Use of Preventive Measures for Cardiovascular Disease in People With HIV

By
Nadine Jaschinski
Bastian Neesgaard
Ferdinand Wit
Marc Van der Valk
Justyna Kowalska
Anna Lisa Ridolfo
Huldrych F Günthard
Marcel Stöckle
Elmar Wallner
Piotr Nowak
Antonella Castagna
Antonella d’Arminio Monforte
Kathy Petoumenos
Jennifer F Hoy
Sean Hosein
Jens Lundgren
Harmony Garges
Felipe Rogatto
Lital Young
Lars Peters
Amanda Mocroft
Lene Ryom
on behalf of the
RESPOND Study Group
F Wit
M van der Valk
M Hillebregt
K Petoumenos
M Law
J Hutchinson
W Min Han
D Rupasinghe
R Zangerle
H Appoyer
J Vera
A Clarke
B Broster
L Barbour
D Carney
L Greenland
R Coughlan
S De Wit
M Delforge
J Begovac
J Kowalska
C Stephan
M Bucht
N Chkhartishvili
O Chokoshvili
A d’Arminio Monforte
A Rodano
A Tavelli
I Fanti
C Mussini
V Borghi
M Menozzi
A Cervo
C Pradier
E Fontas
K Dollet
C Caissotti
J Casabona
J M Miro
F Burns
C Smith
F Lampe
C Chaloner
A Castagna
A Lazzarin
R Lolatto
A Sönnerborg
C Carlander
P Nowal
J Vesterbacka
D Carrick
K Stigsäter
L Mattson
H Günthard
K Kusejko
J C Wasmuth
J Rockstroh
J J Vehreschild
G Fätkenheuer
M Scherer
G Sauer
N Schulze
L Ryom*
M Law*
R Campo
S De Wit
H Garges
H Günthard
J Lundgren
F Bognar
J Rooney
C Mussini
V Vannappagari
G Wandeler
L Young
R Zangerle
J Lundgren
H Günthard
J Begovac
F Burns
A Castagna
R Campo
N Chkhartishvili
A D’Arminio Monforte
N Dedes
M Dunbar
H Garges
J Kowalska
M Law
C Mussini
C Necsoi
L Peters
K Petoumenos
C Pradier
D Raben
J Rockstroh
J Rooney
L Ryom
A Sönnerborg
V Vannappagari
J J Vehreschild
A Volny-Anne
J C Wasmuth
E D Williams
F Wit
L Young
R Zangerle
L Ryom
B Neesgaard
L Greenberg
N Jaschinski
A Timiryasova
L Bansi-Matharu
D Raben
L Peters
E Tusch
W Bannister
A Roen
D Byonanebye
O Fursa
A Pelchen-Matthews
J Reekie
V Svedhem-Johansson
M Van der Valk
F Wit
K Grabmeier-Pfistershammer
R Zangerle
J Hoy
M Bloch
D Braun
A Calmy
G Schüttfort
M Youle
S De Wit
C Mussini
S Zona
A Castagna
A Antinori
N Chkhartishvili
N Bolokadze
E Fontas
K Dollet
C Pradier
J M Miro
J M Llibre
J J Vehreschild
C Schwarze-Zander
J C Wasmuth
J Rockstroh
K Petoumenos
J Hutchinson
M Law
J Begovac
C Duvivier
G Dragovic
R Radoi
C Oprea
M Vasylyev
J Kowalska
R Matulionyte
V Mulabdic
G Marchetti
E Kuzovatova
N Coppola
I Aho
S Martini
H Bucher
A Harxhi
T Wæhre
A Pharris
A Vassilenko
G Fätkenheuer
J Bogner
A Maagaard
E Jablonowska
D Elbirt
G Marrone
C Leen
C Wyen
L Dahlerup Rasmussen
C Hatleberg
C Carlander
F Burns
M Kundro
N Dedes
E Dixon Williams
J Gallant
C Cohen
M Dunbar
A Marongiu
V Vannappagari
H Garges
R Campo
L Young
A Abutidze
I Aho
J Begovac
L Dahlerup Rasmussen
R Campo
M Dunbar
A Ekström
O Elvstam
O Fursa
C Hatleberg
J Gallant
H Garges
J Gruber
H Günthard
J Hosein
J Hoy
O Kirk
M Law
N Jaschinski
A Marongiu
B Neesgaard
L Peters
K Petoumenos
J Rooney
L Ryom
A Sönnerborg
A Timiryasova
M Van der Valk
V Vannappagari
J Vehreschild
A Weibull Wärnberg
F Wit
X Xu
L Young
R Zangerle
A Volny-Anne
N Dedes
L Mendão
E Dixon Williams
N Jaschinski
B Neesgaard
A Timiryasova
O Fursa
L Ryom
O Valdenmaier
J F Larsen
M Gardizi
D Raben
T W Elsing
L Ramesh Kumar
B Pepa
L Peters
L Greenberg
K Petoumenos
J Hutchinson
E Tusch
W Bannister
W Min Han
September 24, 2025
0 min

Open Forum Infectious Diseases

Overview

Between 2012 and 2021, the proportion of people with HIV at very high cardiovascular disease (CVD) risk increased substantially, yet uptake of preventive measures such as antihypertensives, lipid-lowering drugs, and smoking cessation remained suboptimal and largely unchanged. Certain subgroups, including those with ongoing viremia or intravenous drug use, were less likely to receive preventive therapies.

Background

Cardiovascular disease is a leading cause of death among people living with HIV on antiretroviral therapy. The D:A:D risk score, tailored for HIV populations, estimates 10-year CVD risk and guides preventive interventions. European AIDS Clinical Society guidelines recommend initiating preventive measures at >10% 10-year CVD risk, including lifestyle changes and pharmacotherapy. Despite these recommendations, data on the real-world uptake of these preventive strategies in HIV populations have been limited.

Data Highlights

Year	% with >10% 10-year CVD Risk	Antihypertensive Use (%)	Lipid-Lowering Drug Use (%)	Smoking Cessation (%)	Antidiabetic Use (%)	ACEI/ARB Use (%)
2012	32.4	67.4	55.9	7.4	60.3	42.1
2021	52.1	67.4	55.9	7.4	57.2	43.4

Key Findings

The proportion of individuals with >10% estimated 10-year CVD risk increased from 32.4% in 2012 to 52.1% in 2021.
Among very high-risk individuals, 67.4% with hypertension used antihypertensives, 55.9% with dyslipidemia used lipid-lowering drugs, and only 7.4% of smokers ceased smoking, with no significant improvement over time.
Use of antidiabetic medications in people with diabetes slightly declined over the study period (60.3% in 2012–2013 to 57.2% in 2019–2020).
ACE inhibitor or angiotensin receptor blocker use initially declined but later increased slightly (42.1% to 43.4%).
Individuals with ongoing HIV viremia or intravenous drug use were less likely to stop smoking or use lipid-lowering drugs.
Men aged ≥40 and women aged ≥50 were more likely to receive preventive medications; uptake was similar across sexes/genders.

Clinical Implications

Despite an increasing number of people with HIV at very high CVD risk, preventive measure uptake remains inadequate, highlighting the need for enhanced CVD risk management in routine HIV care. Clinicians should prioritize comprehensive risk assessment and address barriers to preventive therapy, especially in subgroups with ongoing viremia or substance use. Regular monitoring and tailored interventions may improve cardiovascular outcomes in this population.

Conclusion

The rising prevalence of very high CVD risk among people with HIV is not matched by increased use of preventive strategies, underscoring a critical gap in cardiovascular risk management. Enhanced awareness and implementation of guideline-recommended interventions are urgently needed to reduce CVD morbidity and mortality in this vulnerable group.

References

RESPOND Consortium 2024 -- Implementation of Cardiovascular Disease Prevention Strategies Among Individuals Living with HIV

Original Source(s)

Open Forum Infectious Diseases

Use of Preventive Measures for Cardiovascular Disease in People With HIV

by Nadine Jaschinski, Bastian Neesgaard, Ferdinand Wit, Marc Van der Valk, Justyna Kowalska, Anna Lisa Ridolfo, Huldrych F Günthard, Marcel Stöckle, Elmar Wallner, Piotr Nowak, Antonella Castagna, Antonella d’Arminio Monforte, Kathy Petoumenos, Jennifer F Hoy, Sean Hosein, Jens Lundgren, Harmony Garges, Felipe Rogatto, Lital Young, Lars Peters, Amanda Mocroft, Lene Ryom, on behalf of the, RESPOND Study Group, F Wit, M van der Valk, M Hillebregt, K Petoumenos, M Law, J Hutchinson, W Min Han, D Rupasinghe, R Zangerle, H Appoyer, J Vera, A Clarke, B Broster, L Barbour, D Carney, L Greenland, R Coughlan, S De Wit, M Delforge, J Begovac, J Kowalska, C Stephan, M Bucht, N Chkhartishvili, O Chokoshvili, A d’Arminio Monforte, A Rodano, A Tavelli, I Fanti, C Mussini, V Borghi, M Menozzi, A Cervo, C Pradier, E Fontas, K Dollet, C Caissotti, J Casabona, J M Miro, F Burns, C Smith, F Lampe, C Chaloner, A Castagna, A Lazzarin, R Lolatto, A Sönnerborg, C Carlander, P Nowal, J Vesterbacka, D Carrick, K Stigsäter, L Mattson, H Günthard, K Kusejko, J C Wasmuth, J Rockstroh, J J Vehreschild, G Fätkenheuer, M Scherer, G Sauer, N Schulze, L Ryom*, M Law*, R Campo, S De Wit, H Garges, H Günthard, J Lundgren, F Bognar, J Rooney, C Mussini, V Vannappagari, G Wandeler, L Young, R Zangerle, J Lundgren, H Günthard, J Begovac, F Burns, A Castagna, R Campo, N Chkhartishvili, A D’Arminio Monforte, N Dedes, M Dunbar, H Garges, J Kowalska, M Law, C Mussini, C Necsoi, L Peters, K Petoumenos, C Pradier, D Raben, J Rockstroh, J Rooney, L Ryom, A Sönnerborg, V Vannappagari, J J Vehreschild, A Volny-Anne, J C Wasmuth, E D Williams, F Wit, L Young, R Zangerle, L Ryom, B Neesgaard, L Greenberg, N Jaschinski, A Timiryasova, L Bansi-Matharu, D Raben, L Peters, E Tusch, W Bannister, A Roen, D Byonanebye, O Fursa, A Pelchen-Matthews, J Reekie, V Svedhem-Johansson, M Van der Valk, F Wit, K Grabmeier-Pfistershammer, R Zangerle, J Hoy, M Bloch, D Braun, A Calmy, G Schüttfort, M Youle, S De Wit, C Mussini, S Zona, A Castagna, A Antinori, N Chkhartishvili, N Bolokadze, E Fontas, K Dollet, C Pradier, J M Miro, J M Llibre, J J Vehreschild, C Schwarze-Zander, J C Wasmuth, J Rockstroh, K Petoumenos, J Hutchinson, M Law, J Begovac, C Duvivier, G Dragovic, R Radoi, C Oprea, M Vasylyev, J Kowalska, R Matulionyte, V Mulabdic, G Marchetti, E Kuzovatova, N Coppola, I Aho, S Martini, H Bucher, A Harxhi, T Wæhre, A Pharris, A Vassilenko, G Fätkenheuer, J Bogner, A Maagaard, E Jablonowska, D Elbirt, G Marrone, C Leen, C Wyen, L Dahlerup Rasmussen, C Hatleberg, C Carlander, F Burns, M Kundro, N Dedes, E Dixon Williams, J Gallant, C Cohen, M Dunbar, A Marongiu, V Vannappagari, H Garges, R Campo, L Young, A Abutidze, I Aho, J Begovac, L Dahlerup Rasmussen, R Campo, M Dunbar, A Ekström, O Elvstam, O Fursa, C Hatleberg, J Gallant, H Garges, J Gruber, H Günthard, J Hosein, J Hoy, O Kirk, M Law, N Jaschinski, A Marongiu, B Neesgaard, L Peters, K Petoumenos, J Rooney, L Ryom, A Sönnerborg, A Timiryasova, M Van der Valk, V Vannappagari, J Vehreschild, A Weibull Wärnberg, F Wit, X Xu, L Young, R Zangerle, A Volny-Anne, N Dedes, L Mendão, E Dixon Williams, N Jaschinski, B Neesgaard, A Timiryasova, O Fursa, L Ryom, O Valdenmaier, J F Larsen, M Gardizi, D Raben, T W Elsing, L Ramesh Kumar, B Pepa, L Peters, L Greenberg, K Petoumenos, J Hutchinson, E Tusch, W Bannister, W Min Han
September 24, 2025

Use of Preventive Measures for Cardiovascular Disease in People With HIV

Implementation of Cardiovascular Disease Prevention in People with HIV

Overview

Background

Data Highlights

Key Findings

Clinical Implications

Conclusion

References

Original Source(s)

Use of Preventive Measures for Cardiovascular Disease in People With HIV

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