A Comparative Analysis of Cardiovascular Risk in Human Immunodeficiency Virus-Seropositive and -Seronegative Pre-Menopausal Women

Abstract

Background: Human immunodeficiency virus (HIV) has been associated with an increased risk of coronary artery disease (CAD) in women. HIV-positive pre-menopausal women lose the cardio-protective effect of estrogen and are at a higher risk for developing CAD. Our study intended to assess the cardiovascular risk in HIV-positive pre-menopausal women.

Methods: This is a cross-sectional study using National Health and Nutrition Examination Survey (NHANES) datasets. The 10-year Framingham risk score for developing CAD was calculated for HIV-positive and HIV-negative women. The individual risk factors contributing to CAD were compared. The populations’ intent to reduce their risk and their doctor’s advice to reduce the risk were analyzed. A P-value < 0.05 was considered significant.

Results: Out of the available sample of 82,091 people, 9,635 women (11.7%) met the inclusion criteria of the study. Among them, 25 women were HIV-seropositive (0.25%). Though there was no significant difference in blood pressure, hemoglobin A1c, C-reactive protein, high-density lipoprotein or total cholesterol (P > 0.05), the mean Framingham risk score in pre-menopausal HIV-positive women (mean (M) = 2.12, standard deviation (SD) = 2.73) was significantly higher than the HIV-negative women (M = 0.95, SD = 1.94) (P < 0.01). Neither did majority of the HIV-positive women intend to decrease their cardiovascular risk nor did their healthcare providers advise them to do so.

Conclusions: The risk of developing CAD in pre-menopausal women is higher from traditional risk factors itself. While HIV is now proven to be an independent risk factor for developing CAD in women, focus should be on reducing the risk from traditional methods.

J Clin Med Res. 2020;12(7):409-414
doi: https://doi.org/10.14740/jocmr4226