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May 1, 2008
Rate of Heart Attacks Stable Despite Increased Risk
Though the number of people with HIV who have risk factors for heart disease and stroke is growing, effective management of those risk factors is keeping the number of heart attacks stable, say the authors of a study published in the April 1 issue of Clinical Infectious Diseases.
Age is a prominent risk factor for heart disease and stroke, and people’s risk increases with age. Thus, as the population of people with HIV gets older, the proportion of them at risk for heart disease and strokes also increases. What remained unknown, however, was whether heart attacks are becoming more common among people with HIV, given that many are now living longer due to the effectiveness of antiretroviral therapy.
The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study Group consists of scientists who have been evaluating 33,389 people living with HIV from 11 cohorts around the world since 1999. The study was designed to follow large groups of people living with HIV over a long period of time to look for rates of cardiovascular disease and other complications from both HIV and HIV treatments. For this most recent analysis, the D:A:D Study Group divided its medical records into six consecutive time periods, ranging from 1999 to 2006.
They found that, over time, the proportion of people for whom age was a risk factor increased from 25 to 37 percent, reflecting the increasing number of study participants entering their late 40s and 50s. The percentage of people with other conditions that raise the risk of heart disease, such as diabetes and high blood pressure, also increased over time. Conversely, the percentage of people who said there were currently smoking decreased from 47 to 38 percent, and the number of people taking treatments to lower cholesterol and triglycerides increased from 6 to 15 percent, likely reflecting efforts by patients and their physicians to minimize heart disease and stroke risk.
The D:A:D researchers hypothesize that such efforts are a significant reason why the rate of heart attacks remained stable over time despite an increase in the proportion of people at risk for heart disease and stroke.
