title: Screening and management of cardiovascular disease in Australian adults with HIV infection.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is common in HIV infection. With no specific Australian guidelines for the screening and management of CVD in HIV-infected patients, best clinical practice is based on data from the general population. We evaluated adherence to these recommendations by primary care physicians who treat HIV-infected patients.
  
  
  METHODS
  Primary care physicians with a special interest in HIV infection were asked to complete details for at least 10 consecutive patient encounters using structured online forms. This included management practices pertaining to blood pressure (BP), blood glucose, electrocardiogram, lipid profile and CVD risk calculations. We assessed overall adherence to screening and follow-up recommendations as suggested by national and international guidelines.
  
  
  RESULTS
  Between May 2009 and March 2010, 43 physicians from 25 centres completed reporting for 530 HIV-infected patients, of whom 93% were male, 25% were aged 41-50 years and 83% were treated with antiretrovirals. Risk factors for CVD were common and included smoking (38%), hyperlipidaemia (16%) and hypertension (28%). In men aged >40 years and women aged >50 years without evidence of ischaemic heart disease, only 14% received a CVD risk assessment. Lipid and BP assessments were performed in 87% and 88% of patients, respectively.
  
  
  CONCLUSIONS
  This Australian audit provides unique information on the characteristics and management of HIV and CVD in clinical practice. We have found a high burden of risk for CVD in HIV-infected Australians, but current screening and management practices in these patients fall short of contemporary guidelines.
authors.affiliation: Albion Centre, Sydney, NSW 2010, Australia.
authors.forename: Derek
authors.initials: D
authors.lastname: Chan
authors.forename: David
authors.initials: D
authors.lastname: Gracey
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.forename: Deborah
authors.initials: D
authors.lastname: Richards
authors.forename: Brad
authors.initials: B
authors.lastname: Dalton
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011320:Primary Health Care; D018570:Risk Assessment