期刊
JOURNAL OF THE AMERICAN HEART ASSOCIATION
卷 3, 期 5, 页码 -出版社
WILEY-BLACKWELL
DOI: 10.1161/JAHA.114.001035
关键词
AIDS; CVD risk factors; Women
资金
- Yale Center for Clinical Investigation and the Clinical and Translational Science Award from the National Center for Research Resources of the National Institutes of Health (NIH) [UL1 RR024139]
- National Institute of Nursing Research of the National Institutes of Health (NIH) [K01 NR013437]
- National Heart, Lung and Blood Institute of the National Institutes of Health (NIH) [HL095136]
- National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH) [AA013566-10, AA020790, AA020794]
Background-HIV infection is associated with increased risk of cardiovascular disease (CVD) in men. Whether HIV is an independent risk factor for CVD in women has not yet been established. Methods and Results-We analyzed data from the Veterans Aging Cohort Study on 2187 women (32% HIV infected [HIV+]) who were free of CVD at baseline. Participants were followed from their first clinical encounter on or after April 01, 2003 until a CVD event, death, or the last follow-up date (December 31, 2009). The primary outcome was CVD (acute myocardial infarction [AMI], unstable angina, ischemic stroke, and heart failure). CVD events were defined using clinical data, International Classification of Diseases, Ninth Revision, Clinical Modification codes, and/or death certificate data. We used Cox proportional hazards models to assess the association between HIV and incident CVD, adjusting for age, race/ethnicity, lipids, smoking, blood pressure, diabetes, renal disease, obesity, hepatitis C, and substance use/abuse. Median follow-up time was 6.0 years. Mean age at baseline of HIV+ and HIV uninfected (HIV-) women was 44.0 versus 43.2 years (P<0.05). Median time to CVD event was 3.1 versus 3.7 years (P=0.11). There were 86 incident CVD events (53%, HIV+): AMI, 13%; unstable angina, 8%; ischemic stroke, 22%; and heart failure, 57%. Incident CVD/1000 person-years was significantly higher among HIV+ (13.5; 95% confidence interval [CI]= 10.1, 18.1) than HIV- women (5.3; 95% CI=3.9, 7.3; P<0.001). HIV+ women had an increased risk of CVD, compared to HIV- (hazard ratio=2.8; 95% CI=1.7, 4.6; P<0.001). Conclusions-HIV is associated with an increased risk of CVD in women.
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