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Risk of coronary heart disease among HIV-infected patients: a multicenter study in Brazil

Sandra C Fuchs1, Paulo R Alencastro, Maria Letícia R Ikeda

  • 1Postgraduate Studies Program in Cardiology, School of Medicine, Clinical Research Center, No. 5 Andar, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil ; Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil ; National Institute for Health Technology Assessment (IATS/CNPq), Hospital de Clinicas de Porto Alegre, 90035-903 Porto Alegre, RS, Brazil.

Thescientificworldjournal
|November 14, 2013
PubMed

Insights

HIV-infected individuals face a growing risk of coronary heart disease. Hypertension and diabetes are the strongest predictors of this 10-year risk, outweighing factors like antiretroviral therapy.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Cardiovascular disease (CVD) is an increasing concern in the human immunodeficiency virus (HIV)-infected population.
  • Assessing CVD risk is crucial for managing long-term health outcomes in individuals with HIV.

Purpose of the Study:

  • To evaluate the 10-year risk of coronary heart disease (CHD) using the Framingham Risk Score (FRS) in HIV-infected patients across three Brazilian regions.
  • To identify key predictors of CHD risk within this population.

Main Methods:

  • Pooled analysis of three Brazilian cohort studies, including 3,829 HIV-infected individuals.
  • Calculation of the 10-year CHD risk using the Framingham Risk Score.
  • Comparison of risk factors and prevalence across different Brazilian regions.

Main Results:

  • The prevalence of an FRS ≥10 was similar across Southern (4.5%), Midwest (4.2%), and Northeast (3.9%) Brazil.
  • Hypertension and diabetes mellitus were the strongest independent predictors of 10-year CHD risk (increased risk >4 times).
  • Women showed a three times higher 10-year CHD risk compared to men. Antiretroviral therapy and time since HIV diagnosis were not significant risk factors.

Conclusions:

  • Hypertension and diabetes are critical independent predictors of 10-year CHD risk in the HIV-infected population.
  • Risk stratification using FRS is essential, with specific attention to modifiable factors like hypertension and diabetes.
  • Regional demographic and clinical differences exist, but key CHD risk factors remain consistent for specific subgroups.

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