Advertisement covers the 17th Conference on Retroviruses and Opportunistic Infections

Smoking Cessation Lowers Cardiovascular Risk

Winter/Spring 2010

Cigarette smoking is associated with a significantly elevated rate of cardiovascular disease among people with HIV, but the risk begins to drop after quitting and continues to decline over time, according to findings from the large D:A:D (Data Collection on Adverse events of Anti-HIV Drugs) study presented at CROI (abstract 124).


D:A:D includes more than 33,000 HIV positive participants in the U.S., Europe, and Australia with generally well-controlled HIV disease (most on ART, more than 60% with viral load below 50 copies/mL, median CD4 count about 450 cells/mm3). More than one-third were current smokers and 19% were former smokers; about 8,200 said they quit after entering the cohort.

Current smokers had more than three times the risk for myocardial infarction (MI; heart attack) and ex-smokers approached twice the risk compared with people who never smoked. Among people who quit smoking during follow-up, excess MI risk decreased from 3.73-fold higher during the first non-smoking year, to 3.00-fold after 1-2 years, and finally to 2.07-fold after more than three years -- still about twice the risk of life-long nonsmokers.

Looking at a broader endpoint of cardiovascular disease, current smokers had 2.19-fold higher risk and former smokers had a 1.38-fold higher risk relative to nonsmokers. Again, excess risk declined steadily among people who quit during the study, falling from 2.32-fold higher during the first year to 1.49-fold after more than three years. But the risk of mortality due to all causes did not decrease in a similar pattern, suggesting that risk of death remains elevated after quitting. "Smoking cessation efforts should be a priority in the management of HIV-positive patients," the researchers recommended.

Liz Highleyman ( is a freelance medical writer based in San Francisco.

This article was provided by San Francisco AIDS Foundation. It is a part of the publication Bulletin of Experimental Treatments for AIDS. Visit San Francisco AIDS Foundation's Web site to find out more about their activities, publications and services.

No comments have been made.

Add Your Comment:
(Please note: Your name and comment will be public, and may even show up in
Internet search results. Be careful when providing personal information! Before
adding your comment, please read's Comment Policy.)

Your Name:

Your Location:

(ex: San Francisco, CA)

Your Comment:

Characters remaining:

Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

The content on this page is free of advertiser influence and was produced by our editorial team. See our content and advertising policies.