Risk Factors

The European AIDS Clinical Society (EACS) highlight several risk factors that should be taken into account when grading and managing hypertension.1 These include:

  • age >45 years for men or >55 years for women
  • smoking
  • family history of premature cardiovascular (CV) disease.

The following factors have been associated with hypertension in studies of HIV-infected patients:

  • family history of hypertension2
  • older age3,5,6
  • male gender3,6
  • higher waist-to-hip ratio4 or body mass index (BMI)3,5,6
  • lipodystrophy,2,6 high total and low density lipoprotein cholesterol (LDL-C)3,6 or lipoaccumulation5
  • higher homeostasis model assessment (HOMA)2
  • metabolic syndrome2
  • microalbuminuria3
  • long duration of combination antiretroviral (ARV) treatment3,7

In the general population, the prevalence, severity and impact of hypertension are known to be increased in African Americans.8



  1. European AIDS Clinical Society (EACS). Guidelines. Version 6.0. Accessed 3 July 2012.
  2. Gazzaruso C, Bruno R, Garzaniti A, et al. Hypertension among HIV patients: prevalence and relationships to insulin resistance and metabolic syndrome. J Hypertens. 2003;21:1377–1382.
  3. Baekken M, Os I, Sandvik L, Oektedalen O. Hypertension in an urban HIV-positive population compared with the general population: influence of combination antiretroviral therapy. J Hypertens. 2008;26:2126–2133.
  4. Jung O, Bickel M, Ditting T, et al. Hypertension in HIV-1-infected patients and its impact on renal and cardiovascular integrity. Nephrol Dial Transplant. 2004;19:2250–2258.
  5. Jericó C, Knobel H, Montero M, et al. Hypertension in HIV-infected patients: prevalence and related factors. Am J Hypertens. 2005;18:1396–1401.
  6. Thiébaut R, El-Sadr WM, Friis-Møller N, et al. Predictors of hypertension and changes of blood pressure in HIV-infected patients. Antivir Ther. 2005;10:811–823.
  7. Seaberg EC, Muñoz A, Lu M, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS. 2005;19:953–960.
  8. US Department of Health and Human Services. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. December 2003. Accessed 8 March 2011.