Use of Preventive Measures for Cardiovascular Disease in People With HIV

Data on uptake of preventive measures for cardiovascular disease (CVD) in people with HIV are limited.

We determined the annual prevalence (2012-2021) of CVD preventive measures use for RESPOND participants with a very high (>10%) estimated D:A:D 10-year CVD risk who were eligible for each specific measure evaluated. We used binomial regression to assess factors associated with each preventative measure uptake.

Between 2012 and 2021, the crude proportion of >10% estimated 10-year CVD risk individuals increased from 32.4% (n = 4272) to 52.1% (n = 5298). At the end of follow-up, among very high-risk individuals, 67.4% (1552/2303) with hypertension used antihypertensives, 55.9% (1562/2792) with dyslipidemia lipid-lowering drugs (LLDs), and 7.4% (159/2149) smokers ceased smoking, without significant changes over time. Conversely, a smaller proportion of individuals with diabetes received antidiabetics in later years (2012-2013: 60.3% [388/643] versus 2019-2020: 57.2% [459/803], global P = .0028). Use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) in those with hypertension or diabetes slightly declined before increasing again (42.1% [864/2052] versus 43.4% [1123/2585], global P = .0009). Individuals with ongoing viremia or intravenous drug use as HIV exposure group were less likely to cease smoking and use LLDs. Men ≥40 years and women ≥50 were more likely to use antihypertensives, ACEIs/ARBs, antidiabetics, and LLDs. The uptake of preventive measures was similar between sexes/genders.

The increasing proportion of individuals at very high estimated 10-year CVD risk without a corresponding increase in use of preventive measures calls for greater awareness of CVD risk management for people with HIV attending routine clinical care.