title: Trends in Nonlipid Cardiovascular Disease Risk Factor Management in the Women's Interagency HIV Study and Association with Adherence to Antiretroviral Therapy.
abstract: Cardiovascular disease (CVD) is increasingly common among women with HIV, but literature on nonlipid CVD risk factor management is lacking. We examined semiannual trends from 2006 to 2014 in hypertension treatment and control (blood pressure <140/90 mmHg), diabetes treatment and control (fasting glucose <130 mg/dL), and smoking quit rates in the Women's Interagency HIV Study. Unadjusted and adjusted Poisson regression models tested time trends and differences between HIV+ and HIV- women. Among antiretroviral therapy (ART) users, we examined the association of ART adherence and virologic suppression with each outcome. We evaluated 1636 HIV+ and 683 HIV- women, with a hypertension prevalence of 40% and 38%, respectively; diabetes prevalence of 21% and 22%; and smoking prevalence of 37% and 48%. Hypertension treatment was higher among HIV+ than HIV- women (77% vs. 67%, p < 0.001) and increased over time with no difference in trend by HIV status. Hypertension control was greater among HIV+ women (56% vs. 43%, p < 0.001) and increased over time among HIV+ but not HIV- women. Diabetes treatment was similar among HIV+ and HIV- women (48% vs. 49%) and increased over time in both groups. Diabetes control was greater among HIV+ women (73% vs. 64%, p = 0.03) and did not change over time. The percent of recent smokers who reported no longer smoking was similar between HIV+ and HIV- women (10% vs. 9%), with no differences over time. Virologic suppression was significantly associated with increased hypertension treatment and greater control. HIV+ women have better control of hypertension and diabetes than HIV- women, but many are still not at target levels.
authors.affiliation: 1 Department of Epidemiology & Population Health, Albert Einstein College of Medicine , Bronx, New York.
authors.forename: David B
authors.initials: DB
authors.lastname: Hanna
authors.affiliation: 1 Department of Epidemiology & Population Health, Albert Einstein College of Medicine , Bronx, New York.
authors.forename: Molly
authors.initials: M
authors.lastname: Jung
authors.affiliation: 1 Department of Epidemiology & Population Health, Albert Einstein College of Medicine , Bronx, New York.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Xue
authors.affiliation: 1 Department of Epidemiology & Population Health, Albert Einstein College of Medicine , Bronx, New York.|2 Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.affiliation: 3 Department of Clinical Pharmacy, University of California-San Francisco , San Francisco, California.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Cocohoba
authors.affiliation: 4 Department of Medicine, John H. Stroger, Jr. Hospital of Cook County , Chicago, Illinois.
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
authors.affiliation: 5 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Golub
authors.affiliation: 3 Department of Clinical Pharmacy, University of California-San Francisco , San Francisco, California.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hessol
authors.affiliation: 6 City of Hope National Medical Center , Duarte, California.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
authors.affiliation: 7 Department of Community Health Sciences, SUNY Downstate Medical Center , Brooklyn, New York.
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Wilson
authors.affiliation: 8 Department of Medicine, Georgetown University Medical Center , Washington, District of Columbia.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Young
authors.affiliation: 1 Department of Epidemiology & Population Health, Albert Einstein College of Medicine , Bronx, New York.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005215:Fasting / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: HIV-1 viral load; antiretroviral therapy; cardiovascular disease; diabetes mellitus; hypertension; smoking