Trends in Cardiovascular Disease Mortality Among Persons With HIV in New York City, 2001–2012

Hanna, David B.; Ramaswamy, Chitra; Kaplan, Robert C.; Kizer, Jorge R.; Anastos, Kathryn; Daskalakis, Demetre; Zimmerman, Regina; Braunstein, Sarah L.

doi:10.1093/cid/ciw470

Cited by 63 publications

(40 citation statements)

References 28 publications

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“…Both adult [1][2][3] and pediatric 4,5 HIV-infected patients are at a greater risk of cardiovascular disease (CVD) than the general population. To improve risk prediction in the adult population, researchers have used numerous imaging techniques, such as carotid intima-media thickness (IMT) and other tools, such as pulse wave velocity (PWV).…”

Section: Introductionmentioning

confidence: 99%

Arterial stiffness in HIV-infected youth and associations with HIV-related variables

et al. 2017

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Children and young adults infected with HIV are at elevated risk for cardiovascular disease (CVD). However, scarce data exist on the utility of non-invasive methods to diagnose subclinical CVD, such as pulse wave velocity (PWV), a non-invasive measure of arterial stiffness. The objectives of this study were to assess the relationship of carotid-femoral PWV with subclinical atherosclerosis measured by carotid intima-media thickness (IMT), compare measurements to healthy controls, and evaluate variables associated with PWV in HIV-infected youth. One hundred and one 8-25 year-old subjects on stable antiretroviral therapy with low-level viremia or an undetectable HIV-1 RNA were enrolled, along with 86 healthy controls similar in age, sex and race. There was no significant difference in PWV between groups (median (Q1, Q3): 5.7 (5.2, 6.3) vs 5.7 (4.9, 6.5) m/s; P = 0.81). Among the HIV-infected subjects, PWV was positively correlated with both internal carotid artery (R = 0.31, P = 0.02) and carotid bulb IMT (R = 0.29, P = 0.01). In multivariable regression, only current alcohol consumption and systolic blood pressure were independently associated with PWV in the HIV-infected group (where current alcohol consumption and higher systolic blood pressure were associated with higher PWV); whereas, age, body mass index, and current marijuana use were associated with PWV in healthy controls. In this study of PWV in HIV-infected youth, measures of arterial stiffness were not different between subjects and controls. However, in HIV-infected youth, there was a significant association between PWV and carotid IMT, as well as between PWV and current alcohol consumption. Thus, PWV may have potential as a useful, non-invasive method to assess CVD risk in HIV-infected youth, but further investigation is needed.

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Section: Introductionmentioning

confidence: 99%

Arterial stiffness in HIV-infected youth and associations with HIV-related variables

et al. 2017

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“…[10] These improvements have been attributed to both greater awareness and treatment of CVD risk factors leading to primary prevention, and the availability of pharmacological and surgical interventions leading to secondary prevention. [11] Understanding recent trends in CVD mortality in the HIV-infected population is of great interest [12–14] given the unique circumstances of HIV infection and the modern context of effective and widely available ART.…”

Section: Introductionmentioning

confidence: 99%

“…Our group analyzed surveillance data and vital statistics records from 145,845 New York City residents living with HIV between 2001 and 2012. [14] This suggested a decrease in the age-standardized CVD mortality rate, from 5.1/1,000 in 2001 to 2.7/1,000 in 2012. Compared with the D:A:D collaboration, the New York City study had higher absolute CVD mortality rates, possibly due to the use of city wide surveillance data to capture a diverse area-based sample.…”

Section: Introductionmentioning

confidence: 99%

“…1920 In contrast, our study comparing HIV infected New Yorkers to the general population found that those with suppressed viral loads (defined as plasma HIV RNA <400 copies per ml) still had a 53% higher rate of CVD mortality as compared with uninfected New Yorkers after controlling for sex, age, race/ethnicity, and county of residence [14] . Thus, in some demographic groups with HIV infection increased CVD risk may persist despite virologic suppression.…”

Section: Introductionmentioning

confidence: 99%

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Recent Insights Into Cardiovascular Disease (CVD) Risk Among HIV-Infected Adults

2016

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While mortality rates related to cardiovascular disease (CVD) have decreased over time among adults with HIV, excess risk of CVD in the HIV-infected population may persist despite highly active antiretroviral therapy (HAART) treatment and aggressive CVD risk factor control. Beyond atherosclerotic CVD, recent studies suggest that HIV infection may be associated with left ventricular systolic and diastolic function, interstitial myocardial fibrosis, and increased cardiac fat infiltration. Thus, with the increasing average age of the HIV-infected population, heart failure and arrhythmic disorders may soon rival coronary artery disease as the most prevalent forms of CVD. Finally, the question of whether HIV infection should be considered in clinical risk stratification has never been resolved, and this question has assumed new importance with recent changes to lipid treatment guidelines for prevention of CVD.

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“…7 Furthermore, coronary atherosclerotic lesions in HIV-infected patients are often unstable and more prone to rupture, resulting in a 1.5-twofold higher incidence of acute coronary syndrome and myocardial infarction. [8][9][10][11] Expectedly, these pathologic changes leave HIV-infected patients at risk for vascular injury, accelerated atherosclerosis, 12 and ultimately disproportionate cardiovascular mortality. 13 Finally, despite widespread use of ART, we are just now appreciating the burden of inflammation and resulting cardiovascular damage which threatens patient survival.…”

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confidence: 99%

The hidden risk: Incorporating inflammation and HIV serostatus into coronary artery disease screening

Payne

Overton

2018

Journal of Nuclear Cardiology

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Trends in Cardiovascular Disease Mortality Among Persons With HIV in New York City, 2001–2012

Abstract: Our findings support continued emphasis by HIV care providers on both viremic control and preventive measures including smoking cessation, blood pressure control, and lipid management.

Cited by 63 publications

References 28 publications

Arterial stiffness in HIV-infected youth and associations with HIV-related variables

Arterial stiffness in HIV-infected youth and associations with HIV-related variables

Recent Insights Into Cardiovascular Disease (CVD) Risk Among HIV-Infected Adults

The hidden risk: Incorporating inflammation and HIV serostatus into coronary artery disease screening

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