The cardiovascular risk management for people living with HIV in Europe: how well are we doing?

M Shahmanesh, A Schultze, F Burns, O Kirk, J Lundgren, C Mussini, C Pedersen, S De Wit, G Kutsyna, A Mocroft, EuroSIDA in EuroCoord

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: HIV has become a chronic condition associated with comorbidities. We investigatedcardiovascular (CV)risk and risk modification in a European HIV-Cohort.

METHODS: EuroSIDA patients (from 1/1/2000) for whom CV-risk could be calculated (D:A:D risk equation) were included in the analysis. Moderate to high risk was defined as 5-year CV risk >5% and risk modification as two measurements meeting the European AIDSClinical Society guidelines. Factors associated with risk development and modifications were investigated using Poisson regression.

RESULTS: Of 8762 individuals, 32.1% were hypertensive, 45.0% had high cholesterol, 47.4% were current smokers, and 27.1% were overweight. 1504 (17.2%) had a 5-year CV-risk of > 5%. Of 7258 individuals with a 5-year risk <5%, 1905 (26.2%) developed CV-risk> 5%, (6.53/100 person-years). These patients were more likely to be older, men, living in East Europe, with traditional CV-risk factors. Men who have sex with men, with longer exposure to antiretroviral therapy,low CD4 nadir, higher current CD4, and prior AIDs events were more likely to develop CV-risk. Those on antihypertensive treatment and living in central Europe wereless likely to develop CV-risk. Of those clinically indicated for risk modification, 1205/2077(58.0%) successfully modified BP; 1283/3919(32.8%) stopped smoking; 277/1394(19.9%) modified cholesterol and 543/2163(25.1%) reduced their BMI. There was variation in modification of individual risk factors, by gender, age, HIV related factors, and region of follow-up. Risk modification for BP and smoking improved over time (p < 0.001).

CONCLUSION: CV-risk was common. More than half modified their CV risk and this improved over time.

OriginalsprogEngelsk
TidsskriftAIDS
Vol/bind30
Udgave nummer16
Sider (fra-til)2505-2518
ISSN0269-9370
DOI
StatusUdgivet - 2016

Fingeraftryk

HIV
Smoking
Comorbidity
Guidelines

Citer dette

Shahmanesh, M., Schultze, A., Burns, F., Kirk, O., Lundgren, J., Mussini, C., ... EuroSIDA in EuroCoord (2016). The cardiovascular risk management for people living with HIV in Europe: how well are we doing? AIDS, 30(16), 2505-2518. https://doi.org/10.1097/QAD.0000000000001207
Shahmanesh, M ; Schultze, A ; Burns, F ; Kirk, O ; Lundgren, J ; Mussini, C ; Pedersen, C ; De Wit, S ; Kutsyna, G ; Mocroft, A ; EuroSIDA in EuroCoord. / The cardiovascular risk management for people living with HIV in Europe : how well are we doing?. I: AIDS. 2016 ; Bind 30, Nr. 16. s. 2505-2518.
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title = "The cardiovascular risk management for people living with HIV in Europe: how well are we doing?",
abstract = "OBJECTIVES: HIV has become a chronic condition associated with comorbidities. We investigatedcardiovascular (CV)risk and risk modification in a European HIV-Cohort.METHODS: EuroSIDA patients (from 1/1/2000) for whom CV-risk could be calculated (D:A:D risk equation) were included in the analysis. Moderate to high risk was defined as 5-year CV risk >5{\%} and risk modification as two measurements meeting the European AIDSClinical Society guidelines. Factors associated with risk development and modifications were investigated using Poisson regression.RESULTS: Of 8762 individuals, 32.1{\%} were hypertensive, 45.0{\%} had high cholesterol, 47.4{\%} were current smokers, and 27.1{\%} were overweight. 1504 (17.2{\%}) had a 5-year CV-risk of > 5{\%}. Of 7258 individuals with a 5-year risk <5{\%}, 1905 (26.2{\%}) developed CV-risk> 5{\%}, (6.53/100 person-years). These patients were more likely to be older, men, living in East Europe, with traditional CV-risk factors. Men who have sex with men, with longer exposure to antiretroviral therapy,low CD4 nadir, higher current CD4, and prior AIDs events were more likely to develop CV-risk. Those on antihypertensive treatment and living in central Europe wereless likely to develop CV-risk. Of those clinically indicated for risk modification, 1205/2077(58.0{\%}) successfully modified BP; 1283/3919(32.8{\%}) stopped smoking; 277/1394(19.9{\%}) modified cholesterol and 543/2163(25.1{\%}) reduced their BMI. There was variation in modification of individual risk factors, by gender, age, HIV related factors, and region of follow-up. Risk modification for BP and smoking improved over time (p < 0.001).CONCLUSION: CV-risk was common. More than half modified their CV risk and this improved over time.",
author = "M Shahmanesh and A Schultze and F Burns and O Kirk and J Lundgren and C Mussini and C Pedersen and {De Wit}, S and G Kutsyna and A Mocroft and {EuroSIDA in EuroCoord}",
year = "2016",
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language = "English",
volume = "30",
pages = "2505--2518",
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Shahmanesh, M, Schultze, A, Burns, F, Kirk, O, Lundgren, J, Mussini, C, Pedersen, C, De Wit, S, Kutsyna, G, Mocroft, A & EuroSIDA in EuroCoord 2016, 'The cardiovascular risk management for people living with HIV in Europe: how well are we doing?', AIDS, bind 30, nr. 16, s. 2505-2518. https://doi.org/10.1097/QAD.0000000000001207

The cardiovascular risk management for people living with HIV in Europe : how well are we doing? / Shahmanesh, M; Schultze, A; Burns, F; Kirk, O; Lundgren, J; Mussini, C; Pedersen, C; De Wit, S; Kutsyna, G; Mocroft, A; EuroSIDA in EuroCoord.

I: AIDS, Bind 30, Nr. 16, 2016, s. 2505-2518.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - The cardiovascular risk management for people living with HIV in Europe

T2 - how well are we doing?

AU - Shahmanesh, M

AU - Schultze, A

AU - Burns, F

AU - Kirk, O

AU - Lundgren, J

AU - Mussini, C

AU - Pedersen, C

AU - De Wit, S

AU - Kutsyna, G

AU - Mocroft, A

AU - EuroSIDA in EuroCoord

PY - 2016

Y1 - 2016

N2 - OBJECTIVES: HIV has become a chronic condition associated with comorbidities. We investigatedcardiovascular (CV)risk and risk modification in a European HIV-Cohort.METHODS: EuroSIDA patients (from 1/1/2000) for whom CV-risk could be calculated (D:A:D risk equation) were included in the analysis. Moderate to high risk was defined as 5-year CV risk >5% and risk modification as two measurements meeting the European AIDSClinical Society guidelines. Factors associated with risk development and modifications were investigated using Poisson regression.RESULTS: Of 8762 individuals, 32.1% were hypertensive, 45.0% had high cholesterol, 47.4% were current smokers, and 27.1% were overweight. 1504 (17.2%) had a 5-year CV-risk of > 5%. Of 7258 individuals with a 5-year risk <5%, 1905 (26.2%) developed CV-risk> 5%, (6.53/100 person-years). These patients were more likely to be older, men, living in East Europe, with traditional CV-risk factors. Men who have sex with men, with longer exposure to antiretroviral therapy,low CD4 nadir, higher current CD4, and prior AIDs events were more likely to develop CV-risk. Those on antihypertensive treatment and living in central Europe wereless likely to develop CV-risk. Of those clinically indicated for risk modification, 1205/2077(58.0%) successfully modified BP; 1283/3919(32.8%) stopped smoking; 277/1394(19.9%) modified cholesterol and 543/2163(25.1%) reduced their BMI. There was variation in modification of individual risk factors, by gender, age, HIV related factors, and region of follow-up. Risk modification for BP and smoking improved over time (p < 0.001).CONCLUSION: CV-risk was common. More than half modified their CV risk and this improved over time.

AB - OBJECTIVES: HIV has become a chronic condition associated with comorbidities. We investigatedcardiovascular (CV)risk and risk modification in a European HIV-Cohort.METHODS: EuroSIDA patients (from 1/1/2000) for whom CV-risk could be calculated (D:A:D risk equation) were included in the analysis. Moderate to high risk was defined as 5-year CV risk >5% and risk modification as two measurements meeting the European AIDSClinical Society guidelines. Factors associated with risk development and modifications were investigated using Poisson regression.RESULTS: Of 8762 individuals, 32.1% were hypertensive, 45.0% had high cholesterol, 47.4% were current smokers, and 27.1% were overweight. 1504 (17.2%) had a 5-year CV-risk of > 5%. Of 7258 individuals with a 5-year risk <5%, 1905 (26.2%) developed CV-risk> 5%, (6.53/100 person-years). These patients were more likely to be older, men, living in East Europe, with traditional CV-risk factors. Men who have sex with men, with longer exposure to antiretroviral therapy,low CD4 nadir, higher current CD4, and prior AIDs events were more likely to develop CV-risk. Those on antihypertensive treatment and living in central Europe wereless likely to develop CV-risk. Of those clinically indicated for risk modification, 1205/2077(58.0%) successfully modified BP; 1283/3919(32.8%) stopped smoking; 277/1394(19.9%) modified cholesterol and 543/2163(25.1%) reduced their BMI. There was variation in modification of individual risk factors, by gender, age, HIV related factors, and region of follow-up. Risk modification for BP and smoking improved over time (p < 0.001).CONCLUSION: CV-risk was common. More than half modified their CV risk and this improved over time.

U2 - 10.1097/QAD.0000000000001207

DO - 10.1097/QAD.0000000000001207

M3 - Journal article

C2 - 27456984

VL - 30

SP - 2505

EP - 2518

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 16

ER -

Shahmanesh M, Schultze A, Burns F, Kirk O, Lundgren J, Mussini C et al. The cardiovascular risk management for people living with HIV in Europe: how well are we doing? AIDS. 2016;30(16):2505-2518. https://doi.org/10.1097/QAD.0000000000001207