Trends in Cardiovascular Disease Mortality among Persons with HIV in New York City, 2001-2012

David B. Hanna, Chitra Ramaswamy, Robert C. Kaplan, Jorge Kizer, Kathryn Anastos, Demetre Daskalakis, Regina Zimmerman, Sarah L. Braunstein

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background. Cardiovascular disease (CVD) has become more prominent among human immunodeficiency virus (HIV)-infected individuals. The extent to which CVD mortality rates are changing is unclear. Methods. We analyzed surveillance data for all persons aged ≥13 years with HIV infection between 2001 and 2012 reported to the New York City HIV Surveillance Registry. We examined age-specific and age-standardized mortality rates due to major CVDs. We compared mortality time trends among persons with HIV with the general population, and examined differences among HIV-infected persons by RNA level. Results. There were 29 588 deaths reported among 145 845 HIV-infected persons. Ten percent of deaths were attributed to CVD as the underlying cause, including chronic ischemic heart disease (42% of CVD deaths), hypertensive diseases (27%), and cerebrovascular diseases (10%). While proportionate mortality due to CVD among persons with HIV increased (6% in 2001 to 15% in 2012, P <. 001), the CVD mortality rate decreased from 5.1 to 2.7 per 1000 person-years. After controlling for sex, race/ethnicity, borough of residence, and year, those with HIV had significantly higher CVD mortality than the general population in all age groups through age 65. The CVD mortality rate was highest among viremic persons (adjusted rate ratio [RR], 3.53 [95% confidence interval {CI}, 3.21-3.87]) but still elevated among virally suppressed (<400 copies/mL) persons (adjusted RR, 1.53 [95% CI, 1.41-1.66]) compared with the general population. Conclusions. Our findings support continued emphasis by HIV care providers on both viremic control and preventive measures including smoking cessation, blood pressure control, and lipid management.

Original languageEnglish (US)
Pages (from-to)1122-1129
Number of pages8
JournalClinical Infectious Diseases
Volume63
Issue number8
DOIs
StatePublished - Oct 15 2016

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Cardiovascular Diseases
HIV
Mortality
Confidence Intervals
Population
Cerebrovascular Disorders
Virus Diseases
Smoking Cessation
Myocardial Ischemia
Registries
Age Groups
RNA
Blood Pressure
Lipids

Keywords

  • Cardiovascular disease
  • HIV infection
  • Mortality
  • Surveillance
  • Viral load

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Trends in Cardiovascular Disease Mortality among Persons with HIV in New York City, 2001-2012. / Hanna, David B.; Ramaswamy, Chitra; Kaplan, Robert C.; Kizer, Jorge; Anastos, Kathryn; Daskalakis, Demetre; Zimmerman, Regina; Braunstein, Sarah L.

In: Clinical Infectious Diseases, Vol. 63, No. 8, 15.10.2016, p. 1122-1129.

Research output: Contribution to journalArticle

Hanna, David B. ; Ramaswamy, Chitra ; Kaplan, Robert C. ; Kizer, Jorge ; Anastos, Kathryn ; Daskalakis, Demetre ; Zimmerman, Regina ; Braunstein, Sarah L. / Trends in Cardiovascular Disease Mortality among Persons with HIV in New York City, 2001-2012. In: Clinical Infectious Diseases. 2016 ; Vol. 63, No. 8. pp. 1122-1129.
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AU - Ramaswamy, Chitra

AU - Kaplan, Robert C.

AU - Kizer, Jorge

AU - Anastos, Kathryn

AU - Daskalakis, Demetre

AU - Zimmerman, Regina

AU - Braunstein, Sarah L.

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N2 - Background. Cardiovascular disease (CVD) has become more prominent among human immunodeficiency virus (HIV)-infected individuals. The extent to which CVD mortality rates are changing is unclear. Methods. We analyzed surveillance data for all persons aged ≥13 years with HIV infection between 2001 and 2012 reported to the New York City HIV Surveillance Registry. We examined age-specific and age-standardized mortality rates due to major CVDs. We compared mortality time trends among persons with HIV with the general population, and examined differences among HIV-infected persons by RNA level. Results. There were 29 588 deaths reported among 145 845 HIV-infected persons. Ten percent of deaths were attributed to CVD as the underlying cause, including chronic ischemic heart disease (42% of CVD deaths), hypertensive diseases (27%), and cerebrovascular diseases (10%). While proportionate mortality due to CVD among persons with HIV increased (6% in 2001 to 15% in 2012, P <. 001), the CVD mortality rate decreased from 5.1 to 2.7 per 1000 person-years. After controlling for sex, race/ethnicity, borough of residence, and year, those with HIV had significantly higher CVD mortality than the general population in all age groups through age 65. The CVD mortality rate was highest among viremic persons (adjusted rate ratio [RR], 3.53 [95% confidence interval {CI}, 3.21-3.87]) but still elevated among virally suppressed (<400 copies/mL) persons (adjusted RR, 1.53 [95% CI, 1.41-1.66]) compared with the general population. Conclusions. Our findings support continued emphasis by HIV care providers on both viremic control and preventive measures including smoking cessation, blood pressure control, and lipid management.

AB - Background. Cardiovascular disease (CVD) has become more prominent among human immunodeficiency virus (HIV)-infected individuals. The extent to which CVD mortality rates are changing is unclear. Methods. We analyzed surveillance data for all persons aged ≥13 years with HIV infection between 2001 and 2012 reported to the New York City HIV Surveillance Registry. We examined age-specific and age-standardized mortality rates due to major CVDs. We compared mortality time trends among persons with HIV with the general population, and examined differences among HIV-infected persons by RNA level. Results. There were 29 588 deaths reported among 145 845 HIV-infected persons. Ten percent of deaths were attributed to CVD as the underlying cause, including chronic ischemic heart disease (42% of CVD deaths), hypertensive diseases (27%), and cerebrovascular diseases (10%). While proportionate mortality due to CVD among persons with HIV increased (6% in 2001 to 15% in 2012, P <. 001), the CVD mortality rate decreased from 5.1 to 2.7 per 1000 person-years. After controlling for sex, race/ethnicity, borough of residence, and year, those with HIV had significantly higher CVD mortality than the general population in all age groups through age 65. The CVD mortality rate was highest among viremic persons (adjusted rate ratio [RR], 3.53 [95% confidence interval {CI}, 3.21-3.87]) but still elevated among virally suppressed (<400 copies/mL) persons (adjusted RR, 1.53 [95% CI, 1.41-1.66]) compared with the general population. Conclusions. Our findings support continued emphasis by HIV care providers on both viremic control and preventive measures including smoking cessation, blood pressure control, and lipid management.

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KW - HIV infection

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KW - Surveillance

KW - Viral load

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