HIV tied to excess heart failure, stroke risk

  • J Am Heart Assoc

  • International Clinical Digest
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Takeaway

  • People living with HIV (PLWH) have increased risk for heart failure (HF) and stroke, specifically, within their overall increased cardiovascular disease (CVD) risk.
  • Afib and myocardial infarction (MI) risks are elevated to a lesser degree.

Why this matters

  • As PLWH age, clinicians need to pay special attention to preventive measures and screening for these specific CVDs.

Key results

  • Mean follow-up was 20 months.
  • Compared with people not living with HIV, PLWH had increased risk (adjusted HRs; 95% CIs) for:
    • MI: 1.2 (0.8-1.8);
    • HF: 2.8 (2.0-3.8);
    • Stroke: 2.3 (1.5-3.6);
    • Afib: 1.3 (1.0-1.7);
    • Peripheral artery disease: 0.9 (0.5-1.4); and
    • CVD hospitalization: 1.6 (1.3-1.9).

Study design

  • Analysis of MarketScan and Medicare data for 19,798 PLWH and 59,302 age‐ and sex‐matched unaffected people, covering 2009-2015.
  • Adjusted HRs calculated for CVD endpoints.
  • Funding: NIH, American Heart Association.

Limitations

  • No specifics on parameters of each person’s HIV status.
  • Uncontrolled confounding likely.
  • Included only insured individuals.

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