Achievement of Primary Prevention Cardiometabolic Targets in Women with HIV: An Urgent Call to Action to Pursue Cardiovascular Health

• Published in: Viruses 2024-04, Vol.16 (4), p.578
• Main Authors: Mazzitelli, Maria, Scaglione, Vincenzo, Cozzolino, Claudia, Zuin, Marco, Putaggio, Cristina, Bragato, Beatrice, Vania, Eleonora, Sasset, Lolita, Leoni, Davide, Baldo, Vincenzo, Cattelan, Annamaria
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Blood pressure; Body mass index; Cardiovascular diseases; Cardiovascular Diseases - prevention & control; cardiovascular risk; Cholesterol; Cross-Sectional Studies; Demographic aspects; Development and progression; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Disease prevention; Drug therapy; Dyslipidemia; Dyslipidemias - epidemiology; educational status; Exercise; Female; Health aspects; Heart attacks; Hemoglobin; Hepatitis; High density lipoprotein; HIV; HIV infection; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; hyperlipidemia; Hypertension; Italy - epidemiology; lifestyle; Low density lipoprotein; Lymphocytes; Metabolic disorders; metabolic risk; Middle Aged; Myocardial infarction; people; Population; Prevention; primary prevention; Primary Prevention - methods; regression analysis; risk; Risk Factors; Smoking; Statins; Statistical analysis; Transients and Migrants; Women; women with HIV; Womens health
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v16040578

Cardiometabolic health has become crucial, especially for women with HIV (WWH). We assessed the achievement of targets for hypertension, dyslipidemia, and diabetes (H/Dy/DT) in primary prevention in a WWH cohort. Cross-sectional analysis including all WWH in our clinic, excluding those who had a myocardial infarction. H/Dy/DT achievement was assessed by both EACS guidelines and individual cardiovascular risk, CVR (measured by ESC calculator), using logistic regression to evaluate differences in H/Dy/DT achievement between migrant and Italian women. We included 292 WWH, 55.5% Italian and 44.5% migrant women; the median age was 50 (IQR:42-58) years, 94.5% had undetectable HIV-RNA, 55.1% had a high level of education, 27.1% were smokers, and 19.2% did regularly physical exercise. Overall, 76%, 19%, and 5% of women presented a low, a high, and a very high CVR, respectively. Among Italians, 28.4% and 6.2% women presented a high and a very high CVR, respectively. Considering migrants, 7.7% and 3.8% women presented a high and a very high CVR, respectively. Overall, among migrant women, those with a high CVR were more likely to be not at target than those with a low risk (especially for LDL-c and blood pressure among people on treatment), despite the fact that we did not detect a statistically significant difference. By contrast, migrants were more likely to achieve glycemic targets than Italians ( = 0.032). H/Dy/DT target achievement is suboptimal, especially in migrants. A more aggressive pharmacological treatment, also assessing adherence to medical prescriptions, and promotion of healthy lifestyle should be urgently implemented, possibly redrawing the current model of care.