Among people living with HIV in New York City, the risk of dying from cardiovascular disease (CVD) is greater among women than men, independent of poverty-related risk factors, a study published in Clinical Infectious Diseases showed.
CVD-related mortality among PLWH in the city increased overall between 2007 and 2017, from 11% to 22%, the study found. During that period, 3,234 of 147,915 people living with HIV in the city died from CVD. Women and men both experienced elevated risk for CVD-related death if they were living with HIV, but the relative risk was higher for women (with an adjusted rate ratio of 1.7) than men (1.2).
Previous studies among PLWH had found that more women than men died of heart disease. However, women are also more likely to live in poorer neighborhoods with greater rates of smoking, hypertension, and other risk factors. The current study found that sex differences in CVD mortality rates persisted even after accounting for poverty, although such differences were greater in high poverty areas. (Lack of viral suppression and lower CD4 counts were also related to CVD mortality risk within the study.)
The observed differences may be related to biological factors, such as estrogen levels, or lifestyle and risk behaviors, study authors hypothesized. “To reduce mortality, HIV providers should emphasize cardiovascular disease prevention (e.g., smoking cessation, hypertension control, lipid management) and viremic control,” they recommended.