The following is a summary of “Traditional Cardiovascular Risk Factors Are Stronger Related to Carotid Intima‐Media Thickness Than to Presence of Carotid Plaques in People Living With HIV,” published in the October 2023 issue of Cardiology by Blaauw et al.
In individuals living with HIV, cardiovascular disease stands as a prominent cause of health issues, necessitating a thorough examination of associated markers and risk factors. This study, encompassing a sizable cohort of individuals with HIV, aimed to discern the links between various cardiovascular, HIV-specific, and lipoproteomic markers with carotid intima-media thickness (cIMT) and the presence of carotid plaques.
The assessment relied on ultrasound technology to measure cIMT and detect plaque presence in 1,814 participants, revealing that 50.1% exhibited carotid plaques, with a median cIMT of 0.66 (0.57–0.76) mm. Factors such as age, Black race, body mass index, type 2 diabetes, and smoking (pack years) were positively associated with increased cIMT. Conversely, higher levels of high-density lipoprotein cholesterol, especially medium and large subclasses, exhibited a negative correlation with elevated cIMT. Interestingly, only age and previous myocardial infarction displayed a positive relationship with the presence of carotid plaques. Notably, lipid-lowering treatments were prescribed to just one-third of HIV-positive individuals at high or very high risk for cardiovascular disease.
The study underscores the significant association between traditional cardiovascular risk factors and heightened cIMT but not carotid plaques, except for age. HIV-specific factors did not manifest associations with either ultrasound measurement. Recommendations include further investigations to unveil factors contributing to plaque development and a focus on improving adherence to guidelines for prescribing lipid-lowering treatments in individuals at higher cardiovascular risk.
Source: ahajournals.org/doi/10.1161/JAHA.123.030606
