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Excess heart age in adult outpatients in routine HIV care

Thompson-Paul, Angela M.a; Palella, Frank J. Jrb; Rayeed, Nabilc; Ritchey, Matthew D.a; Lichtenstein, Kenneth A.d; Patel, Deeshae; Yang, Quanhea; Gillespie, Cathleena; Loustalot, Fleetwooda; Patel, Pragnaf; Buchacz, Katee the HIV Outpatient Study Investigators

doi: 10.1097/QAD.0000000000002304

Objective: Cardiovascular disease (CVD) is a common cause of morbidity and mortality among persons living with HIV (PLWH). We used individual cardiovascular risk factor profiles to estimate heart age for PLWH in medical care in the United States.

Design: Cross-sectional analyses of HIV Outpatient Study (HOPS) data

Methods: Included in this analysis were participants aged 30–74 years, without prior CVD, with at least two HOPS clinic visits during 2010–2017, at least 1-year of follow-up, and available covariate data. We calculated age and race/ethnicity-adjusted heart age and excess heart age (chronological age − heart age), using a Framingham risk score-based model.

Results: We analyzed data from 2467 men and 619 women (mean chronologic age 49.3 and 49.1 years, and 23.6% and 54.6% Non-Hispanic/Latino black, respectively). Adjusted excess heart age was 11.5 years (95% confidence interval, 11.1–12.0) among men and 13.1 years (12.0–14.1) among women. Excess heart age was seen among all age groups beginning with persons aged 30–39 years [men, 7.8 (6.9–8.8); women, 7.7 (4.9–10.4)], with the highest excess heart age among participants aged 50–59 years [men, 13.7 years (13.0–14.4); women, 16.4 years (14.8–18.0)]. More than 50% of participants had an excess heart age of at least 10 years.

Conclusions: Excess heart age is common among PLWH, begins in early adulthood, and impacts both women and men. Among PLWH, CVD risk factors should be addressed early and proactively. Routine use of the heart age calculator may help optimize CVD risk stratification and facilitate interventions for aging PLWH.

aDivision for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

bFeinberg School of Medicine, Northwestern University, Chicago, Illinois

cCerner Corporation, Kansas City, Missouri

dEisenhower Medical Center, Palm Springs, California

eDivision of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, Centers for Disease Control and Prevention, Atlanta

fDivision of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Correspondence to Angela M. Thompson-Paul, PhD, MSPH, LCDR, U.S. Public Health Service, Epidemiologist, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4700 Buford Hwy NE, MS F-73, Atlanta, GA 30341, USA. Tel: +1 770 488 8536; e-mail:

Received 19 March, 2019

Revised 14 June, 2019

Accepted 21 June, 2019

Copyright © 2019 Wolters Kluwer Health, Inc.