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Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study

INTRODUCTION: 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 w...

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Autores principales: Hatleberg, Camilla I, Ryom, Lene, El‐Sadr, Wafaa, Mocroft, Amanda, Reiss, Peter, De Wit, Stephane, Dabis, Francois, Pradier, Christian, d'Arminio Monforte, Antonella, Kovari, Helen, Law, Matthew, Lundgren, Jens D, Sabin, Caroline A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839235/
https://www.ncbi.nlm.nih.gov/pubmed/29509305
http://dx.doi.org/10.1002/jia2.25083
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author Hatleberg, Camilla I
Ryom, Lene
El‐Sadr, Wafaa
Mocroft, Amanda
Reiss, Peter
De Wit, Stephane
Dabis, Francois
Pradier, Christian
d'Arminio Monforte, Antonella
Kovari, Helen
Law, Matthew
Lundgren, Jens D
Sabin, Caroline A
author_facet Hatleberg, Camilla I
Ryom, Lene
El‐Sadr, Wafaa
Mocroft, Amanda
Reiss, Peter
De Wit, Stephane
Dabis, Francois
Pradier, Christian
d'Arminio Monforte, Antonella
Kovari, Helen
Law, Matthew
Lundgren, Jens D
Sabin, Caroline A
author_sort Hatleberg, Camilla I
collection PubMed
description INTRODUCTION: 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.
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spelling pubmed-58392352018-03-12 Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study Hatleberg, Camilla I Ryom, Lene El‐Sadr, Wafaa Mocroft, Amanda Reiss, Peter De Wit, Stephane Dabis, Francois Pradier, Christian d'Arminio Monforte, Antonella Kovari, Helen Law, Matthew Lundgren, Jens D Sabin, Caroline A J Int AIDS Soc Research Articles INTRODUCTION: 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. John Wiley and Sons Inc. 2018-03-06 /pmc/articles/PMC5839235/ /pubmed/29509305 http://dx.doi.org/10.1002/jia2.25083 Text en © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Hatleberg, Camilla I
Ryom, Lene
El‐Sadr, Wafaa
Mocroft, Amanda
Reiss, Peter
De Wit, Stephane
Dabis, Francois
Pradier, Christian
d'Arminio Monforte, Antonella
Kovari, Helen
Law, Matthew
Lundgren, Jens D
Sabin, Caroline A
Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study
title Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study
title_full Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study
title_fullStr Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study
title_full_unstemmed Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study
title_short Gender differences in the use of cardiovascular interventions in HIV‐positive persons; the D:A:D Study
title_sort gender differences in the use of cardiovascular interventions in hiv‐positive persons; the d:a:d study
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839235/
https://www.ncbi.nlm.nih.gov/pubmed/29509305
http://dx.doi.org/10.1002/jia2.25083
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