Even mildly elevated blood pressure raised the risk of myocardial infarction (MI) in HIV-positive US veterans compared with a matched group of HIV-negative veterans. Veterans with treated hypertension had almost a 3 times higher MI risk than HIV-negative veterans.
HIV-positive men and women have higher MI rates than HIV-negative people the same age. HIV-associated inflammation, certain antiretrovirals, and traditional risk factors may all contribute to this inflated MI risk. This study of veterans in the Veterans Aging Cohort Study (VACS) focused on one traditional risk factor, hypertension.
The analysis involved 27,059 HIV-positive veterans matched to 53,967 HIV-negative veterans by age, race/ethnicity, and VACS study site. No one had a record of cardiovascular disease before or up to 6 months after the study baseline date (the first clinic visit after April 2003). The researchers calculated blood pressure for each study participant as the average of three measurements made closest to the baseline date.
The VACS team defined hypertension as follows: normal: systolic 90-120 mm Hg, diastolic 60-80 mm Hg and taking no blood pressure drugs; prehypertension: systolic 120-139 mm Hg, diastolic 80-89 mm Hg and no blood pressure drugs; low prehypertension: systolic 120-129 mm Hg or diastolic 80-84 mm Hg; high prehypertension: systolic 130-139 mm Hg or diastolic 85-89 mm Hg; hypertension: systolic at or above 140 mm Hg, diastolic at or above 100 mg and no blood pressure drugs; treated hypertension: taking blood pressure drugs; very low blood pressure: systolic below 90 mm Hg, diastolic below 60 mm Hg.