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Risk of cardiovascular disease in patients with HIV infection undergoing antiretroviral therapy
V Estrada1, P Domingo2, I Suarez-Lozano3
1Hospital Clínico San Carlos-IdiSSC, Universidad Complutense de Madrid, Madrid, España.
Insights
Cardiovascular risk factors are common in people with HIV on antiretroviral therapy (ART). Improving management of these factors is crucial to reduce cardiovascular disease (CVD) risk in this population.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Antiretroviral therapy (ART) has improved survival for HIV patients.
- Increased survival is associated with a higher incidence of cardiovascular disease (CVD).
- Prevalence of cardiovascular risk factors (CRFs) and CVD risk in HIV patients in Spain was analyzed.
Purpose of the Study:
- To analyze the prevalence of CRFs.
- To estimate CVD risk in a Spanish HIV cohort on ART.
Main Methods:
- Cross-sectional, observational study.
- Utilized the Spanish VACH cohort of HIV patients on ART.
- Assessed 15,559 HIV patients.
Main Results:
- High prevalence of CRFs: hyperlipidemia (64%), tobacco use (47%), hypertension (22%), diabetes (16%).
- 3.7% experienced at least one CVD event.
- 10.9% had high CVD risk, 28.8% had moderate risk (Framingham scale).
- High CVD risk patients frequently used protease inhibitors (49%) and abacavir (43%).
Conclusions:
- Classical CRFs are prevalent in Spanish HIV patients on ART.
- A significant proportion face moderate to high CVD risk.
- Improved control of modifiable CRFs and assessment of drugs with better cardiovascular profiles are recommended.
Background:
The increased survival of patients with HIV infection thanks to antiretroviral therapy (ART) is accompanied by a higher rate of cardiovascular disease (CVD). We analysed the prevalence of the cardiovascular risk factors (CRFs) and estimated the risk of CVD in a cohort of patients with HIV in Spain.
Methods:
We conducted a cross-sectional, observational study of CRFs in the Spanish VACH cohort of patients with HIV who undergo ART.
Results:
The study assessed 15,559 patients with HIV (76% men; mean age, 46 years). Some 3.7% had experienced at least 1 CVD event. The prevalence of CRFs was high (hyperlipidaemia, 64%; tobacco use, 47%; arterial hypertension, 22%; and diabetes, 16%). According to the Framingham scale, 10.9% of the patients presented a high CVD risk, and 28.8% presented a moderate risk. Of the patients with a high CVD risk, 49% took protease inhibitors and 43% took abacavir. Fifty-three percent of the patients diagnosed with arterial hypertension took antihypertensive drugs, and 2.6% of the patients with diabetes took antidiabetic agents.
Conclusions:
Classical CRFs are common in patients with HIV undergoing ART in Spain, and a large proportion of them have a moderate-high risk of CVD. Therefore, controlling the modifiable CRFs in patients with HIV should be improved, and the use of drugs with a better cardiovascular risk profile should be assessed.
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