Division of Cardiology, Department of Medicine, University of California, San Francisco, California.
Department of Global Health, University of Washington School of Medicine.
Curr Opin HIV AIDS. 2022 Sep 1;17(5):270-278. doi: 10.1097/COH.0000000000000756. Epub 2022 Jul 5.
To synthesize current evidence on the impact of cardiovascular disease among women living with HIV (WLWH) with a particular focus on disease prevalence, mechanisms and prevention.
HIV-related cardiovascular disease risk is 1.5-fold to 2-fold higher for women than for men. Mechanisms of enhanced risk are multifactorial and include reinforcing pathways between traditional risk factors, metabolic dysregulation, early reproductive aging and chronic immune activation. These pathways influence both the presentation of overt syndromes of myocardial infarction, stroke and heart failure, as well as subclinical disease, such as microvascular dysfunction and cardiac fibrosis. Cardiovascular disease, therefore, remains a consistent threat to healthy aging among WLWH.
Although no specific prevention strategies exist, patient-centered risk mitigation approaches that are adaptable to the needs of aging individuals are essential to combat disparities in cardiovascular outcomes among WLWH. Further research into the optimal prevention approach for CVD among WLWH, particularly for women living in under-resourced health systems, is needed.
综合目前关于艾滋病毒感染者（HIV）女性心血管疾病的影响的证据，特别关注疾病的流行率、发病机制和预防。
与男性相比，HIV 相关的心血管疾病风险在女性中高出 1.5 至 2 倍。风险增加的机制是多因素的，包括传统危险因素、代谢失调、早期生殖衰老和慢性免疫激活之间的强化途径。这些途径不仅影响心肌梗死、中风和心力衰竭等显性综合征的表现，还影响微血管功能障碍和心脏纤维化等亚临床疾病。因此，心血管疾病仍然是 HIV 感染者健康老龄化的一个持续威胁。
尽管目前没有特定的预防策略，但以患者为中心的降低风险方法对于适应老龄化个体的需求至关重要，这对于减少 HIV 感染者中心血管结局的差异至关重要。需要进一步研究 HIV 女性心血管疾病的最佳预防方法，特别是对于生活在资源匮乏的卫生系统中的女性。
