[Spectrum of cardiovascular disease in HIV-infected patients].
A large body of evidence indicates that HIV-infected patients, both men and women, as well as adults and children, have a higher risk of developing arteriosclerotic cardiovascular disease. This evidence comes from studies whose main primary variables were the clinical manifestations of arteriosclerotic cardiovascular disease (acute myocardial infarction, silent myocardial ischemia, stroke and peripheral arterial disease) and the distinct markers of premature atherosclerosis and endothelial dysfunction determined in different sites (carotid, coronary or peripheral arteries) and with distinct diagnostic procedures (carotid intimamedia thickening, coronary artery calcification, flow-mediated vasodilation, arterial rigidity, ankle/arm index, etc.). This excess risk of arteriosclerotic cardiovascular disease in HIV-positive patients is clearly associated with the HIV infection per se and with classical cardiovascular risk factors, and, to a lesser extent and less uniformly, with the use of first-generation protease inhibitors. Hypertension, whose association with HIV infection is far less clear, is related to both traditional cardiovascular risk factors and to lipodystrophy.
Lozano
Fernando
F
Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario de Valme, Sevilla, España. fernandolozano@telefonica.net
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003952:Diagnostic Imaging; D004198:Disease Susceptibility; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000139:chemically induced / Q000150:complications; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors