Short-term and long-term cardiovascular risk, metabolic syndrome and HIV in Tanzania

Heart. 2016 Aug 1;102(15):1200-5. doi: 10.1136/heartjnl-2015-309026. Epub 2016 Apr 22.


Objective: To compare short-term and long-term cardiovascular disease (CVD) risk scores and prevalence of metabolic syndrome in HIV-infected adults receiving and not receiving antiretroviral therapy (ART) to HIV-negative controls.

Methods: A cross-sectional study including 151 HIV-infected, ART-naive, 150 HIV-infected on ART and 153 HIV-negative adults. Traditional cardiovascular risk factors were determined by standard investigations. The primary outcome was American College of Cardiology/American Heart Association Atherosclerotic CVD (ASCVD) Risk Estimator lifetime CVD risk score. Secondary outcomes were ASCVD 10-year risk, Framingham risk scores, statin indication and metabolic syndrome.

Results: Compared with HIV-negative controls, more HIV-infected adults on ART were classified as high lifetime CVD risk (34.7% vs 17.0%, p<0.001) although 10-year risk scores were similar, a trend which was similar across multiple CVD risk models. In addition, HIV-infected adults on ART had a higher prevalence of metabolic syndrome versus HIV-negative controls (21.3% vs 7.8%, p=0.008), with two common clusters of risk factors. More than one-quarter (28.7%) of HIV-infected Tanzanian adults on ART meet criteria for statin initiation.

Conclusions: HIV-infected ART-treated individuals have high lifetime cardiovascular risk, and this risk seems to develop rapidly in the first 3-4 years of ART as does the development of clusters of metabolic syndrome criteria. These data identify a new subgroup of low short-term/high-lifetime risk HIV-infected individuals on ART who do not currently meet criteria for CVD risk factor modification but require further study.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / drug therapy
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Tanzania / epidemiology
  • Time Factors


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors