Cardiovascular Disease Risk and Falls in Men and Women Living With and Without HIV in MACS/WIHS Combined Cohort Study
Elizabeth Vásquez1,2, Mark H Kuniholm1, Allison A Appleton1,2
1Department of Epidemiology and Biostatistics, College of Integrated Health Sciences, University at Albany, Albany, NY.
Insights
High cardiovascular disease (CVD) risk is linked to increased falls in men and women, especially those with HIV. Targeted, gender-specific prevention strategies are crucial for managing fall risk in clinical practice.
Area of Science:
- Gerontology
- Cardiology
- Epidemiology
Background:
- Cardiovascular disease (CVD) risk is a significant health concern.
- Falls are a common issue, particularly among older adults and individuals with chronic conditions.
- The relationship between CVD risk and falls, especially in populations with HIV, requires further investigation.
Purpose of the Study:
- To examine the cross-sectional association between cardiovascular disease (CVD) risk and fall history.
- To investigate the relationship between CVD risk and the number of falls in the past year.
- To analyze these associations in men and women, with and without HIV.
Main Methods:
- Utilized data from the MACS/WIHS Combined Cohort Study (2020-2022) including 2,723 participants.
- Assessed 10-year CVD risk using pooled cohort equations and categorized into four levels.
- Collected self-reported fall data (recent fall, one fall, multiple falls) and analyzed using multinomial regression, stratified by sex and adjusted for covariates.
Main Results:
- Among men, high CVD risk was significantly associated with a recent fall (aOR: 3.12) and one fall (aOR: 3.66) in the past year.
- Among women, high CVD risk was significantly associated with multiple falls (aOR: 2.06) in the past year.
- These associations were observed in both men and women with and without HIV.
Conclusions:
- Integrating fall risk assessments into cardiovascular disease management is essential.
- Findings underscore the need for targeted, gender-responsive fall prevention strategies.
- Particular attention should be given to individuals with HIV and high CVD risk.
Background:
We examined the cross-sectional relationship between cardiovascular disease (CVD) risk, history of falls, and the number of falls in the past year in the US multicenter MACS/WIHS Combined Cohort Study (2020-2022) of men and women without HIV (MWOH/WWOH) and men and women with HIV (MWH/WWH).
Setting/Methods:
CVD risk was assessed by pooled cohort equation 10-year risk scores and categorized into 4 levels. Self-reported falls outcomes (recent fall, not recent fall, one fall, multiple falls) were assessed using a standardized protocol. Odds ratios of falls were measured using multinomial regression models stratified by sex and adjusted for ethnicity, education attainment, alcohol consumption, body-mass index, fall-risk medications, physical activity, and HIV serostatus.
Results:
There were 2723 participants, 35% were men (577 MWH, 360 MWOH) with a median age of 58 (IQR: 14) years. Women represented 65% (1271 WWH, 515 WWOH) with a median age of 55 (IQR: 11) years. In sex stratified multinomial adjusted models, among men, high CVD risk (vs. low risk) was significantly associated with a recent fall (vs. never fall) (aOR: 3.12, 95% CI: 1.59 to 6.13) and one fall (vs. no fall) in past year (aOR: 3.66; 95% CI: 1.45 to 9.21). Among women, high CVD risk was only significantly associated with multiple falls (vs. no fall) in past year (aOR: 2.06; 95% CI: 1.24 to 3.43).
Conclusion:
Our findings highlight the importance of integrating fall-risk assessments into CVD management, particularly for men and women with living with HIV and high CVD risk, and the need for targeted, gender-responsive fall prevention strategies in clinical practice.
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