Cardiovascular prevention in HIV patients: results from a successful intervention program.
OBJECTIVE
To analyze the effect of a prevention program on the estimated cardiovascular risk calculated by three risk scores.


METHODS
We prospectively evaluated 87 HIV+patients with elevated cardiovascular risk estimation. Framingham (FRS), PROCAM and National Cholesterol Education Program (ATP-III) were applied. Cardiovascular risk was defined as elevated if >10%. All patients received non-pharmacological (diet, exercise, smoking cessation) and, when appropriate, pharmacological therapy.


RESULTS
Mean age was 52 years, 92% were male, 39.1% were smokers, 70.1% had hypertension, 18.4% had diabetes. All patients were under HAART, 56.3% were receiving protease inhibitors (PI). After 6 months, intervention was associated to significant changes on triglycerides (298+/-242 and 206+/-135 mg/dL, p<0.05), total-cholesterol (224+/-47 and 189+/-38 mg/dL, p<0.001), LDL-cholesterol (129+/-44 and 109+/-30 mg/dL, p<0.001). Frequencies of patients with elevated cardiac risk before and 6 months after intervention were 92% x 27.6% (p<0.0001), 80.5% x 50.6% (p<0.0002), and 25.3% x 14.9% (p=0.12), for FRS, ATP III and PROCAM, respectively.


CONCLUSIONS
An intervention program focused on reduction of traditional risk factors was able to decrease the frequency of patients with HIV infection and elevated cardiovascular risk estimation. FRS showed greater sensitivity than the other scores.
Heart Institute, University of São Paulo Medical School, Sao Paulo, SP, Brazil.
Enéas M O
EM
Lima
Danielle M
DM
Gualandro
Pai C
PC
Yu
Isabela de C B
Ide C
Giuliano
André C
AC
Marques
Daniela
D
Calderaro
Bruno
B
Caramelli
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001794:Blood Pressure; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control* / Q000821:virology; D004032:Diet; D015444:Exercise; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy* / Q000821:virology; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016540:Smoking Cessation; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D008055:Lipids