Statin usage and cardiovascular risk among people living with HIV in the U.S. Military HIV Natural History Study

Derek Larson*, Seung Hyun Won, Anuradha Ganesan, Ryan C. Maves, Karl Kronmann, Jason F. Okulicz, Xiuping Chu, Christina Schofield, Thomas O’Bryan, Brian K. Agan, Robert Deiss

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: Using the American College of Cardiology/American Heart Association 2013 atherosclerotic cardiovascular disease (ASCVD) management guidelines, we conducted a retrospective cross-sectional analysis of people living with HIV in the US Military HIV Natural History Study to determine whether individuals were receiving statins when indicated. Methods: Prescription data was taken from Military Health System data. Statin eligibility was defined by ASCVD guidelines. We used the 10-year ASCVD pooled cohorts' equation to evaluate risk for each participant. Results: Across all categories, 31.9% (n = 390) of individuals met criteria for statin use, and when adding these subjects to the number of those already receiving statins (n = 96), 62.1% of all eligible subjects (n = 302/486) were actually receiving statin therapy. In multivariable analysis, individuals of African American race [odds ratio (OR) = 0.48, 95% confidence interval (CI): 0.31–0.73] or Hispanic ethnicity (OR = 0.42, 95% CI: 0.19–0.94) were less likely to receive statin prescriptions than white individuals. Individuals with a higher CD4 count (OR = 1.12, 95% CI: 1.05–1.20 per 100 cells/μL]) were significantly more likely to receive a statin prescription. Conclusions: These data highlight discrepancies between ASCVD guidelines and primary care management of people living with HIV (PLWH) in the military health system, along with important racial differences. Targeted interventions are critical to identify and treat appropriate candidates for statin therapy among PLWH in the military and other settings.

Original languageEnglish
Pages (from-to)249-258
Number of pages10
JournalHIV Medicine
Volume23
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • cardiovascular disease
  • HIV
  • military
  • preventative medicine
  • primary care
  • statin

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