Cardiovascular risk factors and probability for cardiovascular events in HIV-infected patients. Part II: gender differences.

OBJECTIVE

Due to the side effects of antiretroviral therapy and long term survival there is an increasing concern of an elevated rate of cardiovascular diseases in HIV-infected patients. The present study analysed the cardiovascular risk profile and the probability of cardiovascular events in HIV-infected patients, due to differences of gender.

METHODS

Cardiovascular risk factors of 309 HIV-infected adults, including 240 males were analysed. Overall 10-years probability for cardiovascular events was evaluated by the Framingham algorithm.

RESULTS

Gender differences were detected in cardiovascular risk factors such as lipid values, blood pressure and the rate of smoking. Tobacco use was much more common in HIV-infected males compared with HIV-infected females (67.5% vs. 49.3%; p<0.001). Although no significant difference was noticed in total cholesterol (5.49 +/- 0.09 vs. 5.53 +/- 0.19 mmol/L, p = 0.84), the HDL-cholesterol concentration was significantly lower (1.09 +/- 0.03 vs. 1.36 +/- 0.06 mmol/L, p < 0.001) and the triglyceride concentration higher (3.01 +/- 0.21 vs. 2.06 +/- 0.26 mmol/L, p = 0.02) in HIV-infected males compared to HIV-infected females. Additionally, systolic blood pressure was higher in HIV-infected males compared with HIV-infected females (123.1 +/- 1.1 vs. 115.4 +/- 2.1 mmHg, p < 0.01). No significant differences were detected in HbA1c concentrations between both groups (5.15 +/- 0.07 vs. 5.31 +/- 0.11, p = 0.26). The overall 10-years probability for cardiovascular events was 8.7% (median) in HIV-infected males and 1.7% in HIV-infected females (p < 0.0001).

CONCLUSIONS

In the present study, we observed gender differences in the cardiovascular risk profile of HIV-infected individuals. The risk of premature atherosclerosis and associated cardiovascular events was significantly higher in HIV-infected males.