RT Journal Article
SR Electronic
T1 Cardiovascular risk in an HIV-infected population in India
JF Heart Asia
FD BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association
SP e010893
DO 10.1136/heartasia-2017-010893
VO 9
IS 2
A1 Ivan P Marbaniang
A1 Dileep Kadam
A1 Rohan Suman
A1 Nikhil Gupte
A1 Sonali Salvi
A1 Sandesh Patil
A1 Dhananjay Shere
A1 Prasad Deshpande
A1 Vandana Kulkarni
A1 Andrea Deluca
A1 Amita Gupta
A1 Vidya Mave
YR 2017
UL http://heartasia.bmj.com/content/9/2/e010893.abstract
AB Objective To characterise prevalence of traditional cardiovascular disease (CVD) risk factors, assess CVD risk and examine the effect of simulated interventions on CVD risk among HIV-infected Asian Indians.Methods Cross-sectional data between September 2015 and July 2016 wer used to describe the prevalence of CVD risk factors. Five risk scores (Framingham, Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D), Atherosclerotic Cardiovascular, QRISK2 and Ramathibodi—Electricity Generating Authority of Thailand were used to estimate CVD risk. The effect of seven sensitivity analyses: smoking prevention; diabetes prevention; optimal blood pressure and dyslipidaemia control (total cholesterol, high-density lipoprotein (HDL)); CD4 augmentation and a combination of the scenarios on the median cumulative D:A:D CVD scores were assessed.Results Of 402 enrolled, 56% were women, median age was 40 years (IQR: 35–45 years) and median time-updated CD4 counts were 378 cells/μL (IQR: 246–622). Fifty-five and 28% had ever been screened for hypertension and diabetes, respectively prior to enrolment. The prevalence of diabetes, hypertension, hypercholesterolaemia, low HDL, previous and current smokers were 9%, 22%, 20%, 39%, 14% and 4%, respectively. Thirty-six per cent had intermediate-to-high 5-year CVD risk by D:A:D estimates. Thirty-two per cent were eligible for statin therapy by American College of Cardiology/American Heart Association guidelines; 2% were currently on statins. In sensitivity analyses, diabetes prevention was associated with the highest reduction of CVD risk.Conclusion CVD at younger ages among Asian Indian people living with HIV appear to be an imminent risk for morbidity. Stepping up of preventive services including screening services and prescription of statins are important strategies that must be considered.