Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial.
Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial.
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DOI：
10.1093/cid/ciab552
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发表时间：
2021-12-06
期刊：
影响因子：
--
通讯作者：
Grinspoon S
中科院分区：
文献类型：
--
作者：
Douglas PS;Umbleja T;Bloomfield GS;Fichtenbaum CJ;Zanni MV;Overton ET;Fitch KV;Kileel EM;Aberg JA;Currier J;Sponseller CA;Melbourne K;Avihingsanon A;Bustorff F;Estrada V;Ruxrungtham K;Saumoy M;Navar AM;Hoffmann U;Ribaudo HJ;Grinspoon S
除了传统的心血管（CV）危险因素外，抗逆转录病毒治疗、生活方式和人类免疫缺陷病毒（HIV）相关因素也可能导致艾滋病毒感染者（PWH）未来发生心血管事件。在全球 REPRIEVE 随机试验的参与者中，我们根据 ACC/AHA 汇总队列方程 (PCE) 描述了人口统计学和 HIV 特征，以了解动脉粥样硬化 CV 疾病的预测风险和通过 Life's Simple 7（LS7；包括吸烟、饮食、体力活动、体重指数、血压、总胆固醇和血糖）评估的 CV 健康状况。在 7382 名 REPRIEVE 参与者中（31% 为女性，45% 为黑人），PCE 风险评分中位数为 4.5%（第一季度和第三季度的下四分位数和上四分位数：2.2、7.2）； 29% 的人 PCE 得分 <2.5%，9% 的人得分高于 10%。 PCE 评分与已知的 CV 风险因素密切相关，与免疫功能和 HIV 参数有一定的相关性（风险评分差异<1%）。 LS7 得分中位数为 9 分（Q1、Q3：7、10），共 14 分。只有 24 名参与者 (0.3%) 拥有 7/7 个理想组件，36% 的参与者拥有 ≤2 个理想组件； 90% 的理想组件少于 5 个。尽管理想健康状况在低社会人口指数国家和亚洲人中更为常见，但 LS7 的分布并不因年龄或出生性别而变化。在所有 PCE 评分中，包括最低风险类别，LS7 的饮食和身体活动模式均较差。无论 PCE 如何，LS7 导致的 CV 健康状况不佳在 REPRIEVE 参与者中很常见。这表明生活方式干预与常规治疗相结合对于改善感染者的心血管结局具有关键且独立的作用。 临床试验注册：NCT02344290。 艾滋病临床试验小组研究编号：A5332。在 REPRIEVE 试验中，人类免疫缺陷病毒 (HIV) 感染者的心血管 (CV) 风险和健康指标并不密切相关。低心血管风险艾滋病毒感染者的健康评分不佳表明，无论心血管风险预测如何，生活方式干预都发挥着关键作用。
In addition to traditional cardiovascular (CV) risk factors, antiretroviral therapy, lifestyle, and human immunodeficiency virus (HIV)-related factors may contribute to future CV events in persons with HIV (PWH). Among participants in the global REPRIEVE randomized trial, we characterized demographics and HIV characteristics relative to ACC/AHA pooled cohort equations (PCE) for atherosclerotic CV disease predicted risk and CV health evaluated by Life’s Simple 7 (LS7; includes smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and glucose). Among 7382 REPRIEVE participants (31% women, 45% Black), the median PCE risk score was 4.5% (lower and upper quartiles Q1, Q3: 2.2, 7.2); 29% had a PCE score <2.5%, and 9% scored above 10%. PCE score was related closely to known CV risk factors and modestly (<1% difference in risk score) to immune function and HIV parameters. The median LS7 score was 9 (Q1, Q3: 7, 10) of a possible 14. Only 24 participants (0.3%) had 7/7 ideal components, and 36% had ≤2 ideal components; 90% had <5 ideal components. The distribution of LS7 did not vary by age or natal sex, although ideal health was more common in low sociodemographic index countries and among Asians. Poor dietary and physical activity patterns on LS7 were seen across all PCE scores, including the lowest risk categories. Poor CV health by LS7 was common among REPRIEVE participants, regardless of PCE. This suggests a critical and independent role for lifestyle interventions in conjunction with conventional treatment to improve CV outcomes in PWH. Clinical Trials Registration: NCT02344290. AIDS Clinical Trials Group study number: A5332. Measures of cardiovascular (CV) risk and health are not closely related in persons with human immunodeficiency virus (HIV) in the REPRIEVE trial. Poor health scores among low-CV-risk persons with HIV suggest a critical role for lifestyle interventions regardless of CV risk prediction.
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影响因子：
37.8
作者：
Shay CM;Ning H;Allen NB;Carnethon MR;Chiuve SE;Greenlund KJ;Daviglus ML;Lloyd-Jones DM
通讯作者：
Lloyd-Jones DM
影响因子：
39
作者：
Freiberg MS;Chang CC;Kuller LH;Skanderson M;Lowy E;Kraemer KL;Butt AA;Bidwell Goetz M;Leaf D;Oursler KA;Rimland D;Rodriguez Barradas M;Brown S;Gibert C;McGinnis K;Crothers K;Sico J;Crane H;Warner A;Gottlieb S;Gottdiener J;Tracy RP;Budoff M;Watson C;Armah KA;Doebler D;Bryant K;Justice AC
通讯作者：
Justice AC
影响因子：
3.5
作者：
Fang, Na;Jiang, Menglin;Fan, Yu
通讯作者：
Fan, Yu
DOI：
10.1097/qai.0000000000002290
发表时间：
2020-04-15
影响因子：
3.6
作者：
Webel, Allison;Davey, Christine Horvat;Longenecker, Chris T.
通讯作者：
Longenecker, Chris T.
影响因子：
5.8
作者：
Triant, Virginia A.;Lee, Hang;Grinspoon, Steven K.
通讯作者：
Grinspoon, Steven K.