Cardiovascular Disease Risk Management in Persons With HIV: Does Clinician Specialty Matter?

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• The management of cardiovascular disease (CVD) risk factors in people with HIV (PWH) is critical for long-term health.
• The specific influence of clinician specialty on CVD risk factor control in PWH remains under-explored.

Purpose of the Study:

• To investigate the association between clinician specialty and the achievement of hypertension and hyperlipidemia treatment goals in PWH.
• To identify potential disparities in CVD risk factor management based on healthcare provider expertise.

Main Methods:

• Retrospective analysis of 1667 PWH from three academic HIV clinics (2014-2016).
• Patients were stratified by the specialty of the clinician managing hypertension or hyperlipidemia.
• Outcomes included meeting blood pressure (BP) and non-high-density lipoprotein (HDL) cholesterol goals, analyzed using modified Poisson regression.

Main Results:

• Among PWH with hypertension, those managed by infectious diseases (ID) clinicians were less likely to meet JNC-8 BP targets (RR, 0.84; 95% CI, 0.75-0.95).
• No significant difference in mean study BP was observed between ID-managed and other patients.
• No significant association was found between ID clinician management and meeting National Lipid Association (NLA) non-HDL goals for hyperlipidemia.

Conclusions:

• Clinician specialty, particularly infectious diseases, may be associated with suboptimal hypertension control in people with HIV.
• Further research is needed to optimize CVD risk factor management strategies for PWH based on clinician expertise and care coordination.