Key result
HIV infection was independently associated with an 11% higher aortic pulse wave velocity compared to uninfected controls, indicating increased aortic stiffness.
Why the study?
Does treated HIV infection increase aortic stiffness in adults without cardiovascular disease?
Cross-Sectional (n=226)
No
Does treated HIV infection increase aortic stiffness in adults without cardiovascular disease?
Effect estimate: 11% higher
Absolute Event Rate: 6.2% vs 5.6%
p-value: p=0.008
Treated HIV infection is independently associated with increased aortic stiffness, with a detrimental effect magnitude similar to that of the metabolic syndrome.
May support vascular monitoring in treated HIV; hypothesis-generating for its contribution to excess CV risk.
BACKGROUND: Patients with treated Human Immunodeficiency Virus-1 (HIV) infection are at increased risk of cardiovascular events. Traditionally much of this risk has been attributed to metabolic and anthropometric abnormalities associated with HIV, which are similar to the metabolic syndrome (MS), an established risk factor for cardiovascular mortality. It remains unclear whether treated HIV infection is itself associated with increased risk, via increase vascular stiffness. METHODS: 226 subjects (90 with HIV) were divided into 4 groups based on HIV and MS status: 1) HIV-ve/MS-ve, 2) HIV-ve/MS + ve, 3) HIV + ve/MS-ve and 4)HIV + ve/MS + ve. CMR was used to determine aortic pulse wave velocity (PWV) and regional aortic distensibility (AD). RESULTS: PWV was 11% higher and regional AD up to 14% lower in the HIV + ve/MS-ve group when compared to HIV-ve/MS-ve (p < 0.01 all analyses). PWV and AD in the HIV + ve/MS-ve group was similar to that observed in the HIV-ve/MS + ve group (p > 0.99 all analyses). The HIV + ve/MS + ve group had 32% higher PWV and 30-34% lower AD than the HIV-ve/MS-ve group (all p < 0.001), and 19% higher PWV and up to 31% lower AD than HIV + ve/MS-ve subjects (all p < 0.05). On multivariable regression, age, systolic blood pressure and treated HIV infection were all independent predictors of both PWV and regional AD. CONCLUSION: Across multiple measures, treated HIV infection is associated with increased aortic stiffness and is also an independent predictor of both PWV and regional AD. The magnitude of the effect of treated HIV and MS are similar, with additive detrimental effects on central vascular elasticity.
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Rider et al. (2014) conducted a cross-sectional in HIV infection (n=226). HIV infection vs. No HIV infection was evaluated on Aortic pulse wave velocity (PWV) (11% higher, p=0.008). HIV infection was independently associated with an 11% higher aortic pulse wave velocity compared to uninfected controls, indicating increased aortic stiffness.
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