Use of Preventive Measures for Cardiovascular Disease in People With HIV

Abstract

Background: Data on uptake of preventive measures for cardiovascular disease (CVD) in people with HIV are limited.

Methods: We determined the annual prevalence (2012-2021) of CVD preventive measures use for RESPOND participants with a very high (>10%) estimated D:A:D 10-year CVD risk who were eligible for each specific measure evaluated. We used binomial regression to assess factors associated with each preventative measure uptake.

Results: Between 2012 and 2021, the crude proportion of >10% estimated 10-year CVD risk individuals increased from 32.4% (n = 4272) to 52.1% (n = 5298). At the end of follow-up, among very high-risk individuals, 67.4% (1552/2303) with hypertension used antihypertensives, 55.9% (1562/2792) with dyslipidemia lipid-lowering drugs (LLDs), and 7.4% (159/2149) smokers ceased smoking, without significant changes over time. Conversely, a smaller proportion of individuals with diabetes received antidiabetics in later years (2012-2013: 60.3% [388/643] versus 2019-2020: 57.2% [459/803], global P = .0028). Use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) in those with hypertension or diabetes slightly declined before increasing again (42.1% [864/2052] versus 43.4% [1123/2585], global P = .0009). Individuals with ongoing viremia or intravenous drug use as HIV exposure group were less likely to cease smoking and use LLDs. Men ≥40 years and women ≥50 were more likely to use antihypertensives, ACEIs/ARBs, antidiabetics, and LLDs. The uptake of preventive measures was similar between sexes/genders.

Conclusions: The increasing proportion of individuals at very high estimated 10-year CVD risk without a corresponding increase in use of preventive measures calls for greater awareness of CVD risk management for people with HIV attending routine clinical care.

Keywords: HIV; cardiovascular disease; cohort.