| Contributors: |
Hatleberg, C. I.; Ryom, L.; El-Sadr, W.; Mocroft, A.; Reiss, P.; De Wit, S.; Dabis, F.; Pradier, C.; D'Arminio Monforte, A.; Kovari, H.; Law, M.; Lundgren, J. D.; Sabin, C. A.; Calvo, G; Bonnet, F; Kirk, O; Morfeldt, L; Weber, R; Lind-Thomsen, A; Salbøl Brandt, R; Hillebreght, M; Zaheri, S; Wit, F; Scherrer, A; Schöni-Affolter, F; Rickenbach, M; Tavelli, A; Fanti, I; Leleux, O; Mourali, J; Le Marec, F; Boerg, E; Thulin, E; Sundström, A; Bartsch, G; Thompsen, G; Necsoi, C; Delforge, M; Fontas, E; Caissotti, C; Mateu, S; Torres, F; Petoumenos, K; Blance, A; Huang, R; Puhr, R; Laut, K; Kristensen, D; Phillips, An; Kamara, Da; Smith, Cj; Brandt, R; Raben, D; Matthews, C; Bojesen, A; Grevsen, Al; Powderly, B; Shortman, N; Moecklinghoff, C; Reilly, G; Franquet, X; Smit, C; Ross, M; Fux, Ca; Morlat, P; Friis-Møller, N; Kowalska, J; Bohlius, J; Bower, M; Fätkenheuer, G; Grulich, A; Sjøl, A; Meidahl, P; Iversen, J; Hillebregt, M; Prins, Jm; Kuijpers, Tw; Scherpbier, Hj; van der Meer, J; Godfried, Mh; van der Poll, T; Nellen, F; Geerlings, Se; van Vugt, M; Pajkrt, D; Bos, Jc; Wiersinga, Wj; van der Valk, M; Goorhuis, A; Hovius, Jw; van Eden, J; Henderiks, A; van Hes, A; Mutschelknauss, M; Nobel, He; Pijnappel, F; Jurriaans, S; Back, N; Zaaijer, Hl; Berkhout, B |
| Description: |
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. |