Veterans With HIV Tended to Have CVD Events Earlier Than Those Without

ORLANDO, FL — HIV patients have an increased atherosclerotic plaque vulnerability, making them more susceptible to severe cardiovascular complications, according to previous research.

A new study sought to examine the clinical characteristics of people with HIV in comparison to people without HIV admitted to the VHA with their first major acute cardiovascular events (MACE) and compare their total mortality.

Researchers from the University of Central Florida and the Orlando, FL, VA Healthcare System used national VHA data on those admitted to VHA hospitals with MACE, which was defined as acute myocardial infarction (AMI), acute cerebrovascular accident (CVA) or cardiac arrest, during the fiscal years 2003-2021. They estimated the hazard ratio (HR) of mortality for people with HIV vs. people without HIV using Cox proportional hazard regression analysis.

Out of 280,311 veterans—2,510 people with HIV and 277,801 people without HIV—had their first MACE during the study period. Those with HIV were younger, more likely to be African American, had a lower prevalence of diabetes mellitus and hypertension, similar total cholesterol levels and a lower mean 10-year cardiovascular risk score (25.4 in people with HIV vs. 28.7 in people without HIV). The results were reported in the journal HIV Medicine.¹

“Among MACE components, people with HIV had a higher proportion of CVA (27% vs. 21.3%, p < 0.001) and cardiac arrest (13.0% vs. 8.4%, p < 0.001) but a lower incidence of AMI (62.4% vs. 72.5%, p < 0.001) than people without HIV,” the researchers pointed out. “Additionally, people with HIV had a higher risk of total mortality (adjusted HR: 2.05, 95% confidence interval: 1.90-2.22) compared with people without HIV.”

The study concluded that people with HIV experience MACE at younger ages despite lower cardiovascular risks and similar baseline cholesterol and blood pressure levels. “People with HIV had higher mortality and a higher risk of having ventricular fibrillation arrest and stroke as their first MACE,” the researchers added.

1. Hicks WL, Khalil S, Burke FW, Ho MQ, Mansi I. Comparison of risk factors and mortality in veterans with HIV and those without HIV suffering first major acute cardiovascular events. HIV Med. 2024 Oct 27. doi: 10.1111/hiv.13724. Epub ahead of print. PMID: 39462186.