Cardiovascular risk factors and probability for cardiovascular events in HIV-infected patients: Part II: Gender differences

Objective: Due to the side effects of antiretroviral therapy and long term survival there is an increasing concern of an elevated rate of cardiovascular diseases in HIV-infected patients. The present study analysed the cardiovascular risk profile and the probability of cardiovascular events in HIV-infected patients, due to differences of gender. Methods: Cardiovascular risk factors of 309 HIV-infected adults, including 240 males were analysed. Overall 10-years probability for cardiovascular events was evaluated by the Framingham algorithm. Results: Gender differences were detected in cardiovascular risk factors such as lipid values, blood pressure and the rate of smoking. Tobacco use was much more common in HIV-infected males compared with HIV-infected females (67.5% vs. 49.3%; p < 0.001). Although no significant difference was noticed in total cholesterol (5.49 ± 0.09 vs. 5.53 ± 0.19 mmol/L, p = 0.84), the HDL-cholesterol concentration was significantly lower (1.09 ± 0.03 vs. 1.36 ± 0.06 mmol/L, p < 0.001) and the triglyceride concentration higher (3.01 ± 0.21 vs. 2.06 ± 0.26 mmol/L, p = 0.02) in HIV-infected males compared to HIV-infected females. Additionally, systolic blood pressure was higher in HIV-infected males compared with HIV-infected females (123.1 ± 1.1 vs. 115.4 ± 2.1 mmHg, p < 0.01). No significant differences were detected in HbA1c - concentrations between both groups (5.15 ± 0.07 vs. 5.31 ± 0.11,p = 0.26). The overall 10-years probability for cardiovascular events was 8.7% (median) in HIV-infected males and 1.7% in HIV-infected females (p < 0.0001). Conclusions: In the present study, we observed gender differences in the cardiovascular risk profile of HIV-infected individuals. The risk of premature atherosclerosis and associated cardiovascular events was significantly higher in HIV-infected males.