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We sought to understand whether increased renin\u2013angiotensin\u2013aldosterone system (RAAS) activation may be related to arterial inflammation in PWH and when compared with PWOH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Twenty PWH and 9 PWOH followed a controlled, standardized low and liberal sodium diet to simulate a RAAS\u2010activated and RAAS\u2010suppressed state, respectively. We measured serum lipoprotein\u2010associated phospholipase A2 (LpPLA2) concentrations following both conditions to assess the physiologic dynamics of aldosterone in relation to arterial inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LpPLA2 levels were significantly higher among PWH versus PWOH during both the RAAS\u2010activated state[5.3(4.2, 6.1) versus 4.0(3.0, 4.8)nmol\/L, median(interquartile range),<jats:italic>p<\/jats:italic>\u2009=\u2009.01]) and RAAS\u2010suppressed state[4.4(3.9, 5.3) versus 3.8(3.4, 4.1)nmol\/L,<jats:italic>p<\/jats:italic>\u2009=\u2009.01]. Among PWH, but not PWOH, LpPLA2 increased significantly with RAAS activation(<jats:italic>p<\/jats:italic>\u2009=\u2009.03). LpPLA2 levels measured during the RAAS\u2010suppressed state among PWH remained relatively higher than LpPLA2 levels under both conditions among PWOH. Log LpPLA2 was related to log aldosterone during the RAAS\u2010activated state(<jats:italic>r<\/jats:italic>\u2009=\u2009.39,<jats:italic>p<\/jats:italic>\u2009=\u2009.04) among all participants. Log LpPLA2 was correlated with visceral fat(<jats:italic>r<\/jats:italic>\u2009=\u2009.46,<jats:italic>p<\/jats:italic>\u2009=\u2009.04) and log systolic blood pressure(<jats:italic>r<\/jats:italic>\u2009=\u2009.57,<jats:italic>p<\/jats:italic>\u2009=\u2009.009) during a RAAS\u2010activated state when an increase in aldosterone was stimulated in HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LpPLA2 is increased during a RAAS\u2010activated state among PWH, but not among PWOH. Further, LpPLA2 was increased in both RAAS\u2010activated and suppressed states in PWH compared with PWOH. These data suggest a biological link between increased aldosterone and arterial inflammation in this population. Future studies should test RAAS blockade on arterial inflammation as a targeted treatment approach in HIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14784","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T05:23:40Z","timestamp":1653542620000},"page":"581-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Role of renin\u2013angiotensin\u2013aldosterone system activation and other metabolic variables in relation to arterial inflammation in HIV"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-8764","authenticated-orcid":false,"given":"Grace","family":"Shen","sequence":"first","affiliation":[{"name":"Metabolism Unit Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teressa 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