Increased risk of cardiovascular disease (CVD) with age in HIV‐positive men: a comparison of the D:A:D CVD risk equation and general population CVD risk equations

Abstract

ObjectivesThe aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. MethodsWe analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. ResultsA total of 24 323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age 2 for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population.

Review of Cardiovascular Disease in HIV-Infected Women

“…Freiberg et al looked at the veteran population and found an increase rate of cardiovascular events in HIV-infected male veterans compared with HIV-uninfected male veterans HR 1.48 (95% CI, 1.27-1.72) [3]. Similarly, Silverberg et al demonstrated a 44% increased risk of MIs among a predominately male HIV-infected population compared with a predominately male HIV-uninfected population [48].…”

“…Numerous studies report increased risk of CHD in HIV-infected people, but most of these studies were conducted in men or in predominantly male cohorts [3][4][5]. In the general population, men have been reported to have higher rates of CHD and at younger age than women [6,7].…”

The Prevalence of Cardiovascular Disease Risk Factors among Students of International Islamic University Malaysia, Kuantan Campus

“…Most of the people who didn't take much care of their health when they were younger, in the 20's, would develop much of the related risk conditions as they entered the middle age. A number of studies reported that CVD prevalence increases with the increasing age (Al-Alwan et al, 2013;Petoumenos et al, 2014;Peker et al, 2002). Another study reported that, with increasing age there was a gradual shift for DBP to SBP as a predictor of CHD risk (Franklin et al, 2001).…”

Cancer prevention in HIV-infected populations

“…While aspirin has not been evaluated for cancer prevention in people with HIV, it has been studied in this population for modulation of cardiovascular risk. HIV patients have a higher risk of cardiovascular disease than the general population 221,222 . In addition to traditional cardiovascular risk factors, low CD4+ counts and increased inflammation are biomarkers of risk in people with HIV.…”