心血管疾病风险因素控制在艾滋病毒感染者和没有艾滋病毒感染者的控制
Michael J Silverberg1, Tory M Levine1, Alexandra N Lea1
1Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
概括
人类免疫缺陷病毒 (HIV) 感染者面临更高的心血管疾病 (CVD) 风险. 控制糖尿病和失脂症,但不控制高血压,可以降低这种风险. 不健康的酒精使用显著增加了艾滋病毒感染者的心血管疾病风险.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 是人类免疫缺陷病毒 (HIV) 感染者的重要关注点.
- 管理可修改的风险因素,如高血压,脂质失调和糖尿病可能会影响心血管疾病风险的人与艾滋病毒感染者 (PWH) 相比,没有艾滋病毒的人 (PWoH).
研究的目的:
- 评估艾滋病毒状况与心血管疾病风险之间的关联.
- 为了确定控制可修改的风险因素是否能减轻PWH的心血管疾病风险.
- 确定影响PWH中心血管疾病风险的特定风险因素.
主要方法:
- 追溯队列研究涉及8285个PWH和170,517个PWoH.
- 利用一种新的疾病管理指数 (DMI) 来量化高血压,脂质失调和糖尿病的控制.
- 员工调整了考克斯的比例危险模型,以根据艾滋病毒状况和子组评估心脏病风险.
主要成果:
- 与PWoH相比,PWH的心血管疾病风险更高 (HR,1.18).
- 控制的脂质失调和糖尿病减轻了与艾滋病毒相关的心血管疾病风险.
- 控制高血压并没有减弱相关性;不健康的酒精使用显示PWH中与心血管疾病的最强相关性 (HR,2.13).
结论:
- 失脂症和糖尿病控制,与高血压控制不同,降低了PWH中心血管疾病风险的增加.
- 频繁的不健康的酒精使用显著放大了PWH中心血管疾病的风险,这证明了有针对性的查和治疗干预措施.
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