Differences by Sex in Cardiovascular Comorbid Conditions Among Older Adults (Aged 50-64 or ≥65 Years) Receiving Care for Human Immunodeficiency Virus

Clin Infect Dis. 2019 Nov 27;69(12):2091-2100. doi: 10.1093/cid/ciz126.

Abstract

Background: Differences by sex in cardiovascular comorbid conditions among human immunodeficiency virus (HIV)-infected persons aged 50-64 years have been understudied; even fewer data are available for persons aged ≥65 years.

Methods: We used matched interview and medical record abstraction data from the 2009-2012 data cycles of the Medical Monitoring Project, a nationally representative sample of HIV-infected adults in care. We included men and women aged 50-64 and ≥65 years at time of interview. We calculated weighted prevalence estimates and used logistic regression to compute adjusted prevalence differences and 95% confidence intervals (CIs) assessing sex differences in various characteristics and cardiovascular comorbid conditions. Comorbid conditions included overweight/obesity (body mass index ≥25), abnormal total cholesterol level (defined as ≥200 mg/dL), diagnosed diabetes mellitus, or diagnosed hypertension.

Results: Of 7436 participants, 89.5% were aged 50-64 years and 10.4% aged ≥65 years, 75.1% were men, 40.4% (95% CI, 33.5%-47.2%) were non-Hispanic black, 72.0% (70.4%-73.6%) had HIV infection diagnosed ≥10 years earlier. After adjustment for sociodemographic and behavioral factors, women aged 50-64 years were more likely than men to be obese (adjusted prevalence difference, 8.4; 95% CI, 4.4-12.3), have hypertension (3.9; .1-7.6), or have high total cholesterol levels (9.9; 6.2-13.6). Women aged ≥65 years had higher prevalences of diabetes mellitus and high total cholesterol levels than men.

Conclusions: Cardiovascular comorbid conditions were prevalent among older HIV-infected persons in care; disparities existed by sex. Closer monitoring and risk-reduction strategies for cardiovascular comorbid conditions are warranted for older HIV-infected persons, especially older women.

Keywords: HIV; aging; cardiovascular; comorbidity; sex differences.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Delivery of Health Care*
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • HIV Infections / therapy
  • HIV*
  • Healthcare Disparities*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Public Health Surveillance
  • Sex Factors
  • Socioeconomic Factors