The contribution of pre-existing cardiovascular (CV) risk factors to the risk of stroke or heart attack among non-Hodgkin lymphoma (NHL) survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10082-10082
Author(s):  
Talya Salz ◽  
Emily Craig Zabor ◽  
Peter de Nully Brown ◽  
Susanne Oksbjerg Dalton ◽  
Nirupa Jaya Raghunathan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Heart Disease ◽  
Vascular Disease ◽  
Hospital Discharge ◽  
Full Range ◽  
Population Based ◽  
Hospital Discharge Register ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk

10082 Background: Increased risk of myocardial infarction (MI) and cerebrovascular accident (CVA) among NHL survivors is commonly attributed to NHL treatment. The extent to which pre-existing CV risk factors also contribute to increased risk is unknown. We investigated this association among an entire national population of NHL survivors who have a full range of important CV risk factors. Methods: Using Danish population-based registries, we identified all adults diagnosed with primary aggressive NHL from 2000-2010 and followed them for MI and CVA from 9 months after diagnosis through 2012. MI and CVA diagnoses were ascertained from the nationwide Hospital Discharge Register and Cause of Death Register. CV risk factors (hypertension, dyslipidemia, and diabetes), vascular disease, and intrinsic heart disease prevalent at NHL diagnosis were ascertained algorithmically using the National Prescription Register and the Hospital Discharge Register. Cumulative anthracycline dose was coded continuously. Receipt of radiation was coded dichotomously for both chest and neck. Controlling for age, sex, treatment, and CV diseases, we used Cox multivariate regression to test the association between pre-existing CV risk factors and subsequent CVA or MI. Results: Among 2604 patients with NHL, median age was 62, and median follow-up time was 2.4 years. Overall, 131 patients were diagnosed with MI or CVA. Before NHL diagnosis, 40% of patients had at ≥1 CV risk factor, 13% had vascular disease, and 6% had intrinsic heart disease. 90% of the patients were treated with anthracyclines, 9% had received chest radiation, and 15% had received neck radiation. Patients with ≥1 CV risk factor had an increased risk of MI or CVA compared to patients with none (HR = 1.5 [95% CI = 1.1-2.2). Prevalent vascular disease, prevalent intrinsic heart disease, and NHL treatment were not associated with MI or CVA (p’s > 0.05). Conclusions: In a large, well-characterized, and nationally representative cohort of NHL survivors, prevalent CV risk factors were associated with later CVA and MI. To prevent MI and CVA among survivors, decisions about post-treatment monitoring should take into account prevalent CV risk.

Prediagnosis cardiovascular risk and subsequent myocardial infarction (MI) among lymphoma survivors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 7564-7564
Author(s):  
Talya Salz ◽  
Emily Craig Zabor ◽  
Peter de Nully Brown ◽  
Susanne Oksbjerg Dalton ◽  
Nirupa Jaya Raghunathan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Hodgkin Lymphoma ◽  
Hospital Discharge ◽  
Cardiovascular Risk Factor ◽  
Hospital Discharge Register ◽  
Increased Risk ◽  
Lymphoma Survivors

7564 Background: Chest radiation is associated with increased risk of MI among lymphoma survivors. The extent to which pre-existing cardiovascular risk factors also contribute to risk is understudied. We investigated this association among a national population of lymphoma survivors with a full range of cardiovascular risk factors. Methods: Using Danish population-based registries, we identified all adults diagnosed with aggressive non-Hodgkin lymphoma or Hodgkin lymphoma from 2000-2010 and followed them from 1 year after diagnosis through 2016. MI was ascertained from the nationwide Hospital Discharge Register and Cause of Death Register. Cardiovascular risk factors (hypertension, dyslipidemia, and diabetes), vascular disease, and intrinsic heart disease prevalent at lymphoma diagnosis were ascertained algorithmically using the National Prescription Register and the Hospital Discharge Register. Controlling for age, sex, histology, receipt of chest radiation, and prevalent cardiovascular diseases, we used multivariable Cox regression to test the association between pre-existing cardiovascular risk factors and subsequent MI. Results: Among 4246 survivors of lymphoma, median age at diagnosis was 60 (interquartile range 45-70 years); median follow-up was 6.9 years (range 0-16 years). 115 survivors were diagnosed with MI. Before lymphoma diagnosis, 28% of survivors had ≥1 cardiovascular risk factor, and 16% of survivors received chest radiation. In multivariable analysis, survivors who received chest radiation had an increased risk of MI compared to survivors who did not (HR=1.92 [95% CI=1.16-3.17]). Survivors with ≥1 cardiovascular risk factor had an increased risk of MI compared to survivors with none (HR = 2.44 [95% CI=1.65-3.62]). Conclusions: In a large, well-characterized, nationally representative study of contemporarily treated lymphoma survivors, prevalent hypertension, dyslipidemia, and diabetes were associated with later MI. Findings suggest that pre-existing cardiovascular risk factors confer the same amount of MI risk as does chest radiation. To prevent MI among survivors, decisions about post-treatment monitoring should address prevalent cardiovascular risk.

scholarly journals Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study

2015 ◽  
Vol 18 (6) ◽  
pp. 806-811 ◽  
Author(s):  
Yoshie Yokoyama ◽  
Terumi Oda ◽  
Noriyo Nagai ◽  
Masako Sugimoto ◽  
Kenji Mizukami
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Child Maltreatment ◽  
Personal Information ◽  
Population Based ◽  
Multiple Births ◽  
Population Based Study ◽  
Factors Associated ◽  
Increased Risk ◽  
The Relationship

Background: The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Methods: Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. Results: After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Conclusion: Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

scholarly journals Apoprotein(A) Isoforms Risk Factors for Atherogenesis in Esrd Patients on Haemodialysis

2014 ◽  
Vol 68 (1) ◽  
pp. 16-20
Author(s):  
Danica Labudovic ◽  
Katerina Tosheska-Trajkovska ◽  
Sonja Alabakovska
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Renal Disease ◽  
Vascular Disease ◽  
End Stage Renal Disease ◽  
Relative Risks ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Introduction. End-stage renal disease (ESRD) patients undergoing hemodialysis are at an increased risk of arteriosclerotic vascular disease (ASVD). The increased risk is commonly attributed to the traditional risk factors related to ESRD. However, interest for more recent risk factors for ASVD, such as the level of lipoprotein(a) and its specific apoprotein(a) has been promoted. The aim of this paper is to determine whether apo(a) phenotype is a risk factor for arteriosclerotic vascular disease in ESRD patients who are on hemodialysis. Methods. Apo(a) phenotypisation was performed by using the Western Blot Technique of blood samples from 96 end-stage renal disease patients who were undergoing hemodialysis, and from 100 healthy individuals. Results. Frequency distribution of the basic apo(a) isoforms calculated by means of the χ2-test has shown that there was no significant statistical difference in distribution among patients on hemodialysis, and healthy carriers (χ2-0.36, p<0.548-for carriers of single apo(a) isoforms, (χ2-0.10, p<0.7545-for carriers of double apo(a) isoforms). The calculated relative risks have demonstrated that apo(a) phenotype was not a risk factor for ASVD in HD patients. Conclusion. Based on the results obtained, it can be concluded that the apo(a) phenotype is not a risk factor for arteriosclerotic vascular disease in patients undergoing hemodialysis.

scholarly journals Arterial Thrombotic Complications Are Uncommon in Patients without Cardiovascular Risk Factors and Occur at Equivalent Rates in Chronic Myeloid Leukemia (CML) Patients Treated with Imatinib and Nilotinib

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1811-1811 ◽  
Author(s):  
Hesam Hekmatjou ◽  
Gail J. Roboz ◽  
Ellen K. Ritchie ◽  
Sangmin Lee ◽  
Pinkal Desai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Ischemic Heart ◽  
Increased Risk ◽  
Prior Risk

Abstract Arterial thrombosis (AT), including ischemic heart disease, stroke, and peripheral artery occlusive disease (PAOD), have been observed in several studies of CML patients treated with tyrosine kinase inhibitors (TKI’s), most often in patients treated with ponatinib. Reports of AT in patients treated with other TKI’s are based on anecdotal observations and/or studies with relatively short follow-up times and limited data on underlying risk factors. From 1999 to 2014, 408 patients with CML were seen at Weill-Cornell/New York Presbyterian Hospital. Of these, a cohort of 224 patients in chronic phase received ongoing therapy with TKI’s with continuous clinical observation with a median follow-up of 7 years (range 1-15 years). There were 124 (55.4%) men and 100 (44.6%) women with a median age of 52 years (range 21-75 years). Initial therapy with a TKI occurred in 86% whereas 14% had received prior therapy with interferon-alpha and 2% had a prior allogeneic transplant. The initial TKI therapy was imatinib in 82%, nilotinib in 14% and dasatinib in 4%. 49% of patients were treated with only 1 TKI, 21% with 2 TKI’s and 30% with > 2 TKI’s. Over the course of therapy, overall 82% of patients were exposed to imatinib, 33.9% to nilotinib, 25% to dasatinib and 2.2% to ponatinib. Information on pre-treatment cardiovascular risk factors which included; a history of a prior AT, diabetes, hyperlipidemia, hypertension and smoking, were available on all patients. Prior AT occurred in 7.5%; 25% had 1 risk factor and 20.6% had 2 or more risk factors. Overall AT was observed in 7.1% (95% CI = 3.8%, 10.5%) of all patients and there were no deaths associated with AT. Ischemic heart disease occurred in 4.9%, a stroke in 0.4% and PAOD in 1.8%. The median time from start of TKI therapy to development of AT was 7 years (range 4-14). The median age of patients who developed AT was 68 years (range 47-80). AT occurred predominantly in patients with pre-existing risk factors; the incidence was 14.6% in patients with prior risk factors whereas only 1.6% of patients without risk factors developed this complication (p<0.0001). In 16 /224 patients, 17 AT’s occurred; 10 while on treatment with imatinib, 5 on nilotinib, 1 on dasatinib and 2 on ponatinib. By overall TKI exposure, AT occurred in 5.4 % of patients exposed to imatinib 6.6% exposed to nilotinib and 1.8% exposed to dasatinib (p=not significant). Apart from ponatinib, neither the initial TKI used, the overall exposure or length of exposure to TKI’s, or the number of TKI’s administered were associated with an increased risk of AT. These data would suggest that the development of AT is uncommon in patients without prior risk factors and occurs with equal frequency in patients exposed to either imatinib or nilotinib. Additional data are needed to conclusively determine whether treatment with a TKI (excluding ponatinib) is an independent risk factor for the development of AT in CML patients. Importantly, identification of the mechanism(s) associated with TKI-related AT in CML patients are needed to plan preventive measures, particularly in patients with preexisting risk factors. Disclosures Roboz: Novartis: Consultancy; Agios: Consultancy; Celgene: Consultancy; Glaxo SmithKline: Consultancy; Astra Zeneca: Consultancy; Sunesis: Consultancy; Novartis: Consultancy; Teva Oncology: Consultancy; Astex: Consultancy. Allen-Bard:Novartis: Speakers Bureau. Feldman:Novartis: Honoraria, Research Funding, Speakers Bureau; Ariad: Honoraria, Speakers Bureau.

scholarly journals Comparisons of Risk Factors for Abdominal Aortic Aneurysm and Coronary Heart Disease: A Prospective Cohort Study

Angiology ◽  
2020 ◽  
Vol 72 (1) ◽  
pp. 24-31
Author(s):  
Jun Xiao ◽  
Yan Borné ◽  
Xue Bao ◽  
Margaretha Persson ◽  
Anders Gottsäter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Abdominal Aortic Aneurysm ◽  
Heart Disease ◽  
Aortic Aneurysm ◽  
Cox Regression ◽  
Total Leukocyte Count ◽  
Abdominal Aortic ◽  
Increased Risk

Even though abdominal aortic aneurysm (AAA) and coronary heart disease (CHD) are both related to atherosclerosis, there could be important differences in risk factors. Based on Malmö Diet and Cancer Cohort, the incidence of AAA and CHD was followed prospectively. Cox regression was used to calculate the association of each factor with AAA and CHD and hazards ratio were compared using a modified Lunn-McNeil method; 447 participants developed AAA and 3129 developed CHD. After multivariate adjustments, smoking, antihypertensive medications, lipid-lowing medications, systolic and diastolic blood pressures, apolipoprotein (Apo) A1 (inversely), ApoB, ApoB/ApoA1 ratio, total leukocyte count, neutrophil count, and neutrophil to lymphocyte ratio were associated with the risks of both AAA and CHD. When comparing risk factor profiles for the 2 diseases, smoking, diastolic blood pressure, ApoA1, and ApoB/ApoA1 ratio had stronger associations with risk of AAA than with risk of CHD, while diabetes and unmarried status showed increased risk of CHD, but not of AAA (all P values for equal association <.01). The results from this big population study confirm that the risk factor profiles for AAA and CHD show not only many similarities but also several important differences.

scholarly journals Coronary Heart Disease Risk Associated with Primary Isolated Hypertriglyceridemia; a Population‐Based Study

2021 ◽  
Author(s):  
Seyedmohammad Saadatagah ◽  
Ahmed K. Pasha ◽  
Lubna Alhalabi ◽  
Harigopal Sandhyavenu ◽  
Medhat Farwati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Triglyceride Level ◽  
Disease Risk ◽  
Population Based ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Age And Sex

Background Hypertriglyceridemia is associated with increased risk of coronary heart disease but the association is often attributed to concomitant metabolic abnormalities. We investigated the epidemiology of primary isolated hypertriglyceridemia (PIH) and associated cardiovascular risk in a population‐based setting. Methods and Results We identified adults with at least one triglyceride level ≥500 mg/dL between 1998 and 2015 in Olmsted County, Minnesota. We also identified age‐ and sex‐matched controls with triglyceride levels <150 mg/dL. There were 3329 individuals with elevated triglyceride levels; after excluding those with concomitant hypercholesterolemia, a secondary cause of high triglycerides, age <18 years or an incomplete record, 517 patients (49.4±14.0 years, 72.0% men) had PIH (triglyceride 627.6±183.6 mg/dL). The age‐ and sex‐adjusted prevalence of PIH in adults was 0.80% (0.72–0.87); the diagnosis was recorded in 60%, 46% were on a lipid‐lowering medication for primary prevention and a triglyceride level <150 mg/dL was achieved in 24.1%. The association of PIH with coronary heart disease was attenuated but remained significant after adjustment for demographic, socioeconomic, and conventional cardiovascular risk factors (hazard ratio [HR], 1.53; 95% CI, 1.06‐2.20; P = 0.022). There was no statistically significant association between PIH and cerebrovascular disease (HR, 1.06; 95% CI, 0.65‐1.73, P = 0.813), peripheral artery disease (HR, 1.27; 95% CI, 0.43‐3.75; P = 0.668), or the composite end point of all 3 (HR, 1.28; 95% CI, 0.92‐1.80; P =0.148) in adjusted models. Conclusions PIH was associated with incident coronary heart disease events (although there was attenuation after adjustment for conventional risk factors), supporting a causal role for triglycerides in coronary heart disease. The condition is relatively prevalent but awareness and control are low.

scholarly journals IS HABITAT PATTERNING THE RISK OF LIFESTYLE DISEASES AMONG AO NAGAS?

2017 ◽  
Vol 4 (3) ◽  
pp. 16
Author(s):  
Imkongtenla Pongen ◽  
Satwanti Kapoor
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Urban Areas ◽  
Tobacco Consumption ◽  
Population Based ◽  
Overweight And Obesity ◽  
Healthcare Sector ◽  
Cross Sectional ◽  
Increased Risk ◽  
Lifestyle Diseases

<p><strong>Introduction:</strong> An increased risk of lifestyle diseases in populations with rapid nutritional transition and urbanization, its patterning in urban-rural continuum with clusters of risk factors has been documented in various populations but there has been limited data on tribal population in India.</p><p><strong>Objective</strong>: To compare the distribution pattern of risk factors associated with lifestyle diseases among Ao Nagas residing in different habitats: city, town and villages in Nagaland, India.</p><p><strong>Methodology</strong>: Design: Population based cross-sectional study Setting: Delhi and Mokokchung town and its adjoining villages in Nagaland. Population: 1250 Ao Nagas, aged 20-49 years Protocol: WHO Stepwise approach to Surveillance of Non-communicable diseases (STEP1 and STEP 2).</p><p><strong>Findings:</strong> WHO STEP 1 risk factors,viz.,low physical activity and alcohol consumption; STEP 2 risk factor,viz.,overweight and obesity were significantly higher among city dwellers .Tobacco consumption (STEP 1 risk factor) was significantly higher among town dwellers. However, villagers were found to be significantly more hypertensive (STEP 2 risk factor) than their urban counterparts. Clustering of ≥ 3 risk factors for lifestyle diseases were more likely to be prevalent among the city dwellers as compared to town and village dwellers.</p><p><strong>Implications</strong>: This study calls for careful implementation of different strategies to combat the burden of lifestyle diseases in the population both in rural and urban areas considering a comprehensive approach integrated at the primary healthcare sector. Market penetration of smokeless tobacco products in town and villages should be a concern for the policy makers. Binge drinking and alcohol abuse in the population despite Nagaland been declared as a ‘Dry state’ warrants rigorous and timely health intelligence as prohibitive measures.</p>

P5528Extremely elevated lipoprotein (a) as an independent risk factor for coronary heart disease in large patient cohort

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M R Poudel ◽  
S Kirana ◽  
K P Mellwig ◽  
D Horstkotte ◽  
C Knabbe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Independent Risk Factor ◽  
The United States ◽  
Lipoprotein A ◽  
Vessel Disease ◽  
Large Patient ◽  
Increased Risk

Abstract Background Elevated lipoprotein (a) [LP (a)] levels are an independent risk factor for coronary heart disease (CHD) and associated with myocardial infarction (MI). CHD took a devastating toll in Europe and in the United States in the 20th century, killing more people than any other disease. It remains the leading cause of death in most countries worldwide. CHD shares risk factors with atherosclerosis. It has been shown that elevated LP (a) levels are associated with an increased risk for CHD across various ethnic groups. LP (a) is genetically determined, stable throughout life and yet refractory to drug therapy. While 30 mg/dl is considered the upper normal value for LP (a) in central Europe, extremely high LP (a) levels (>150mg/dl) are rare in the general population. The aim of our study was to analyse the correlation between lipoprotein (a) [LP (a)] levels and an incidence of coronary heart disease (CHD) in high-risk patients. Patients and methods We reviewed the LP (a) concentrations of 52.898 consecutive patients admitted to our cardiovascular center between January 2004 and December 2014. Of these, 579 patients had LP (a) levels above 150 mg/dl (mean 181.45±33.1mg/dl). In the control collective LP (a) was <30mg/dl (n=350). Other atherogenic risk factors in this group were HbA1c 6.58±1.65%, low density lipoprotein (LDL) 141.99±43.76 mg/dl, and body mass index 27.81±5.61. 54.40% were male, 26.07% were smokers, 93.2% had hypertension, and 24% had a family history of cardiovascular diseases. More than 82.6% were under statins. The mean glomerular filtration rate (GFR) was 69.13±24.8 ml/min [MDRD (Modification of Diet in Renal Disease)]. Results 64.98% (n=373) of the patients with LP (a) >150mg/dl had CHD. The prevalence of CHD in patients with LP (a) <30mg/dl in our control collective was 37.14%. (P- Value 0.0001). Patients with LP (a) >150mg/dl had a significantly increased risk for CHD (Odds ratio 5.98). 12.72% (n=73) of these patients suffered from CHD with single-vessel disease (VD), 14.63% (n=84) from CHD with 2VD and 37.63% (n=216) from CHD with 3VD. 47.92% of patients were re-vascularized by percutaneous coronary angioplasty (PTCA) and 37.06% of patients had to undergo coronary artery bypass grafting (CABG). 19.13% of patients had both, PTCA and CABG. Mean LP (a) level in patients with 1-vessel CHD was 181.5±29.98, in patients with 2-vessel CHD 178.94±34.26 and in patients with 3-vessel CHD 180.97±32.38 mg/dl. Conclusion Elevated LP (a) levels above 150 mg/dl are associated with a significantly increased risk of CHD in our collective and it confirms our hypothesis. Most of these patients had severe CHD with 3-vessel disease (VD) requiring coronary revascularization therapy. We need more prospective studies to confirm our findings.

Epilepsy as a Risk Factor for Submersion Injury in Children

PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 612-616 ◽  
Author(s):  
Douglas S. Diekema ◽  
Linda Quan ◽  
Victoria L. Holt
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Confidence Interval ◽  
Retrospective Cohort ◽  
Population Based ◽  
King County ◽  
Relative Risks ◽  
Increased Risk

The purpose of this study was to determine the risk of submersion injury and drowning among children with epilepsy and to define further specific risk factors. In a population-based retrospective cohort study the authors identified and reviewed records of all 0- through 19-year-old residents of King County Washington, who suffered a submersion incident between 1974 and 1990. Children with epilepsy were compared with those without epilepsy with regard to age, sex, site of incident, supervision, outcome, and presence of preexisting handicap. Relative risks were determined using population-based estimates of epilepsy prevalence. Of 336 submersions, 21 (6%) occurred among children with epilepsy. Children with epilepsy were more likely to be greater than 5 years old (86% vs 47%) and more likely to submerge in a bathtub (38% vs 11%). The relative risk of submersion for children with epilepsy was 47 (95% confidence interval [CI] 22 to 100) in the bathtub and 18.7 (95% CI 9.8 to 35.6) in the pool. The relative risk of drowning for children with epilepsy was 96 (95% CI 33 to 275) in the bathtub and 23.4 (95% CI 7.1 to 77.1) in the pool. These data support an increased risk of submersion and drowning among children with epilepsy.

scholarly journals Incidence of cardiometabolic diseases in people living with and without HIV in the UK: a population-based matched cohort study

2021 ◽  
Author(s):  
Tiffany E Gooden ◽  
Mike Gardner ◽  
Jingya Wang ◽  
Kate Jolly ◽  
Deirdre A Lane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Population Based ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Hiv Negative

Abstract Background Evidence on the risk of cardiovascular disease (CVD) and CVD risk factors in people with HIV (PWH) is limited. We aimed to identify the risk of composite CVD, individual CVD events and common risk factors. Methods This was a nationwide population-based cohort study comparing adult (≥18y) PWH with HIV-negative individuals matched on age, sex, ethnicity and location. The primary outcome was composite CVD comprising stroke, myocardial infarction (MI), peripheral vascular disease (PVD), ischaemic heart disease and heart failure. The secondary outcomes were individual CVD events, hypertension, diabetes, chronic kidney disease (CKD) and all-cause mortality. Cox proportional hazard regression models were used to examine the risk of each outcome. Results We identified 9233 PWH and 35721 HIV-negative individuals. An increased risk was found for composite CVD (adjusted hazard ratio [aHR] 1.50, 95% CI 1.28-1.77), stroke (aHR 1.42, 95% CI 1.08-1.86), ischaemic heart disease (aHR 1.55, 95% CI 1.24-1.94), hypertension (aHR 1.37, 95% CI 1.23-1.53), type 2 diabetes (aHR 1.28, 95% CI 1.09-1.50), CKD (aHR 2.42, 95% CI 1.98-2.94) and all-cause mortality (aHR 2.84, 95% CI (2.48-3.25). Conclusions PWH have a heightened risk for CVD and common CVD risk factors, reinforcing the importance for regular screening for such conditions.

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