 blood pressure measurements were taken, while 95 patients showed an increase in systolic blood pressure (n = 83), diastolic blood pressure (n = 33) or the first diagnosis of hypertension arterial (n = 11) after the start of HAART.

Results of a multivariate analysis indicated that treatment with lopinavir / ritonavir was associated with a higher risk of increased blood pressure (odds ratio (OR) 2.5; P = 0.03) compared to regimens involving efavirenz. At the same time, when an indicator such as the body mass index was included in the analysis, a statistically significant relationship was found between its increase and the increase in blood pressure (OS 1.3; P = 0.02), and the relationship between lopinavir / ritonavir use and increased blood pressure has disappeared. In patients treated with atazanavir (OS 0.2; P = 0.03), efavirenz (OS 0.4; P = 0.02), nelfinavir (OS 0.3; P = 0.02) or indinavir (OS 0.3; P = 0.01), the risk of increased blood pressure was lower compared to those receiving lopinavir / ritonavir.

Thus, a statistically significant relationship was found between treatment with lopinavir / ritonavir and an increase in blood pressure, which can be mediated by an increase in patient weight. In patients receiving atazanavir therapy, the risk of increased blood pressure was lowest. According to researchers, the revealed effect of antiretroviral therapy on the risk of developing cardiovascular pathology, in particular an increase in blood pressure, should be one of the important criteria when choosing a treatment regimen for infected people by HIV.