Total Mortality Decreases as Cardiovascular Mortality Increases in All HIV Infected Adult Males and Only in Black Females

In a 2016 study researchers examined patterns of cardiovascular disease (CVD) mortality for HIV-infected adults between 1999-2013. Total and proportionate cardiovascular disease mortality in HIV-infected adults was compared to the general population and those with another chronic inflammatory condition, inflammatory polyarthroplasty.  Total mortality in HIV-infected men and women decreased from 15,739 to 8,660. CVD mortality significantly increased from 307 to 400 during the same period. This pattern was observed across all racial groups for HIV-infected men, but only non-Hispanic Black HIV-infected women experienced significantly higher CVD mortality. Proportionate cardiovascular disease mortality decreased in the general population and individuals with inflammatory polyarthropathy. HIV-infected subjects dying from CVD were more likely to be men, black, younger, urban-dwelling, and to have died in a medical facility compared to the general population. CVD mortality was greater among older individuals. Ischemic heart disease decreased in the general population, but a threefold increase in ischemic heart disease was observed for HIV-infected adults. Sensitivity analyses showed that CVD mortality in HIV-infected subjects was more likely due to hypertensive heart disease and pulmonary diseases (including pulmonary embolism and pulmonary hypertension).

By B. Caceres BA, BS, MS, NP and PhD Candidate is a Nurse Clinician and Adj. Instructor at the NYU Rory Meyers College of Nursing, NY, NY.

In Feinstein et al. (2016). Patterns of Cardiovascular Mortality for HIV-Infected Adults in the United States: 1999 to 2013. The Am J Cardiol 117(2), 214–20. http://www.ncbi.nlm.nih.gov/pubmed/26639041.

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