Abstract 10667: Psychosocial Predictors of Cardiovascular Disease Risk Among Older Persons with HIV

Abstract

Introduction: People with HIV (PWH) are twice as likely to develop cardiovascular disease (CVD) at an average of 8 years earlier than persons without HIV independent of known risk factors; as a result, CVD is a major cause of morbidity and mortality in older PWH. Traditional CVD risk calculators do not reliably predict CVD in PWH. Psychosocial factors have been linked to higher rates of CVD in persons with and without HIV and PWH report higher rates of depression. Hypothesis: Clinical and psychosocial predictors were examined for associations with CVD risk scores among PWH. Methods: Clinical measures including blood pressure, cholesterol, CVD medications, smoking status and comorbidities were extracted from electronic medical records of PWH aged 40 years and older. CVD risk scores were calculated using the Atherosclerotic Cardiovascular Disease (ASCVD) calculator. Psychosocial factors were measured by the Perceived Stress Scale, the Internalized HIV Stigma Scale, Beck’s Depression Index-II, and the PROMIS-Sleep Disturbance and Emotional Support Scales. Multiple linear regression was used to examine associations between CVD risk scores and clinical/psychosocial variables. Covariates included age, gender, and race, and education. Results: Of the n=90 participants, the majority were male (n=52, 57.8%) and African American (n=77, 85.6%). Overall, the average CVD risk score for the total sample was low (mean 10.6, SD 7.0). Older age, which was significantly associated with higher CVD risk scores, is included in the ASCVD calculation, therefore, age was excluded from the model. Psychosocial variables and other covariates were examined with CVD risk scores and higher depressive symptom scores explained 6% of the variance (adj r 2 =0.061, p=0.01). No additional clinical or psychosocial variables were significant. Conclusions: The low ASCVD risk scores suggests that other factors such as chronic inflammation may contribute to higher CVD rates in this population and merits further research. Older age and higher depressive symptoms were significantly associated with CVD greater risk which may be bidirectional. Screening for depressive symptoms during routine clinic visits may provide a window of opportunity to reduce CVD burden in older PWH.