Related Experiment Video
Updated: Jul 21, 2025
Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
Cardiovascular health among persons with HIV without existing atherosclerotic cardiovascular disease
Megan M McLaughlin1, Matthew S Durstenfeld1,2, Monica Gandhi3
1Division of Cardiology, Department of Medicine, University of California San Francisco.
Insights
Many people with HIV (PWH) eligible for cardiovascular disease prevention have intermediate-high ASCVD risk. Improving guideline-based therapy, nicotine exposure, and blood pressure control is crucial for PWH.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Atherosclerotic cardiovascular disease (ASCVD) is a significant concern for persons with HIV (PWH).
- Primary prevention strategies for ASCVD are essential in managing the health of PWH.
- Understanding cardiovascular health metrics in PWH is critical for targeted interventions.
Purpose of the Study:
- To characterize ASCVD risk and cardiovascular health using Life's Essential 8 (LE8) metrics in PWH eligible for primary prevention.
- To identify specific areas for improvement in ASCVD primary prevention among PWH.
Main Methods:
- A cross-sectional study involving 2567 PWH aged 40 and older without documented ASCVD.
- Utilized ICD-10 codes and electronic health records to assess ASCVD risk factors and LE8 metrics (nicotine exposure, BMI, lipids, glucose, blood pressure).
Main Results:
- 50% of PWH assessed had intermediate-high ASCVD risk (≥7.5%).
- Average LE8 cardiovascular health score was 66.2, with lower scores for nicotine exposure (55.1) and blood pressure (56.0).
- Lower cardiovascular health scores were observed in patients with Medicare, Black patients, and those with sleep apnea or chronic kidney disease.
Conclusions:
- Significant opportunities exist to enhance ASCVD primary prevention in PWH.
- Focusing on guideline-based therapy, nicotine exposure reduction, and blood pressure management is recommended.
- Optimizing cardiovascular health in PWH requires addressing specific risk factors and improving treatment adherence.
Objectives:
We sought to characterize atherosclerotic cardiovascular disease (ASCVD) risk and metrics of cardiovascular health in persons with HIV (PWH) eligible for primary prevention of ASCVD.
Design:
A cross-sectional study of PWH 40 years and older without documented ASCVD who received care at three HIV clinics in San Francisco from 2019 to 2022.
Methods:
We used ICD-10 codes and electronic health record data to assess ASCVD risk and cardiovascular health, as defined by the American Heart Association's Life's Essential 8 (LE8) metrics for nicotine exposure, BMI, lipids, glucose, and blood pressure (BP).
Results:
Among 2567 PWH eligible for primary prevention of ASCVD, the median age was 55 years, 14% were women, and 95% were on antiretroviral therapy. Seventy-seven percent had undergone complete assessment of ASCVD risk factors, and 50% of these patients had intermediate-high ASCVD risk (≥7.5%). Of those with hypertension, 39% were prescribed an antihypertensive. Among those eligible, 43% were prescribed a statin. The mean LE8 cardiovascular health score [0--100 (best health)] was 55.1 for nicotine exposure, 71.3 for BMI, 70.4 for lipids, 81.2 for blood glucose, 56.0 for BP, with an average score of 66.2 across the five metrics. Patients with Medicare insurance, black patients, and those with sleep apnea and chronic kidney disease had on average lower cardiovascular health scores; patients with undetectable viral loads had higher cardiovascular health scores.
Conclusion:
We highlight opportunities for improving primary prevention of ASCVD among PWH, especially in the areas of guideline-based therapy, nicotine exposure, and BP control.
More Related Videos
07:29Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
Published on: October 12, 2017
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:26Atherosclerosis III: Management
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...