Cardiovascular Risk in HIV-Infected and Uninfected Postmenopausal Minority Women: Use of the Framingham Risk Score.
To characterize and compare cardiovascular disease (CVD) risk in HIV-infected and uninfected postmenopausal minority women using the Framingham Risk Score (FRS) as an assessment measure.



A cross-sectional analysis was performed in 152 (109 HIV+, 43 HIV-) subjects from an existing study cohort of postmenopausal Hispanic and African American women. Data necessary to calculate FRS and menopause features were retrieved by retrospective chart review. Bivariate statistics was used to compare CVD risk factors. Multivariable linear regression was used to determine factors associated with FRS in HIV-infected women.



The HIV-infected group was younger, less obese, and with lower rates of diabetes versus controls. In a subset of age-matched participants, median FRS did not differ between groups (14.6 [IQR = 9.1, 21.6] vs. 15.5 [IQR = 12.3, 22.1]; p = 0.73). Fourteen percent of HIV-infected women meeting criteria for the low-risk FRS category (<10%) had a history of CVD, a similar rate as controls. HIV-infected women at intermediate/high CVD risk had higher rates of surgical menopause. According to 2013 clinical guidelines, more than half of HIV-infected women not prescribed statin therapy (52%) were eligible for treatment; however, statin therapy was similarly under-prescribed in uninfected women.



In this study, CVD risk as assessed by the FRS was not significantly different by HIV status. Performance of the FRS may be compromised in postmenopausal HIV-infected minority women. HIV-infected and uninfected women may be undertreated with statin therapy. Large longitudinal cohorts and inclusion of subclinical measures of CVD are necessary to better characterize risk.
1 Columbia University School of Nursing , New York, New York.
Yamnia I
YI
Cortés
1 Columbia University School of Nursing , New York, New York.
Nancy
N
Reame
2 Bronx-Lebanon Hospital Center , Bronx, New York.
Cosmina
C
Zeana
1 Columbia University School of Nursing , New York, New York.
Haomiao
H
Jia
3 Department of Medicine, Mt Sinai St. Luke's and Mt Sinai Roosevelt , New York, New York.
David C
DC
Ferris
4 Department of Medicine, Columbia University College of Physicians and Surgeons , New York, New York.
Elizabeth
E
Shane
4 Department of Medicine, Columbia University College of Physicians and Surgeons , New York, New York.
Michael T
MT
Yin
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D017698:Postmenopause; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Framingham Risk Score; HIV; menopause