Prevalence, treatment, and control of dyslipidemia and hypertension in 4278 HIV outpatients.

Abstract

Patients with HIV may have an increased risk of cardiovascular disease (CVD). The objective of this study was to determine the prevalence, treatment, and control of low-density lipoprotein cholesterol (LDL-C) dyslipidemia and hypertension in a population of HIV-infected patients at an HIV/AIDS clinic in New York City. Review of electronic medical records of 4278 HIV-infected patients aged 20 years or older in a racially and ethnically diverse urban HIV/AIDS clinic based in a large tertiary hospital and designated New York State AIDS Center that provides comprehensive care. LDL-C dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III goals and hypertension according to Joint National Committee VII criteria. The prevalence of LDL-C dyslipidemia was 35%. Ninety percent of patients with LDL-C dyslipidemia were treated and 75% of those treated were at goal. Patients in high-risk groups (56%), including known coronary heart disease (57%) or coronary heart disease equivalents (62%), were less likely to be at LDL-C goal. The prevalence of hypertension was 43%. Seventy-five percent of patients with hypertension were treated but only 57% overall were at goal. Although most patients with HIV and LDL-C dyslipidemia or hypertension are treated, a significant percentage did not have adequate control of these risk factors. As patients with HIV are at higher risk for CVD and living to an age where CVD is more common, it will be important to identify ways to better manage and control CVD risk factors in this patient population. A comprehensive care model such as our setting may serve as an option.