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Antiretroviral treatment and antihypertensive therapy


Nicolás Roberto Robles*, Francesco Fici, Julian Valladares and Guido Grassi  


The presence of hypertension among the population with human immunodeficiency virus (HIV) has become a new threat to the health and well-being of people living with this disease, in particular, among those who received antiretroviral therapy. The estimated prevalence of high blood pressure in HIV‐infected patients is significantly higher than the rate observed in HIV‐uninfected subjects. The approach to the HIV-positive patient requires the assessment of individual cardiovascular risk and its consideration when designing the individualized target. On the other hand, the numerous pharmacological interactions of antiretroviral (ARV) drugs are essential elements to take into account. Serum levels of any kind of antihypertensive drugs may be influenced by the coadministration of protease inhibitors, non-nucleoside reverse transcriptase inhibitor, or other antiretroviral. Similarly, plasma concentrations of antiretroviral drugs can be increased by the concomitant use of calcium channel blockers or diuretics. In this regard, the treatment of high blood pressure in HIV patients should be preferentially based on ACE inhibitors or thiazide/thiazide-like diuretics or their combination.


Antiretroviral, Hypertension, Antihypertensive treatment, HIV Infection, Interactions, Cardiovascular disease


Servicio de Nefrología. Hospital Universitario de Badajoz. Badajoz, Cardiovascular Risk Chair. University of Salamanca School of Medicine Salamanca, Servicio de Nefrología. Hospital Universitario de Badajoz. Badajoz, Clinica Medica, Università Milano-Bicocca, Milan

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