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Objectives: Previous studies have suggested that hypertension in HIV‐positive individuals is associated primarily with traditional risk factors such as older age, diabetes and dyslipidaemia. However, controversy remains as to whether exposure to antiretroviral (ARV) drugs poses additional risk, and we investigated this question in the Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) cohort. Methods: The incidence of hypertension [systolic blood pressure (BP) > 140 and/or diastolic BP > 90 mmHg and/or initiation of antihypertensive treatment] was determined overall and in strata defined by demographic, metabolic and HIV‐related factors, including cumulative exposure to each individual ARV drug. Predictors of hypertension were identified using uni‐ and multivariable Poisson regression models. Results: Of 33 278 included persons, 7636 (22.9%) developed hypertension over 223 149 person‐years (PY) [incidence rate: 3.42 (95% confidence interval (CI) 3.35–3.50) per 100 PY]. In univariable analyses, cumulative exposure to most ARV drugs was associated with an increased risk of hypertension. After adjustment for demographic, metabolic and HIV‐related factors, only associations for nevirapine [rate ratio 1.07 (95% CI: 1.04–1.13) per 5 years] and indinavir/ritonavir [rate ratio 1.12 (95% CI: 1.04–1.20) per 5 years] remained statistically significant, although effects were small. The strongest independent predictors of hypertension were male gender, older age, black African ethnicity, diabetes, dyslipidaemia, use of lipid‐lowering drugs, high body mass index (BMI), renal impairment and a low CD4 count. Conclusions: We did not find evidence for any strong independent association between exposure to any of the individual ARV drugs and the risk of hypertension. Findings provide reassurance that screening policies and preventative measures for hypertension in HIV‐positive persons should follow algorithms used for the general population. [ABSTRACT FROM AUTHOR]

Objectives The aim of the study was to statistically model the relative increased risk of cardiovascular disease ( CVD) per year older in Data collection on Adverse events of anti- HIV Drugs ( D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. Methods We analysed three endpoints: myocardial infarction ( MI), coronary heart disease ( CHD: MI or invasive coronary procedure) and CVD ( CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy ( ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D: A: D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. Results A total of 24 323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age2 for CHD and CVD. In D: A: D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D: A: D and the general population. Conclusions We found only limited evidence of accelerating increased risk of CVD with age in D: A: D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain. [ABSTRACT FROM AUTHOR]