Cardiovascular risk factors and probability for cardiovascular events in HIV-infected patients - part III: age differences.
OBJECTIVE
In recent years, concerns have been growing about an elevated rate of cardiovascular diseases in HIV-infected patients due to side effects of antiretroviral therapy. The present study analyses the cardiovascular risk profile and the probability of cardiovascular events with regard to the age of HIV-infected patients.


METHODS
Cardiovascular risk factors of 309 HIV-infected adults were analysed. Patients were divided into four groups: 18-30 years (group 1), 31-40 years (group 2), 41-50 years (group 3), > 50 years (group 4). Overall 10-years probability for cardiovascular events was evaluated by the Framingham algorithm.


RESULTS
Differences between the groups were detected in cardiovascular risk factors including changes in lipid- and glucose metabolism. Lipid values increased with elevated age, such as total cholesterol concentration (Mean +/- SEM in group 1 vs. group 4: 4.71 +/- 0.20 to 6.36 +/- 0.21 mmol/L, p < 0.05), LDL-cholesterol concentration (2.86 +/- 0.17 vs. 4.17 +/- 0.21 mmol/L, p < 0.05) and triglyceride concentration (1.56 +/- 0.14 vs. 3.48 +/- 0.40 mmol/L, p < 0.05). HDL-cholesterol concentration did not show a significant difference (1.15 +/- 0.03 mmol/L). Glucose concentration increased with elevated age in HIV-infected patients (5.28 +/- 0.19 vs. 6.46 +/- 0.24 mmHg, p < 0.05), but there was no significant difference in HbA1c - concentration, blood pressure and smoking rate between the groups. The overall 10-years probability for cardiovascular events was higher in group 1 (median: 1.9%) than in group 4 (20.5%; p < 0.01).


CONCLUSIONS
The risk of cardiovascular events is related to the age in HIV-infected patients. Therefore, an increased duration of life due to a more effective antiretroviral therapy will have a significant impact on the rate of cardiovascular events in this patient population. In the future, further increase of cardiovascular events in HIV-infected patients may be expected.
Neumann
Till
T
Department of Cardiology, University of Duisburg-Essen, Medical School, Hufelandstr. 55, D-45122 Essen, Germany. till.neumann@uni-essen.de
Woiwod
T
T
Neumann
A
A
Miller
M
M
Von Birgelen
C
C
Volbracht
L
L
Esser
S
S
Brockmeyer
N
N
Gerken
G
G
Erbel
R
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000465:Algorithms; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology*; D002784:Cholesterol / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006456:Hemoglobinuria / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011336:Probability; D012307:Risk Factors; D012907:Smoking
D019380:Anti-HIV Agents; D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D008055:Lipids