UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
Popul Health Manag. 2013 Jun;16(3):201-7. doi: 10.1089/pop.2012.0043. Epub 2012 Nov 29.
Therapeutic advances have resulted in an epidemiological shift in the predominant causes of hospitalization for patients with HIV/AIDS. An emerging cause for hospitalization in this patient population is cardiovascular disease (CVD); however, data are limited regarding how this shift affects different racial groups. The objective of this observational, retrospective study was to evaluate the association between race and hospitalization for CVD in African Americans and whites with HIV/AIDS and to compare the types of CVD-related hospitalizations between African Americans and whites with HIV/AIDS. Approximately 1.5 million hospital discharges from the US National Hospital Discharge Surveys for the years of 1996 to 2008 were identified. After controlling for potential confounders, the odds of CVD-related hospitalization in patients with HIV/AIDS were 45% higher for African Americans than whites (odds ratio [OR]=1.45, 95% CI, 1.39-1.51). Other covariates that were associated with increased odds of hospitalization for CVD included chronic kidney disease (OR=1.43, 95% CI, 1.36-1.51), age≥50 years (OR=3.22, 95% CI, 2.94-3.54), region in the Southern United States (OR=1.17, 95% CI, 1.11-1.23), and Medicare insurance coverage (OR=1.71, 95% CI, 1.60-1.83). Male sex was not significantly associated with the study outcome (OR=0.99, 95% CI, 0.96-1.02). Compared to whites with HIV/AIDS, African Americans with HIV/AIDS had more hospitalizations for heart failure and hypertension, but fewer hospitalizations for stroke and coronary heart disease. In conclusion, African Americans with HIV/AIDS have increased odds of CVD-related hospitalization as compared to whites with HIV/AIDS. Furthermore, the most common types of CVD-related hospitalizations differ significantly in African Americans and whites.
治疗方法的进步导致因 HIV/AIDS 住院的患者的主要病因在流行病学上发生了转变。在这一患者群体中,心血管疾病(CVD)成为导致住院的新兴病因;然而,有关这一转变如何影响不同种族群体的数据有限。本观察性、回顾性研究的目的是评估在 HIV/AIDS 患者中,种族与 CVD 住院之间的关联,并比较 HIV/AIDS 患者中非洲裔美国人和白人 CVD 相关住院的类型。从 1996 年至 2008 年的美国国家医院出院调查中,共确定了约 150 万例住院出院记录。在控制了潜在混杂因素后,HIV/AIDS 患者 CVD 相关住院的几率是非裔美国人比白人高 45%(比值比 [OR] =1.45,95%可信区间 [CI],1.39-1.51)。与 CVD 住院几率增加相关的其他协变量包括慢性肾脏病(OR=1.43,95%CI,1.36-1.51)、年龄≥50 岁(OR=3.22,95%CI,2.94-3.54)、美国南部地区(OR=1.17,95%CI,1.11-1.23)和医疗保险覆盖(OR=1.71,95%CI,1.60-1.83)。男性与研究结果无显著相关性(OR=0.99,95%CI,0.96-1.02)。与 HIV/AIDS 白人患者相比,HIV/AIDS 非裔美国患者心力衰竭和高血压的住院治疗更多,但中风和冠心病的住院治疗更少。总之,与 HIV/AIDS 白人患者相比,HIV/AIDS 非裔美国患者 CVD 相关住院的几率更高。此外,非裔美国人和白人 HIV/AIDS 患者 CVD 相关住院的最常见类型存在显著差异。