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Published on: July 24, 2013
Factors associated with high cardiovascular risk in a primarily African American, urban HIV-infected population
Shashwatee Bagchi1,2, Shana Ab Burrowes3, Lori E Fantry1,2
1Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Insights
High-risk HIV patients face persistent cardiovascular disease (CVD) risk. Factors like hepatitis C, high triglycerides, and low albumin are associated with increased CVD risk, alongside unexplained gender disparities.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Cardiovascular disease (CVD) is a significant concern in patients with HIV.
- The Pooled Cohort Equation (PCE) is commonly used to assess CVD risk.
- Understanding risk factors in high-risk populations is crucial for targeted interventions.
Purpose of the Study:
- To identify factors associated with an increased risk of developing cardiovascular disease in a high-risk patient population.
- To analyze cardiovascular disease risk in HIV-infected individuals.
Main Methods:
- Retrospective cohort study with cross-sectional analysis.
- Included 100 patients from an inner-city HIV clinic in 2008.
- Calculated atherosclerotic vascular disease (AVD) risk score using the Pooled Cohort Equation and performed Chi-square tests.
Main Results:
- Eighty-one participants (95.1% African American, 38.3% women) were analyzed.
- Median AVD risk scores were 8.8% (2008) and 8.1% (2012).
- Hepatitis C infection, elevated triglycerides, and low albumin were associated with increased AVD risk (p<0.05).
- Women had more known AVD despite lower median risk scores.
Conclusions:
- Elevated CVD risk persists in HIV-infected populations.
- Non-traditional risk factors may contribute to excess CVD risk in HIV patients.
- An unexplained gender disparity in CVD risk exists.
Objective:
To determine factors associated with increased risk of developing cardiovascular disease in a high-risk patient population.
Design:
Cross-sectional analysis of a retrospective cohort study.
Methods:
One-hundred patients at an inner city HIV clinic in 2008 were reviewed. The atherosclerotic vascular disease risk score was calculated using the Pooled Cohort Equation. Chi-square test was performed to identify associations of potential risk factors with elevated atherosclerotic vascular disease risk.
Results:
Eighty-one participants were included in the final analysis. In total, 95.1% were African American, and 38.3% were women. The median atherosclerotic vascular disease risk score was 8.8% and 8.1% in 2008 and 2012, respectively. The medical co-morbidities associated with increased atherosclerotic vascular disease risk were hepatitis C infection (X2 = 3.93; p value = 0.048), elevated triglycerides levels (X2 = 4.0; p value = 0.046), and low albumin (X2 = 4.65; p value = 0.031). There were a higher number of women with known atherosclerotic vascular disease despite lower median atherosclerotic vascular disease risk score compared to men.
Conclusion:
An elevated risk of developing cardiovascular disease persists in high-risk demographic groups of the HIV epidemic even in the current HIV era. There is an unexplained gender disparity and some non-traditional risk factors not accounted for in the Pooled Cohort Equation may be contributing to the excess cardiovascular disease risk observed among HIV-infected patients.
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