Signs and symptoms

Hypertension may be frequent in persons living with HIV (PLWHIV),1–3 but is generally asymptomatic. 

  • This lack of apparent symptoms, coupled with the risk of potentially severe, long-term complications if left untreated, have led to hypertension being termed ‘the silent killer’.4
  • The asymptomatic nature of the condition may also increase the likelihood of patient non-adherence to treatment related to denial of illness because of lack of symptoms.5

PLWHIV should have their blood pressure (BP) assessed at HIV diagnosis, before beginning antiretroviral (ARV) treatment, and every year irrespective of ARV treatment.6

Find out about Diagnostic tools and other recommended assessments.


  1. Triant VA, Lee H, Hadigan C, et al. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92:2506–2512.
  2. Onen NF, Overton ET, Seyfried W, et al. Aging and HIV infection: a comparison between older HIV-infected persons and the general population. HIV Clin Trials. 2010;11:100–109.
  3. 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.
  4. American Heart Association. Symptoms, Diagnosis & Monitoring of High Blood Pressure. 21 Jan 2011. Accessed 28 February 2011.
  5. 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.
  6. European AIDS Clinical Society. Guidelines. Version 6.0. Accessed 18 October 2011.