老年人（50-64 岁或≥65 岁）接受人类免疫缺陷病毒治疗的心血管合并症中性别差异。

Differences by Sex in Cardiovascular Comorbid Conditions Among Older Adults (Aged 50-64 or ≥65 Years) Receiving Care for Human Immunodeficiency Virus.

机构信息

Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention.

Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia.

出版信息

Clin Infect Dis. 2019 Nov 27;69(12):2091-2100. doi: 10.1093/cid/ciz126.

DOI:10.1093/cid/ciz126

PMID:31051034

Abstract

BACKGROUND

Differences by sex in cardiovascular comorbid conditions among human immunodeficiency virus (HIV)-infected persons aged 50-64 years have been understudied; even fewer data are available for persons aged ≥65 years.

METHODS

We used matched interview and medical record abstraction data from the 2009-2012 data cycles of the Medical Monitoring Project, a nationally representative sample of HIV-infected adults in care. We included men and women aged 50-64 and ≥65 years at time of interview. We calculated weighted prevalence estimates and used logistic regression to compute adjusted prevalence differences and 95% confidence intervals (CIs) assessing sex differences in various characteristics and cardiovascular comorbid conditions. Comorbid conditions included overweight/obesity (body mass index ≥25), abnormal total cholesterol level (defined as ≥200 mg/dL), diagnosed diabetes mellitus, or diagnosed hypertension.

RESULTS

Of 7436 participants, 89.5% were aged 50-64 years and 10.4% aged ≥65 years, 75.1% were men, 40.4% (95% CI, 33.5%-47.2%) were non-Hispanic black, 72.0% (70.4%-73.6%) had HIV infection diagnosed ≥10 years earlier. After adjustment for sociodemographic and behavioral factors, women aged 50-64 years were more likely than men to be obese (adjusted prevalence difference, 8.4; 95% CI, 4.4-12.3), have hypertension (3.9; .1-7.6), or have high total cholesterol levels (9.9; 6.2-13.6). Women aged ≥65 years had higher prevalences of diabetes mellitus and high total cholesterol levels than men.

CONCLUSIONS

Cardiovascular comorbid conditions were prevalent among older HIV-infected persons in care; disparities existed by sex. Closer monitoring and risk-reduction strategies for cardiovascular comorbid conditions are warranted for older HIV-infected persons, especially older women.

摘要

背景

在 50-64 岁的感染人类免疫缺陷病毒（HIV）人群中，心血管合并症的性别差异研究较少；年龄≥65 岁的人群的数据则更少。

方法

我们使用了 2009-2012 年医疗监测项目的数据循环中的匹配访谈和病历摘录数据，该项目是一个全国性的接受护理的 HIV 感染成年人的代表性样本。我们纳入了在访谈时年龄为 50-64 岁和≥65 岁的男性和女性。我们计算了加权患病率估计值，并使用逻辑回归计算了调整后的患病率差异和 95%置信区间（CI），以评估不同特征和心血管合并症的性别差异。合并症包括超重/肥胖（体重指数≥25）、总胆固醇水平异常（定义为≥200mg/dL）、确诊糖尿病或确诊高血压。

结果

在 7436 名参与者中，89.5%年龄为 50-64 岁，10.4%年龄≥65 岁，75.1%为男性，40.4%（95%CI，33.5%-47.2%）为非西班牙裔黑人，72.0%（70.4%-73.6%）HIV 感染诊断时间≥10 年。调整社会人口统计学和行为因素后，50-64 岁的女性比男性更有可能肥胖（调整后的患病率差异为 8.4%；95%CI，4.4-12.3%）、患有高血压（3.9%；.1-7.6%）或总胆固醇水平升高（9.9%；6.2-13.6%）。≥65 岁的女性患糖尿病和总胆固醇水平升高的患病率高于男性。