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Cardiovascular disease in women living with HIV: A narrative review
Danielle Solomon1, Caroline A Sabin2, Patrick W G Mallon3
1UCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Insights
Women living with HIV (WLHIV) face a higher risk of cardiovascular disease (CVD) compared to men. Optimal management of risk factors like hyperlipidemia and hypertension is crucial for this population.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Advances in HIV treatment increase the number of older individuals living with HIV.
- Cardiovascular disease (CVD) is a growing concern for people living with HIV (PLWHIV).
- Women constitute over half of the global PLWHIV population.
Purpose of the Study:
- To review the literature on cardiovascular disease (CVD) in women living with HIV (WLHIV).
- To focus on coronary heart disease epidemiology, pathophysiology, risk factors, and management in WLHIV.
Main Methods:
- A narrative literature review of 39 studies was conducted.
- The review focused on epidemiology, pathophysiology, risk factors (traditional and HIV-related), and management of CVD in WLHIV.
Main Results:
- HIV appears to increase CVD risk in women more than in men.
- Certain cardiometabolic risk factors, including obesity and metabolic syndrome, are more prevalent in WLHIV.
- Risk factors like hyperlipidemia and hypertension are not optimally managed in WLHIV.
Conclusions:
- WLHIV represent a population at elevated cardiovascular risk.
- Clinicians must be aware of increased CVD risk and adhere to relevant management guidelines for WLHIV.
- Gaps in the literature highlight the need for further research on CVD in WLHIV.
Abstract:
Advances in the treatment of HIV have led to increasing numbers of people living with HIV reaching older age. Age-related comorbid conditions, such as cardiovascular disease (CVD), are therefore of increasing importance in HIV clinical practice. Over half the global population of people living with HIV are female. We present a narrative literature review of 39 studies exploring CVD in women living with HIV (WLHIV), with particular reference to coronary heart disease, and focusing on: (1) epidemiology, (2) pathophysiology, (3) risk factors (including traditional risk factors and HIV-related risk factors), and (4) management. Although we found significant gaps in the literature on CVD in WLHIV, data suggest that: HIV increases the risk of CVD in women even more than it does in men; certain cardiometabolic risk factors (such as obesity and metabolic syndrome) are more prevalent in WLHIV than their male counterparts; and risk factors such as hyperlipidaemia and hypertension are not optimally managed in this population. Clinicians working with WLHIV therefore need to be aware that this is a patient group at elevated cardiovascular risk, and should be familiar with relevant guidelines.
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