TY - JOUR
T1 - Gender differences in the use of cardiovascular interventions in HIV-positive persons; the D:A:D study
AU - Data Collection of Adverse Events of Anti-HIV drugs (D:A:D) Study group
AU - Hatleberg, Camilla I.
AU - Ryom, Lene
AU - el-Sadr, Wafaa
AU - Mocroft, Amanda
AU - Reiss, Peter
AU - de Wit, Stephane
AU - Dabis, Francois
AU - Pradier, Christian
AU - D’Arminio Monforte, Antonella
AU - Kovari, Helen
AU - Law, Matthew
AU - Lundgren, Jens D.
AU - Sabin, Caroline A.
AU - Calvo, G.
AU - Bonnet, F.
AU - Kirk, O.
AU - Morfeldt, L.
AU - Weber, R.
AU - Lind-Thomsen, A.
AU - Salbøl Brandt, R.
AU - Hillebreght, M.
AU - Zaheri, S.
AU - Wit, Fwnm
AU - Scherrer, A.
AU - Schöni-Affolter, F.
AU - Rickenbach, M.
AU - Tavelli, A.
AU - Fanti, I.
AU - Leleux, O.
AU - Mourali, J.
AU - le Marec, F.
AU - Boerg, E.
AU - Thulin, E.
AU - Sundström, A.
AU - Bartsch, G.
AU - Thompsen, G.
AU - Necsoi, C.
AU - Delforge, M.
AU - Prins, J. M.
AU - Kuijpers, T. W.
AU - Scherpbier, H. J.
AU - Godfried, M. H.
AU - Geerlings, S. E.
AU - Bos, J. C.
AU - Wiersinga, W. J.
AU - Hovius, J. W.
AU - Zaaijer, H. L.
AU - Schinkel, C. J.
AU - Stelma, F. F.
AU - Ang, C. W.
PY - 2018
Y1 - 2018
N2 - There is paucity of data related to potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) among HIV-positive individuals. We investigated whether such differences exist in the observational D:A:D cohort study. Methods: Participants were followed from study enrolment until the earliest of death, six months after last visit or February 1, 2015. Initiation of CVD interventions [lipid-lowering drugs (LLDs), angiotensin-converting enzyme inhibitors (ACEIs), anti-hypertensives, invasive cardiovascular procedures (ICPs) were investigated and Poisson regression models calculated whether rates were lower among women than men, adjusting for potential confounders. Results: Women (n = 12,955) were generally at lower CVD risk than men (n = 36,094). Overall, initiation rates of CVD interventions were lower in women than men; LLDs: incidence rate 1.28 [1.21, 1.35] vs. 2.40 [2.34, 2.46]; ACEIs: 0.88 [0.82, 0.93] vs. 1.43 [1.39, 1.48]; anti-hypertensives: 1.40 [1.33, 1.47] vs. 1.72 [1.68, 1.77] and ICPs: 0.08 [0.06, 0.10] vs. 0.30 [0.28, 0.32], and this was also true for most CVD interventions when exclusively considering periods of follow-up for which individuals were at high CVD risk. In fully adjusted models, women were less likely to receive CVD interventions than men (LLDs: relative rate 0.83 [0.78, 0.88]; ACEIs: 0.93 [0.86, 1.01]; ICPs: 0.54 [0.43, 0.68]), except for the receipt of anti-hypertensives (1.17 [1.10, 1.25]). Conclusion: The use of most CVD interventions was lower among women than men. Interventions are needed to ensure that all HIV-positive persons, particularly women, are appropriately monitored for CVD and, if required, receive appropriate CVD interventions.
AB - There is paucity of data related to potential gender differences in the use of interventions to prevent and treat cardiovascular disease (CVD) among HIV-positive individuals. We investigated whether such differences exist in the observational D:A:D cohort study. Methods: Participants were followed from study enrolment until the earliest of death, six months after last visit or February 1, 2015. Initiation of CVD interventions [lipid-lowering drugs (LLDs), angiotensin-converting enzyme inhibitors (ACEIs), anti-hypertensives, invasive cardiovascular procedures (ICPs) were investigated and Poisson regression models calculated whether rates were lower among women than men, adjusting for potential confounders. Results: Women (n = 12,955) were generally at lower CVD risk than men (n = 36,094). Overall, initiation rates of CVD interventions were lower in women than men; LLDs: incidence rate 1.28 [1.21, 1.35] vs. 2.40 [2.34, 2.46]; ACEIs: 0.88 [0.82, 0.93] vs. 1.43 [1.39, 1.48]; anti-hypertensives: 1.40 [1.33, 1.47] vs. 1.72 [1.68, 1.77] and ICPs: 0.08 [0.06, 0.10] vs. 0.30 [0.28, 0.32], and this was also true for most CVD interventions when exclusively considering periods of follow-up for which individuals were at high CVD risk. In fully adjusted models, women were less likely to receive CVD interventions than men (LLDs: relative rate 0.83 [0.78, 0.88]; ACEIs: 0.93 [0.86, 1.01]; ICPs: 0.54 [0.43, 0.68]), except for the receipt of anti-hypertensives (1.17 [1.10, 1.25]). Conclusion: The use of most CVD interventions was lower among women than men. Interventions are needed to ensure that all HIV-positive persons, particularly women, are appropriately monitored for CVD and, if required, receive appropriate CVD interventions.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058435182&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29509305
U2 - https://doi.org/10.1002/jia2.25083
DO - https://doi.org/10.1002/jia2.25083
M3 - Article
C2 - 29509305
SN - 1758-2652
VL - 21
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
IS - 3
M1 - e25083
ER -