Open AccessGender differences in cardiovascular risk factors in HIV‐infected patients on antiretroviral therapy: data from the Spanish Coronator study
Author(s) -
Santos J,
Olalla J,
Pérez Elías M,
Miralles C,
Lozano F,
Iribarren J,
Masiá M,
Domingo P,
Bernardino J,
Estrada V
Publication year - 2012
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.15.6.18131
Subject(s) - medicine , abdominal obesity , framingham risk score , population , antiretroviral therapy , obesity , men who have sex with men , demography , human immunodeficiency virus (hiv) , family history , disease , viral load , metabolic syndrome , immunology , environmental health , syphilis , sociology
Purpose HIV‐infected patients present an increased cardiovascular risk (CVR) of multifactorial origin, usually lower in women than in men. Information by gender about prevalence of modifiable risk factors is scarce. Methods Coronator is a cross‐sectional survey of a representative sample of HIV‐infected patients on ART within 10 hospitals across Spain in 2011. Variables include sociodemographics, CVR factors and 10‐year CV disease risk estimation (Regicor: Framingham score adapted to the Spanish population). Results We included 860 patients (76.3% male) with no history of CVD. Median age 45.6 years; 84.1% were Spaniards; 29.9% women were IDUs. Median time since HIV diagnosis for men and women was 10 and 13 years (p=0.001), 28% had an AIDS diagnosis. Median CD4 cell count was 596 cells/mm 3 , 88% had undetectable viral load. Median time on ART was 91 and 108 months (p=0.017). There was a family history of early CVD in 113 men (17.9%) and 41 women (20.6%). Classical CVR factors are described in the table. Median (IQR) Regicor Score was 3% (2‐5) for men and 2% (1–3) for women (p=0.000), and the proportion of subjects with mid‐high risk (>5%) was 26.1% for men and 9.4% for women (p=0.000). Conclusions In this population of HIV‐infected patients, women have lower cardiovascular risk than men, partly due to higher levels of HDL cholesterol. Of note is the high frequency of smoking, abdominal obesity and sedentary lifestyle in our population.Men n=656 Women n=204 P valueAge (men >55 y, women >65 y) n (%) 72 (11.0) 8 (3.9) 0.002 Smoking, n (%) 358 (54.9) 110 (53.9) 0.805 Waist >102 cm (men), >88 cm (women), n (%) 84 (12.9) 55 (27.4) 0.000 Hypertension, n (%) 208 (31.8) 45 (22.2) 0.009 Diabetes, n (%) 50 (7.8) 11 (5.4) 0.262 Total cholesterol>240 mg/dL, n (%) 63 (9.8) 24 (11.9) 0.399 HDL‐cholesterol <40 mg/dL, n (%) 239 (37.5) 34 (16.8) 0.000 Total cholesterol/HDL >5, n (%) 197 (30.9) 23 (11.4) 0.000 Physical inactivity, n (%) 324 (56.7) 108 (69.2) 0.005