Use of preventive measures for cardiovascular disease in people with HIV
This study was conducted within the large international RESPOND cohort consortium spanning 19 clinical sites across Europe and Australia. The authors examined whether people living with HIV at high cardiovascular disease (CVD) risk (>10% estimated D:A:D 10-year CVD risk) were receiving recommended preventive interventions in 2012-2021.
The proportion of people with HIV with high CVD risk increased by about 20% during the 10 year study period, reflecting the population ageing and the longer cumulative use of antiretrovirals associated with increased CVD risk.
Overall, the authors showed a systematic underutilization of preventive measures in participants of CVD. Antihypertensive medication (67%) and lipid-lowering drugs (56%) were the most used preventive interventions. Smoking cessation was infrequent (7%) and weight loss among obese individuals was achieved among 10% of participants with little changes over the study period. Unexpectedly, the use of antidiabetic medication declined over the study period.
Individuals living with HIV with ongoing HIV viral replication or a history of intravenous drug use were less likely to receive lipid-lowering drugs or successfully cease smoking, pointing to a need for targeted support in these populations. Differences between men and women were small overall.
The authors conclude that the increasing proportion of people with HIV at very high cardiovascular risk, without a corresponding increase in preventive measure uptake, calls for greater awareness of CVD risk management in routine HIV care, and underscores the importance of bridging the gap between clinical guidelines and real-world practice.