Do Traditional Risk Factors for CVD Play Larger Role in HIV-Positive Premenopausal Women?
More efforts should be focused on reducing traditional CVD risk factors in HIV-positive premenopausal women.
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SAN DIEGO — Traditional risk factors for cardiovascular disease (CVD) appear to be associated with a higher heart disease risk in HIV-positive premenopausal women than the HIV infection itself, according to a poster abstract session presented by lead investigator Ambreen Raza, MD, at IDWeek 2017.
According to Dr Raza, HIV-positive premenopausal women tend to lose the cardioprotective effect of estrogen and “[these women] should be more vigilant in reducing their risk for developing CVD.”
This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) datasets to evaluate specific CVD risk factors among HIV-positive premenopausal women between 1999 and 2014. These risk factors included smoking status, family history of CVD, hemoglobin A1c (HbA1c) and C-reactive protein (CRP) levels, blood pressure, and cholesterol level. In addition, the investigators used the 10-year Framingham risk score in their analysis.
A total of 9635 premenopausal women with no history of prior coronary artery disease were included in the final analysis. Of these women, 25 (0.25%) were HIV seropositive. The investigators found no difference in the specific risk factors of HbA1c, cholesterol, blood pressure, or CRP.
Despite these findings, premenopausal women who tested positive for HIV did have a significantly higher mean Framingham risk score compared with HIV-negative women (2.12 vs 0.95; P <.01). Premenopausal women with HIV were not advised by their doctors to decrease their CVD risk factors; however, significantly more women in the HIV-positive population were told to exercise (28.0 % vs 13.0%; P =.027) and modify their diet (28.0% vs 13.3%; P =.031).
“While HIV is an independent risk factor for developing CVD in women,” Dr Raza noted, “more focus should be on reducing the risk from traditional methods like smoking cessation, diet and lifestyle modification, blood pressure, diabetes, and cholesterol and management.”
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Raza A, Malayala SV. A comparative analysis of cardiovascular risk in HIV sero-positive and sero-negative premenopausal women. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Poster 573.