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J Am Heart Assoc. 2014 Oct 16;3(5):e001035. doi: 10.1161/JAHA.114.001035.

HIV infection and cardiovascular disease in women.

Author information

1
Yale School of Nursing, West Haven, CT (J.A.W.).
2
University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.) University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (C.C.H.C., C.A.).
3
Yale University School of Medicine, New Haven, CT (K.A.S.A., A.C.J., J.S.).
4
University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (C.C.H.C., C.A.).
5
University of Minnesota Department of Medicine, Hennepin County Medical Center, Minneapolis, MN (J.V.B.).
6
James J. Peters VA Medical Center, Bronx, NY (S.T.B.) Icahn School of Medicine at Mt. Sinai, New York, NY (S.T.B.).
7
Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, CA (M.B.).
8
University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.) VA Pittsburgh Healthcare System, Pittsburgh, PA (A.A.B.) Sheikh Khalifa Medical City, Abu Dhabi, UAE (A.A.B.).
9
VA Medical Center and George Washington University School of Medicine, Washington, DC (C.G.).
10
David Geffen School of Medicine, University of California, Los Angeles, CA (M.B.G., D.L., A.W.) VA Greater Los Angeles Health Care System, Los Angeles, CA (M.B.G., D.L., A.W.).
11
University of Maryland School of Medicine, Baltimore, MD (J.G., S.G.).
12
Yale University School of Medicine, New Haven, CT (K.A.S.A., A.C.J., J.S.) Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT (A.C.J., K.M.G., J.S., M.S.).
13
Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT (A.C.J., K.M.G., J.S., M.S.).
14
Emory University School of Medicine and Atlanta VA Medical Center, Atlanta, GA (D.R.).
15
Infectious Diseases Section, Michael E. DeBakey VA Medical Center, and Department of Medicine, Baylor College of Medicine, Houston, TX (M.C.R.B.).
16
University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.).
17
University of Vermont College of Medicine, Burlington, VT (R.P.T.).
18
Vanderbilt University School of Medicine, Nashville, TN (M.S.F.).

Abstract

BACKGROUND:

HIV infection is associated with increased risk of cardiovascular disease (CVD) in men. Whether HIV is an independent risk factor for CVD in women has not yet been established.

METHODS AND RESULTS:

We analyzed data from the Veterans Aging Cohort Study on 2187 women (32% HIV infected [HIV(+)]) who were free of CVD at baseline. Participants were followed from their first clinical encounter on or after April 01, 2003 until a CVD event, death, or the last follow-up date (December 31, 2009). The primary outcome was CVD (acute myocardial infarction [AMI], unstable angina, ischemic stroke, and heart failure). CVD events were defined using clinical data, International Classification of Diseases, Ninth Revision, Clinical Modification codes, and/or death certificate data. We used Cox proportional hazards models to assess the association between HIV and incident CVD, adjusting for age, race/ethnicity, lipids, smoking, blood pressure, diabetes, renal disease, obesity, hepatitis C, and substance use/abuse. Median follow-up time was 6.0 years. Mean age at baseline of HIV(+) and HIV uninfected (HIV(-)) women was 44.0 versus 43.2 years (P<0.05). Median time to CVD event was 3.1 versus 3.7 years (P=0.11). There were 86 incident CVD events (53%, HIV(+)): AMI, 13%; unstable angina, 8%; ischemic stroke, 22%; and heart failure, 57%. Incident CVD/1000 person-years was significantly higher among HIV(+) (13.5; 95% confidence interval [CI]=10.1, 18.1) than HIV(-) women (5.3; 95% CI=3.9, 7.3; P<0.001). HIV(+) women had an increased risk of CVD, compared to HIV(-) (hazard ratio=2.8; 95% CI=1.7, 4.6; P<0.001).

CONCLUSIONS:

HIV is associated with an increased risk of CVD in women.

KEYWORDS:

AIDS; CVD risk factors; Women

PMID:
25324353
PMCID:
PMC4323817
DOI:
10.1161/JAHA.114.001035
[Indexed for MEDLINE]
Free PMC Article

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