For individuals with HIV and hypertension, the kind of medication utilized to reduce their high blood pressure might affect future cardiovascular danger, brand-new research study programs.
The research study, released Monday in the Detonic.shop journal High blood pressure, discovered particular high blood pressure medications increased the danger for heart illness, heart or stroke failure while others reduced the danger of cardiac arrest in a group of primarily male veterans.
With present anti-retroviral medications, individuals with HIV have the ability to live longer. Individuals taking these medications are more most likely to establish high blood pressure and associated heart issues than individuals in the basic population. This is the very first massive research study to take a look at how the option of high blood pressure medication affects the long-lasting danger of heart illness, heart and stroke failure in individuals with HIV and hypertension.
Scientist examined the records of 8,041 veterans with HIV who established hypertension in between 2000 and 2018. As a very first treatment, 13% were recommended beta blockers; 24% were begun with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs); 23% were provided thiazide or comparable diuretics; and 11% were recommended calcium channel blockers (CCBs).
Individuals without cardiovascular disease at the start of the research study who were recommended beta blockers had a 90% greater danger of establishing cardiovascular disease, cardiac arrest or stroke throughout a typical 6.5 years of follow-up than those provided ACE inhibitors or ARBs, even if their high blood pressure was well managed. Thiazide ccbs and diuretics did not increase danger.
Amongst individuals without persistent kidney illness, taking ACE inhibitors or ARBs was connected with a lower danger of cardiac arrest compared to taking other high blood pressure medications, which increased the danger of establishing cardiac arrest by about 50%.
The research study’s senior author Dr. Jordana Cohen stated in a press release the option of high blood pressure medication individuals were recommended might have differed due to prospective drug interactions with HIV medications. Cohen is an assistant teacher of medication and public health in the renal-electrolyte and high blood pressure department at the University of Pennsylvania Perelman School of Medication in Philadelphia.
“Additionally, factors such as how the body handles salt, inflammation and the accelerated aging of blood vessels may affect the risk of cardiac events in people with HIV differently than people who do not have HIV, which could be influenced by which blood pressure medication is used,” she stated.
Cohen stated it was uncommon to discover such high usage of beta blockers given that they are not usually suggested as the very first line of treatment for hypertension.
“We suspect this may be due to the fact that many people with HIV receive primary care from their infectious disease team, who do an amazing job at managing HIV but may not be focused on blood pressure treatment guidelines and contraindications,” Cohen stated. “Ideally, a patient’s primary care and infectious disease teams work together for the best possible outcomes.”
Cohen stated the outcomes likewise highlight possible damage from utilizing beta blockers as first-line treatment for high blood pressure whether an individual has HIV or not.
“While many people are appropriately treated with beta blockers for various reasons,” she stated, “if you think you are taking them only for hypertension and aren’t on any other blood pressure medications, I’d recommend talking to your doctor to make sure it’s the best medication for you.”
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