Use of Preventive Measures for Cardiovascular Disease in People With HIV - Scorecard - MDSpire

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

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Clinical Scorecard: Implementation of Cardiovascular Disease Prevention Strategies Among Individuals Living with HIV

At a Glance

CategoryDetail
ConditionCardiovascular disease (CVD) risk and prevention in people living with HIV
Key MechanismsUse of D:A:D 10-year CVD risk score incorporating traditional and HIV-specific factors to guide preventive interventions
Target PopulationPeople living with HIV aged ≥18 years, especially those with very high (>10%) estimated 10-year CVD risk
Care SettingRoutine clinical care in HIV cohorts across Europe and Australia

Key Highlights

  • Proportion of individuals with very high (>10%) 10-year CVD risk increased from 32.4% in 2012 to 52.1% in 2021.
  • Preventive measure uptake among very high-risk individuals was suboptimal: 67.4% used antihypertensives, 55.9% used lipid-lowering drugs, and only 7.4% of smokers ceased smoking.
  • Individuals with ongoing viremia or intravenous drug use were less likely to use lipid-lowering drugs or cease smoking; men ≥40 and women ≥50 were more likely to receive preventive treatments.

Guideline-Based Recommendations

Diagnosis

  • Annual CVD risk assessment recommended for all people with HIV aged ≥40 years using the D:A:D risk score.
  • Identify hypertension, diabetes, dyslipidemia, and smoking status to guide preventive interventions.

Management

  • Initiate lifestyle interventions including weight loss and smoking cessation for individuals with >10% 10-year CVD risk.
  • Use antihypertensive agents in those with hypertension and antidiabetic medications in those with diabetes.
  • Consider lipid-lowering drugs in individuals with dyslipidemia and in low to moderate risk individuals aged ≥40 years.
  • Modify antiretroviral therapy where indicated to reduce CVD risk.

Monitoring & Follow-up

  • Regular follow-up to assess adherence and effectiveness of preventive measures.
  • Monitor blood pressure, lipid profiles, glucose control, and smoking status periodically.

Risks

  • Underuse of preventive measures despite increasing CVD risk may lead to higher incidence of myocardial infarction, stroke, and other cardiovascular events.
  • Ongoing viremia and intravenous drug use are associated with lower uptake of preventive treatments.

Patient & Prescribing Data

People living with HIV at very high (>10%) 10-year CVD risk enrolled in RESPOND cohort (Europe and Australia).

Despite increased CVD risk over time, uptake of antihypertensives, lipid-lowering drugs, and smoking cessation remained suboptimal and largely unchanged; antidiabetic medication use slightly declined.

Clinical Best Practices

  • Implement routine annual CVD risk assessment using HIV-specific risk models like D:A:D.
  • Prioritize initiation and adherence to antihypertensives, lipid-lowering drugs, and antidiabetics in eligible patients.
  • Promote smoking cessation aggressively, especially in patients with ongoing viremia or intravenous drug use.
  • Address barriers to preventive care in vulnerable subgroups including women and older adults.
  • Increase clinician awareness and patient education regarding CVD risk management in HIV care.

References

Original Source(s)

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

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