Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy

Rosan A van Zoest; Marc van der Valk; Ferdinand W N M Wit; Ilonca Vaartjes; Katherine W. Kooij; Joppe W. Hovius; Maria Prins; Peter Reiss

doi:10.1177/2047487317714350

Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy

Rosan A van Zoest
, Marc van der Valk
, Ferdinand W N M Wit
, Ilonca Vaartjes
, Katherine W. Kooij
, Joppe W. Hovius
, Maria Prins
, Peter Reiss

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background
We aimed to identify the prevalence of cardiovascular risk factors, and investigate preventive cardiovascular medication use and achievement of targets as per Dutch cardiovascular risk management guidelines among human immunodeficiency virus (HIV)-positive and HIV-negative individuals.

Design
The design was a cross-sectional analysis within an ongoing cohort study.

Methods
Data on medication use and cardiovascular disease prevalence were available for 528 HIV-positive and 521 HIV-negative participants. We identified cardiovascular risk factors and applied cardiovascular risk management guidelines, mainly focusing on individuals eligible for (a) primary prevention because of high a priori cardiovascular risk, or for (b) secondary prevention.

Results
One hundred and three (20%) HIV-positive and 77 (15%) HIV-negative participants were classified as having high cardiovascular risk; 53 (10%) HIV-positive and 27 (5%) HIV-negative participants were eligible for secondary prevention. Of HIV-positive individuals 57% at high cardiovascular risk and 42% of HIV-positive individuals eligible for secondary prevention had systolic blood pressures above guideline-recommended thresholds. Cholesterol levels were above guideline-recommended thresholds in 81% of HIV-positive individuals at high cardiovascular risk and 57% of HIV-positive individuals eligible for secondary prevention. No statistically significant differences were observed between HIV-positive and HIV-negative participants regarding achievement of targets, except for glycaemic control (glycated haemoglobin ≤ 53 mmol/mol) among individuals using diabetes medication (90% vs 50%, p = 0.017) and antiplatelet/anticoagulant use for secondary prevention (85% vs 63%, p = 0.045), which were both superior among HIV-positive participants.

Conclusions
Cardiovascular risk management is suboptimal in both HIV-positive and HIV-negative individuals and should be improved.

Original language	English
Pages (from-to)	1297-1307
Number of pages	11
Journal	European Journal of Preventive Cardiology
Volume	24
Issue number	12
DOIs	https://doi.org/10.1177/2047487317714350
Publication status	Published - Aug 2017

Keywords

Human immunodeficiency virus
cardiovascular disease
dyslipidaemia
hypertension
prevention

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title = "Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy",

abstract = "Background We aimed to identify the prevalence of cardiovascular risk factors, and investigate preventive cardiovascular medication use and achievement of targets as per Dutch cardiovascular risk management guidelines among human immunodeficiency virus (HIV)-positive and HIV-negative individuals. Design The design was a cross-sectional analysis within an ongoing cohort study. Methods Data on medication use and cardiovascular disease prevalence were available for 528 HIV-positive and 521 HIV-negative participants. We identified cardiovascular risk factors and applied cardiovascular risk management guidelines, mainly focusing on individuals eligible for (a) primary prevention because of high a priori cardiovascular risk, or for (b) secondary prevention. Results One hundred and three (20\%) HIV-positive and 77 (15\%) HIV-negative participants were classified as having high cardiovascular risk; 53 (10\%) HIV-positive and 27 (5\%) HIV-negative participants were eligible for secondary prevention. Of HIV-positive individuals 57\% at high cardiovascular risk and 42\% of HIV-positive individuals eligible for secondary prevention had systolic blood pressures above guideline-recommended thresholds. Cholesterol levels were above guideline-recommended thresholds in 81\% of HIV-positive individuals at high cardiovascular risk and 57\% of HIV-positive individuals eligible for secondary prevention. No statistically significant differences were observed between HIV-positive and HIV-negative participants regarding achievement of targets, except for glycaemic control (glycated haemoglobin ≤ 53 mmol/mol) among individuals using diabetes medication (90\% vs 50\%, p = 0.017) and antiplatelet/anticoagulant use for secondary prevention (85\% vs 63\%, p = 0.045), which were both superior among HIV-positive participants. Conclusions Cardiovascular risk management is suboptimal in both HIV-positive and HIV-negative individuals and should be improved.",

keywords = "Human immunodeficiency virus, cardiovascular disease, dyslipidaemia, hypertension, prevention",

author = "\{van Zoest\}, \{Rosan A\} and \{van der Valk\}, Marc and Wit, \{Ferdinand W N M\} and Ilonca Vaartjes and Kooij, \{Katherine W.\} and Hovius, \{Joppe W.\} and Maria Prins and Peter Reiss",

note = "Publisher Copyright: {\textcopyright} European Society of Cardiology.",

year = "2017",

month = aug,

doi = "10.1177/2047487317714350",

language = "English",

volume = "24",

pages = "1297--1307",

journal = "European Journal of Preventive Cardiology",

issn = "2047-4873",

publisher = "Oxford University Press",

number = "12",

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TY - JOUR

T1 - Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy

AU - van Zoest, Rosan A

AU - van der Valk, Marc

AU - Wit, Ferdinand W N M

AU - Vaartjes, Ilonca

AU - Kooij, Katherine W.

AU - Hovius, Joppe W.

AU - Prins, Maria

AU - Reiss, Peter

N1 - Publisher Copyright: © European Society of Cardiology.

PY - 2017/8

Y1 - 2017/8

N2 - Background We aimed to identify the prevalence of cardiovascular risk factors, and investigate preventive cardiovascular medication use and achievement of targets as per Dutch cardiovascular risk management guidelines among human immunodeficiency virus (HIV)-positive and HIV-negative individuals. Design The design was a cross-sectional analysis within an ongoing cohort study. Methods Data on medication use and cardiovascular disease prevalence were available for 528 HIV-positive and 521 HIV-negative participants. We identified cardiovascular risk factors and applied cardiovascular risk management guidelines, mainly focusing on individuals eligible for (a) primary prevention because of high a priori cardiovascular risk, or for (b) secondary prevention. Results One hundred and three (20%) HIV-positive and 77 (15%) HIV-negative participants were classified as having high cardiovascular risk; 53 (10%) HIV-positive and 27 (5%) HIV-negative participants were eligible for secondary prevention. Of HIV-positive individuals 57% at high cardiovascular risk and 42% of HIV-positive individuals eligible for secondary prevention had systolic blood pressures above guideline-recommended thresholds. Cholesterol levels were above guideline-recommended thresholds in 81% of HIV-positive individuals at high cardiovascular risk and 57% of HIV-positive individuals eligible for secondary prevention. No statistically significant differences were observed between HIV-positive and HIV-negative participants regarding achievement of targets, except for glycaemic control (glycated haemoglobin ≤ 53 mmol/mol) among individuals using diabetes medication (90% vs 50%, p = 0.017) and antiplatelet/anticoagulant use for secondary prevention (85% vs 63%, p = 0.045), which were both superior among HIV-positive participants. Conclusions Cardiovascular risk management is suboptimal in both HIV-positive and HIV-negative individuals and should be improved.

AB - Background We aimed to identify the prevalence of cardiovascular risk factors, and investigate preventive cardiovascular medication use and achievement of targets as per Dutch cardiovascular risk management guidelines among human immunodeficiency virus (HIV)-positive and HIV-negative individuals. Design The design was a cross-sectional analysis within an ongoing cohort study. Methods Data on medication use and cardiovascular disease prevalence were available for 528 HIV-positive and 521 HIV-negative participants. We identified cardiovascular risk factors and applied cardiovascular risk management guidelines, mainly focusing on individuals eligible for (a) primary prevention because of high a priori cardiovascular risk, or for (b) secondary prevention. Results One hundred and three (20%) HIV-positive and 77 (15%) HIV-negative participants were classified as having high cardiovascular risk; 53 (10%) HIV-positive and 27 (5%) HIV-negative participants were eligible for secondary prevention. Of HIV-positive individuals 57% at high cardiovascular risk and 42% of HIV-positive individuals eligible for secondary prevention had systolic blood pressures above guideline-recommended thresholds. Cholesterol levels were above guideline-recommended thresholds in 81% of HIV-positive individuals at high cardiovascular risk and 57% of HIV-positive individuals eligible for secondary prevention. No statistically significant differences were observed between HIV-positive and HIV-negative participants regarding achievement of targets, except for glycaemic control (glycated haemoglobin ≤ 53 mmol/mol) among individuals using diabetes medication (90% vs 50%, p = 0.017) and antiplatelet/anticoagulant use for secondary prevention (85% vs 63%, p = 0.045), which were both superior among HIV-positive participants. Conclusions Cardiovascular risk management is suboptimal in both HIV-positive and HIV-negative individuals and should be improved.

KW - Human immunodeficiency virus

KW - cardiovascular disease

KW - dyslipidaemia

KW - hypertension

KW - prevention

UR - https://www.scopus.com/pages/publications/85025078893

U2 - 10.1177/2047487317714350

DO - 10.1177/2047487317714350

M3 - Article

SN - 2047-4873

VL - 24

SP - 1297

EP - 1307

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

IS - 12

ER -

Suboptimal primary and secondary cardiovascular disease prevention in HIV-positive individuals on antiretroviral therapy

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