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Cardiovascular Disease Risk Factor Control in People With and Without HIV.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Cardiovascular Disease Risk Factor Control in People With and Without HIV.
Συγγραφείς: Silverberg, M.J., Levine, T.M., Lea, A.N., Williams, A.E., Alexeeff, S.E., Bryant, K., Cavassini, M., Flamm, J.A., Hare, C.B., Ingle, S.M., Justice, A.C., Lam, J.O., Sterling, S.A., Horberg, M.A., Satre, D.D.
Έτος έκδοσης: 2024
Συλλογή: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Θεματικοί όροι: Humans, HIV Infections/complications, Male, Female, Retrospective Studies, Middle Aged, Cardiovascular Diseases/epidemiology, Adult, Risk Factors, Heart Disease Risk Factors, Dyslipidemias/epidemiology, Dyslipidemias/complications, Hypertension/complications, Hypertension/epidemiology, Diabetes Mellitus/epidemiology, Aged, HIV, cardiovascular disease, diabetes, dyslipidemia, hypertension
Περιγραφή: Management of hypertension, dyslipidemia, diabetes and other modifiable factors may mitigate the cardiovascular disease (CVD) risk in people with human immunodeficiency virus (HIV, PWH) compared with people without HIV (PWoH). This was a retrospective cohort study of 8285 PWH and 170 517 PWoH from an integrated health system. Risk factor control was measured using a novel disease management index (DMI) accounting for amount/duration above treatment goals (0% to 100% [perfect control]), including 2 DMIs for hypertension (diastolic and systolic blood pressure), 3 for dyslipidemia (low-density lipoprotein, total cholesterol, triglycerides), and 1 for diabetes (HbA1c). CVD risk by HIV status was evaluated overall and in subgroups defined by DMIs, smoking, alcohol use, and overweight/obesity in adjusted Cox proportional hazards models. PWH and PWoH had similar DMIs (80%-100%) except for triglycerides (worse for PWH) and HbA1c (better for PWH). In adjusted models, PWH had an elevated risk of CVD compared with PWoH (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.07-1.31). This association was attenuated in subgroups with controlled dyslipidemia and diabetes but remained elevated for PWH with controlled hypertension or higher total cholesterol. The strongest HIV status association with CVD was seen in the subgroup with frequent unhealthy alcohol use (HR, 2.13; 95% CI, 1.04-4.34). Control of dyslipidemia and diabetes, but not hypertension, attenuated the HIV status association with CVD. The strong association of HIV and CVD with frequent unhealthy alcohol use suggests enhanced screening and treatment of alcohol problems in PWH is warranted.
Τύπος εγγράφου: article in journal/newspaper
Γλώσσα: English
ISSN: 1537-6591
38227614
Relation: Clinical Infectious Diseases; https://iris.unil.ch/handle/iris/59806; serval:BIB_30B7DB913B8C; 001143313500001
DOI: 10.1093/cid/ciad728
Διαθεσιμότητα: https://iris.unil.ch/handle/iris/59806
https://doi.org/10.1093/cid/ciad728
Αριθμός Καταχώρησης: edsbas.F0963153
Βάση Δεδομένων: BASE
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  Data: Cardiovascular Disease Risk Factor Control in People With and Without HIV.
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  Data: <searchLink fieldCode="AR" term="%22Silverberg%2C+M%2EJ%2E%22">Silverberg, M.J.</searchLink><br /><searchLink fieldCode="AR" term="%22Levine%2C+T%2EM%2E%22">Levine, T.M.</searchLink><br /><searchLink fieldCode="AR" term="%22Lea%2C+A%2EN%2E%22">Lea, A.N.</searchLink><br /><searchLink fieldCode="AR" term="%22Williams%2C+A%2EE%2E%22">Williams, A.E.</searchLink><br /><searchLink fieldCode="AR" term="%22Alexeeff%2C+S%2EE%2E%22">Alexeeff, S.E.</searchLink><br /><searchLink fieldCode="AR" term="%22Bryant%2C+K%2E%22">Bryant, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Cavassini%2C+M%2E%22">Cavassini, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Flamm%2C+J%2EA%2E%22">Flamm, J.A.</searchLink><br /><searchLink fieldCode="AR" term="%22Hare%2C+C%2EB%2E%22">Hare, C.B.</searchLink><br /><searchLink fieldCode="AR" term="%22Ingle%2C+S%2EM%2E%22">Ingle, S.M.</searchLink><br /><searchLink fieldCode="AR" term="%22Justice%2C+A%2EC%2E%22">Justice, A.C.</searchLink><br /><searchLink fieldCode="AR" term="%22Lam%2C+J%2EO%2E%22">Lam, J.O.</searchLink><br /><searchLink fieldCode="AR" term="%22Sterling%2C+S%2EA%2E%22">Sterling, S.A.</searchLink><br /><searchLink fieldCode="AR" term="%22Horberg%2C+M%2EA%2E%22">Horberg, M.A.</searchLink><br /><searchLink fieldCode="AR" term="%22Satre%2C+D%2ED%2E%22">Satre, D.D.</searchLink>
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  Data: 2024
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  Data: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
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  Data: <searchLink fieldCode="DE" term="%22Humans%22">Humans</searchLink><br /><searchLink fieldCode="DE" term="%22HIV+Infections%2Fcomplications%22">HIV Infections/complications</searchLink><br /><searchLink fieldCode="DE" term="%22Male%22">Male</searchLink><br /><searchLink fieldCode="DE" term="%22Female%22">Female</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+Aged%22">Middle Aged</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiovascular+Diseases%2Fepidemiology%22">Cardiovascular Diseases/epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22Adult%22">Adult</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+Factors%22">Risk Factors</searchLink><br /><searchLink fieldCode="DE" term="%22Heart+Disease+Risk+Factors%22">Heart Disease Risk Factors</searchLink><br /><searchLink fieldCode="DE" term="%22Dyslipidemias%2Fepidemiology%22">Dyslipidemias/epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22Dyslipidemias%2Fcomplications%22">Dyslipidemias/complications</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension%2Fcomplications%22">Hypertension/complications</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension%2Fepidemiology%22">Hypertension/epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22Diabetes+Mellitus%2Fepidemiology%22">Diabetes Mellitus/epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22Aged%22">Aged</searchLink><br /><searchLink fieldCode="DE" term="%22HIV%22">HIV</searchLink><br /><searchLink fieldCode="DE" term="%22cardiovascular+disease%22">cardiovascular disease</searchLink><br /><searchLink fieldCode="DE" term="%22diabetes%22">diabetes</searchLink><br /><searchLink fieldCode="DE" term="%22dyslipidemia%22">dyslipidemia</searchLink><br /><searchLink fieldCode="DE" term="%22hypertension%22">hypertension</searchLink>
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  Data: Management of hypertension, dyslipidemia, diabetes and other modifiable factors may mitigate the cardiovascular disease (CVD) risk in people with human immunodeficiency virus (HIV, PWH) compared with people without HIV (PWoH). This was a retrospective cohort study of 8285 PWH and 170 517 PWoH from an integrated health system. Risk factor control was measured using a novel disease management index (DMI) accounting for amount/duration above treatment goals (0% to 100% [perfect control]), including 2 DMIs for hypertension (diastolic and systolic blood pressure), 3 for dyslipidemia (low-density lipoprotein, total cholesterol, triglycerides), and 1 for diabetes (HbA1c). CVD risk by HIV status was evaluated overall and in subgroups defined by DMIs, smoking, alcohol use, and overweight/obesity in adjusted Cox proportional hazards models. PWH and PWoH had similar DMIs (80%-100%) except for triglycerides (worse for PWH) and HbA1c (better for PWH). In adjusted models, PWH had an elevated risk of CVD compared with PWoH (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.07-1.31). This association was attenuated in subgroups with controlled dyslipidemia and diabetes but remained elevated for PWH with controlled hypertension or higher total cholesterol. The strongest HIV status association with CVD was seen in the subgroup with frequent unhealthy alcohol use (HR, 2.13; 95% CI, 1.04-4.34). Control of dyslipidemia and diabetes, but not hypertension, attenuated the HIV status association with CVD. The strong association of HIV and CVD with frequent unhealthy alcohol use suggests enhanced screening and treatment of alcohol problems in PWH is warranted.
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  Data: Clinical Infectious Diseases; https://iris.unil.ch/handle/iris/59806; serval:BIB_30B7DB913B8C; 001143313500001
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