{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:44:36Z","timestamp":1760031876500,"version":"build-2065373602"},"reference-count":52,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30MH062512","R25MH081482","N01 MH22005","HHSN271201000036C","R01 MH107345"],"award-info":[{"award-number":["P30MH062512","R25MH081482","N01 MH22005","HHSN271201000036C","R01 MH107345"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institutes of Health","award":["P30MH062512","R25MH081482","N01 MH22005","HHSN271201000036C","R01 MH107345"],"award-info":[{"award-number":["P30MH062512","R25MH081482","N01 MH22005","HHSN271201000036C","R01 MH107345"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Aging-related comorbidities such as cardiovascular disease and neurocognitive impairment are more common among people with HIV (PWH). Hypertension (HTN) has been implicated in cognitive decline, and antihypertensives with anticholinergic properties may exacerbate this decline. Our research probed the relationship between neurocognitive performance and antihypertensives in hypertensive PWH and in those without HIV (PWoH), examining whether increased antihypertensives followed the worsening in neurocognitive performance. Methods: This longitudinal analysis encompassed seven visits over five years, enrolled between 1999 and 2022. Participants were included if they reported HTN or used antihypertensives. All participants underwent comprehensive cognitive assessments, and their global cognitive performance was evaluated using summary, demographically corrected T-scores. The association between the global T-score and the number of antihypertensives was evaluated using generalized linear mixed-effects models. Summary regression-based change score (sRCS) was analyzed as an indicator of global performance over time. Results: Among 1158 hypertensive PWH (79.9% were on ART), worsening cognitive performance was associated with an increased number of antihypertensives (p = 0.012) but not in PWoH (p = 0.58). PWH had lower mean arterial pressure (MAP) than PWoH after adjusting for demographics (\u03b2 = \u22125.05, p = 2.3 \u00d7 10\u221211). In PWH, an association between mean arterial pressure (MAP) and sRCS suggested that those with cognitive improvement had lower MAP (p = 0.027). PWH taking more anticholinergics were more likely to have worse cognitive performance over time (p &lt; 0.001). Conclusions: PWH with declining neurocognitive performance over time used increasing numbers of antihypertensives, suggesting that their providers prescribed more antihypertensives because of either treatment refractory HTN or poor adherence. Prescribers should avoid using antihypertensives with anticholinergic properties when possible.<\/jats:p>","DOI":"10.3390\/v17040470","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T06:58:43Z","timestamp":1742972323000},"page":"470","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implications of Cognitive Impairment on Antihypertensive Medication Use in HIV"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2147-3144","authenticated-orcid":false,"given":"Azin","family":"Tavasoli","sequence":"first","affiliation":[{"name":"Department of Neurosciences, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4895-1214","authenticated-orcid":false,"given":"Mohammadsobhan S.","family":"Andalibi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald R.","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Letendre","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K.","family":"Heaton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-752X","authenticated-orcid":false,"given":"Ronald J.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e266","DOI":"10.1016\/S2352-3018(20)30358-1","article-title":"Estimated life expectancy gains with antiretroviral therapy among adults with HIV in Latin America and the Caribbean: A multisite retrospective cohort study","volume":"8","author":"Smiley","year":"2021","journal-title":"Lancet HIV"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ijid.2016.10.004","article-title":"HIV and aging","volume":"53","author":"Wing","year":"2016","journal-title":"Int. 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