Prevalence, Treatment, and Control of Dyslipidemia and Hypertension in 4278 HIV Outpatients

Myerson, Merle MD, EdD*,†; Poltavskiy, Eduard BS; Armstrong, Ehrin J. MD, MSc§; Kim, Shari MS; Sharp, Victoria MD; Bang, Heejung PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000168
Clinical Science
Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Author Information

*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.

Correspondence to: Merle Myerson, MD, EdD, Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai Roosevelt Hospital, 1111 Amsterdam Avenue, New York, NY 10025 (e-mail: myersonm@optonline.net).

Supported in part by a grant from the Center for Comprehensive Care.

The authors have no conflicts of interest to disclose.

Received November 12, 2013

Accepted February 25, 2014

© 2014 by Lippincott Williams & Wilkins