HIV increases cardiovascular disease risk, according to a recent study presented by the National Institutes of Health at the 2024 Conference on Retroviruses and Opportunistic Infections in Denver.
Takeaways
- A recent study presented by the National Institutes of Health highlights that individuals with HIV face an increased risk of cardiovascular diseases.
- The REPRIEVE trial examined the effectiveness of pitavastatin, a cholesterol-lowering drug, in reducing major cardiovascular events such as heart attacks and strokes among patients with HIV.
- The REPRIEVE trial involved 7,769 HIV patients aged 40 to 75, with a diverse range of races and genders represented among the participants.
- Certain subgroups, including those in high-income countries, Black individuals, and cis women, had increased cardiovascular event risks, indicating the importance of tailored approaches to managing cardiovascular health in HIV patients.
- Current tools for assessing cardiovascular risk may underestimate the risk in these populations, necessitating updates to provide optimal care.
The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) trial was a large clinical trial evaluating whether a cholesterol-lowering drug known as pitavastatin is effective at reducing the risk of major cardiovascular events such as heart attacks and strokes in patients with HIV.
Major cardiovascular event incidence was evaluated in patients not receiving pitavastatin or other statins. Incidence in these patients was compared to incidence predicted by standard estimates, which was based on the American College of Cardiology and American Heart Association’s Pooled Cohort Risk Equations score.
There were 7,769 patients aged 40 to 75 years with HIV included in the REPRIEVE trial. Diversity in race and gender was reported among these participants. A primary measure of a 35% reduced risk of major cardiovascular events when taking pitavastatin calcium vs placebo was reported.
Many subgroups of patients had differing rates of cardiovascular events when compared to predicted rates. This included a 2-fold increased risk of major adverse cardiovascular events in patients with HIV vs those without HIV.
Higher rates of cardiovascular events were reported in high income countries, with a 2.5-fold increased risk reported among cis women. Black participants also had increased cardiovascular event risk, with the rate increased by over 50% in these patients.
Additionally, the risk of experiencing a first major adverse cardiovascular even was increased in patients with HIV from high-income countries, Black, aged over 50 years, with hypertension or family history of early cardiovascular disease onset, current or former smokers, or with a detectable HIV viral load.
Current tools used to measure cardiovascular event risk may also underestimate the risk in certain patients with HIV. Investigators recommended tools be updated to provide high-quality care among the diverse population of patients with HIV.
Reference
Tools underestimate cardiovascular event risk in people with HIV. National Institutes of Health. March 4, 2024. Accessed March 4, 2024. https://www.nih.gov/news-events/news-releases/tools-underestimate-cardiovascular-event-risk-people-hiv
