*Division of Cardiology, Cardiovascular Disease Prevention Program, Mount Sinai Roosevelt and St. Luke's Hospital, New York, NY; †Institute of Advanced Medicine, Spencer Cox Center for Health, Mount Sinai Health System, New York, NY; ‡Department of Statistics, University of California at Davis, Davis, CA; §Division of Cardiology, Department of Medicine, University of Colorado, Denver, CO; and ‖Division of Biostatistics, Department of Public Health Sciences, University of California at Davis, Davis, CA.
J Acquir Immune Defic Syndr. 2014 Aug 1;66(4):370-7. doi: 10.1097/QAI.0000000000000168.
Patients with HIV may have an increased risk of cardiovascular disease (CVD). The objective of this study was to determine the prevalence, treatment, and control of low-density lipoprotein cholesterol (LDL-C) dyslipidemia and hypertension in a population of HIV-infected patients at an HIV/AIDS clinic in New York City.
Review of electronic medical records of 4278 HIV-infected patients aged 20 years or older in a racially and ethnically diverse urban HIV/AIDS clinic based in a large tertiary hospital and designated New York State AIDS Center that provides comprehensive care. LDL-C dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III goals and hypertension according to Joint National Committee VII criteria.
The prevalence of LDL-C dyslipidemia was 35%. Ninety percent of patients with LDL-C dyslipidemia were treated and 75% of those treated were at goal. Patients in high-risk groups (56%), including known coronary heart disease (57%) or coronary heart disease equivalents (62%), were less likely to be at LDL-C goal. The prevalence of hypertension was 43%. Seventy-five percent of patients with hypertension were treated but only 57% overall were at goal.
Although most patients with HIV and LDL-C dyslipidemia or hypertension are treated, a significant percentage did not have adequate control of these risk factors. As patients with HIV are at higher risk for CVD and living to an age where CVD is more common, it will be important to identify ways to better manage and control CVD risk factors in this patient population. A comprehensive care model such as our setting may serve as an option.
HIV 感染者发生心血管疾病（CVD）的风险可能会增加。本研究旨在确定纽约市一家 HIV/AIDS 诊所中 HIV 感染者人群中 LDL-C 血脂异常和高血压的患病率、治疗和控制情况。
对一家位于大型三级医院的、种族和民族多样化的城市 HIV/AIDS 诊所中 4278 名年龄在 20 岁或以上的 HIV 感染者的电子病历进行回顾性分析。该诊所是纽约州艾滋病中心指定的艾滋病综合护理机构。根据国家胆固醇教育计划成人治疗专家组 III 目标定义 LDL-C 血脂异常，根据联合国家委员会 VII 标准定义高血压。
LDL-C 血脂异常的患病率为 35%。90%的 LDL-C 血脂异常患者接受了治疗，其中 75%的治疗患者达到了目标。处于高风险组（56%，包括已知冠心病[57%]或冠心病等危症[62%]）的患者，达到 LDL-C 目标的可能性较低。高血压的患病率为 43%。75%的高血压患者接受了治疗，但总体上只有 57%的患者达到了目标。
尽管大多数 HIV 感染者合并 LDL-C 血脂异常或高血压患者得到了治疗，但这些危险因素控制不佳的患者比例仍然较高。由于 HIV 感染者发生 CVD 的风险较高，且寿命延长后 CVD 的发病率也更高，因此重要的是要找到更好的方法来管理和控制该患者人群的 CVD 危险因素。像我们这样的综合护理模式可能是一种选择。
