Standardized comparison of cardiovascular risk factors prevalence in Spanish women and men living with HIV and in the general population

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spain’s Ministry of Science and Innovation (Madrid, Spain), co-financed with European Union European Regional Development Funds –ERDF- [CIBERCV CB16/11/00229]; the Health Department of the Generalitat de Catalunya (Barcelona, Spain) through the Agència de Gestió d’Ajuts Universitaris de Recerca de Catalunya (AGAUR) (Barcelona, Spain) [2017SGR222]. OnBehalf DARIOS and VACH investigators Background People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared age-standardized prevalence and management of CV risk factors in PLWH to that of general population in Spain. Methods Blood pressure, lipid, glucose and anthropometric profile were cross-sectionally compared along with treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations by gender. Results We included 39,598 individuals aged 35 to 74 years: 28,360 from the general population cohort and 11,238 from the PLWH cohort. Compared to general population, PLWH had a higher concentration of triglycerides (>35mg/dL in women and >26mg/dL in men), and a higher prevalence of metabolic syndrome (>10% and >7.8%) and diabetes (>8.5% and >5.3%) (Table). The proportion of treated diabetes, dyslipidemia, and hypertension were up to 3-fold lower in both women and men living with HIV than in general population (Table). Conclusions Lipid, gluco-metabolic profiles were significantly worse in PLWH compared to general population. In addition, PLWH were less often treated for diagnosed diabetes, dyslipidemia, and hypertension. CV risk factor standardized prevalence Cardiovascular risk factor WOMEN MEN General population People living with HIV p-Value General population People living with HIV p-Value N = 15,159 N = 2,171 N = 13,201 N = 9,067 Hypertension, % 27.4 (26.7 - 28.0) 24.8 (21.6 - 28.1) 0.136 29.0 (28.2 - 29.7) 22.9 (21.4 - 24.4) <0.001 Treated hypertension, % a 62.7 (60.7 - 64.7) 18.9 (13.5 - 24.4) <0.001 59.3 (57.5 - 61.1) 24.1 (21.0 - 27.1) <0.001 Triglycerides, mg/dL b 99 (99 - 100) 134 (134 - 148) <0.001 122 (121 - 122) 148 (148 - 164) <0.001 Total cholesterol, mg/dL 214 (213 - 215) 207 (199 - 215) 0.111 214 (213 - 216) 195 (191 - 198) <0.001 Treated dyslipidaemia, % c 14.0 (13.5 - 14.6) 7.80 (5.60 - 10.0) <0.001 15.1 (14.5 - 15.7) 7.8 (6.8 - 8.7) <0.001 Glucose, mg/dL 97 (96 - 97) 103 (98 - 107) 0.007 104 (103 - 105) 106 (104 - 109) 0.122 Diabetes, % 10.6 (10.1 - 11.1) 19.1 (16.0 - 22.1) <0.001 15.4 (14.8 - 16.0) 20.7 (19.2 - 22.2) <0.001 Treated diabetes, % d 34.4 (31.5 - 37.2) 12.8 (8.00 - 17.5) <0.001 40.0 (37.1 - 42.9) 16.6 (13.9 - 19.3) <0.001 Metabolic Syndrome, % 20.5 (19.8 - 21.1) 31.1 (25.8 - 36.4) <0.001 27.9 (27.1 - 28.7) 35.7 (33.1 - 38.2) <0.001 Values are expressed as mean (95% confidence interval). a Among patients with history of hypertension. b Mean (95% confidence interval) were obtained with log-transformed values. c Among all cohort participants. d Among patients with history of diabetes. HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol