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

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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.

Original languageEnglish
JournalAIDS
Volume30
Issue number16
Pages (from-to)2505-2518
ISSN0269-9370
DOIs
Publication statusPublished - 2016

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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?. In: AIDS. 2016 ; Vol. 30, No. 16. pp. 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}",
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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, vol. 30, no. 16, pp. 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.

In: AIDS, Vol. 30, No. 16, 2016, p. 2505-2518.

Research output: Contribution to journalJournal articleResearchpeer-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