title: HIV infection and cardiovascular disease in women.
abstract: BACKGROUND
  HIV infection is associated with increased risk of cardiovascular disease (CVD) in men. Whether HIV is an independent risk factor for CVD in women has not yet been established.
  
  
  RESULTS
  We analyzed data from the Veterans Aging Cohort Study on 2187 women (32% HIV infected [HIV(+)]) who were free of CVD at baseline. Participants were followed from their first clinical encounter on or after April 01, 2003 until a CVD event, death, or the last follow-up date (December 31, 2009). The primary outcome was CVD (acute myocardial infarction [AMI], unstable angina, ischemic stroke, and heart failure). CVD events were defined using clinical data, International Classification of Diseases, Ninth Revision, Clinical Modification codes, and/or death certificate data. We used Cox proportional hazards models to assess the association between HIV and incident CVD, adjusting for age, race/ethnicity, lipids, smoking, blood pressure, diabetes, renal disease, obesity, hepatitis C, and substance use/abuse. Median follow-up time was 6.0 years. Mean age at baseline of HIV(+) and HIV uninfected (HIV(-)) women was 44.0 versus 43.2 years (P<0.05). Median time to CVD event was 3.1 versus 3.7 years (P=0.11). There were 86 incident CVD events (53%, HIV(+)): AMI, 13%; unstable angina, 8%; ischemic stroke, 22%; and heart failure, 57%. Incident CVD/1000 person-years was significantly higher among HIV(+) (13.5; 95% confidence interval [CI]=10.1, 18.1) than HIV(-) women (5.3; 95% CI=3.9, 7.3; P<0.001). HIV(+) women had an increased risk of CVD, compared to HIV(-) (hazard ratio=2.8; 95% CI=1.7, 4.6; P<0.001).
  
  
  CONCLUSIONS
  HIV is associated with an increased risk of CVD in women.
authors.affiliation: Yale School of Nursing, West Haven, CT (J.A.W.).
authors.forename: Julie A
authors.initials: JA
authors.lastname: Womack
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.) University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (C.C.H.C., C.A.).
authors.forename: Chung-Chou H
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Yale University School of Medicine, New Haven, CT (K.A.S.A., A.C.J., J.S.).
authors.forename: Kaku A
authors.initials: KA
authors.lastname: So-Armah
authors.affiliation: University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (C.C.H.C., C.A.).
authors.forename: Charles
authors.initials: C
authors.lastname: Alcorn
authors.affiliation: University of Minnesota Department of Medicine, Hennepin County Medical Center, Minneapolis, MN (J.V.B.).
authors.forename: Jason V
authors.initials: JV
authors.lastname: Baker
authors.affiliation: James J. Peters VA Medical Center, Bronx, NY (S.T.B.) Icahn School of Medicine at Mt. Sinai, New York, NY (S.T.B.).
authors.forename: Sheldon T
authors.initials: ST
authors.lastname: Brown
authors.affiliation: Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, CA (M.B.).
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.) VA Pittsburgh Healthcare System, Pittsburgh, PA (A.A.B.) Sheikh Khalifa Medical City, Abu Dhabi, UAE (A.A.B.).
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
authors.affiliation: VA Medical Center and George Washington University School of Medicine, Washington, DC (C.G.).
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gibert
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, CA (M.B.G., D.L., A.W.) VA Greater Los Angeles Health Care System, Los Angeles, CA (M.B.G., D.L., A.W.).
authors.forename: Matthew Bidwell
authors.initials: MB
authors.lastname: Goetz
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD (J.G., S.G.).
authors.forename: John
authors.initials: J
authors.lastname: Gottdiener
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD (J.G., S.G.).
authors.forename: Stephen
authors.initials: S
authors.lastname: Gottlieb
authors.affiliation: Yale University School of Medicine, New Haven, CT (K.A.S.A., A.C.J., J.S.) Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT (A.C.J., K.M.G., J.S., M.S.).
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, CA (M.B.G., D.L., A.W.) VA Greater Los Angeles Health Care System, Los Angeles, CA (M.B.G., D.L., A.W.).
authors.forename: David
authors.initials: D
authors.lastname: Leaf
authors.affiliation: Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT (A.C.J., K.M.G., J.S., M.S.).
authors.forename: Kathleen
authors.initials: K
authors.lastname: McGinnis
authors.affiliation: Emory University School of Medicine and Atlanta VA Medical Center, Atlanta, GA (D.R.).
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.affiliation: Infectious Diseases Section, Michael E. DeBakey VA Medical Center, and Department of Medicine, Baylor College of Medicine, Houston, TX (M.C.R.B.).
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.affiliation: Yale University School of Medicine, New Haven, CT (K.A.S.A., A.C.J., J.S.) Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT (A.C.J., K.M.G., J.S., M.S.).
authors.forename: Jason
authors.initials: J
authors.lastname: Sico
authors.affiliation: Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, West Haven, CT (A.C.J., K.M.G., J.S., M.S.).
authors.forename: Melissa
authors.initials: M
authors.lastname: Skanderson
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.).
authors.forename: Hilary
authors.initials: H
authors.lastname: Tindle
authors.affiliation: University of Vermont College of Medicine, Burlington, VT (R.P.T.).
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, CA (M.B.G., D.L., A.W.) VA Greater Los Angeles Health Care System, Los Angeles, CA (M.B.G., D.L., A.W.).
authors.forename: Alberta
authors.initials: A
authors.lastname: Warner
authors.affiliation: Vanderbilt University School of Medicine, Nashville, TN (M.S.F.).
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Freiberg
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014584:User-Computer Interface; D014728:Veterans / Q000706:statistics & numerical data
keywords: AIDS; CVD risk factors; Women