Abstract
PURPOSE OF REVIEW
To review the risk of cardiovascular complications in HIV-infected patients receiving combination antiretroviral treatment.
RECENT FINDINGS
Recent data suggest that patients with chronic HIV infection will require continuous lifelong combination antiretroviral treatment, which may increase the risk of cardiovascular disease in all populations by substantial amounts. Simple, safe and effective interventions to reduce cardiovascular complications in HIV-infected patients will be required. Studies in the general population suggest that the primary prevention of cardiovascular disease with a pill combining blood-pressure-lowering, cholesterol-lowering and antiplatelet treatments (a polypill) might decrease cardiovascular events. An HIV polypill study with 8000 HIV-infected patients with a moderate risk of cardiovascular disease randomized to either a polypill of low-dose pravastatin, aspirin, hydrochlorothiazide and lisinopril or to placebo is described. The primary clinical endpoint would be a composite of cardiovascular mortality, non-fatal myocardial infarction and stroke. A vanguard study of 400 patients could assess changes in cholesterol, blood pressure and other risk factors. The clinical endpoint study described would have 80% power to detect a 23% reduction in the rate of cardiovascular events in the polypill arm.
SUMMARY
A study of a polypill like that proposed for the general population will provide crucial information on the risks and benefits of primary cardiovascular prevention in HIV-infected patients.
TY - JOUR
T1 - Cardiovascular complications of HIV: an overview of risk and a novel approach to prevention - the HIV polypill study.
A1 - Law,Matthew G,
PY - 2009/4/18/entrez
PY - 2006/11/1/pubmed
PY - 2006/11/1/medline
SP - 482
EP - 7
JF - Current opinion in HIV and AIDS
JO - Curr Opin HIV AIDS
VL - 1
IS - 6
N2 - PURPOSE OF REVIEW: To review the risk of cardiovascular complications in HIV-infected patients receiving combination antiretroviral treatment. RECENT FINDINGS: Recent data suggest that patients with chronic HIV infection will require continuous lifelong combination antiretroviral treatment, which may increase the risk of cardiovascular disease in all populations by substantial amounts. Simple, safe and effective interventions to reduce cardiovascular complications in HIV-infected patients will be required. Studies in the general population suggest that the primary prevention of cardiovascular disease with a pill combining blood-pressure-lowering, cholesterol-lowering and antiplatelet treatments (a polypill) might decrease cardiovascular events. An HIV polypill study with 8000 HIV-infected patients with a moderate risk of cardiovascular disease randomized to either a polypill of low-dose pravastatin, aspirin, hydrochlorothiazide and lisinopril or to placebo is described. The primary clinical endpoint would be a composite of cardiovascular mortality, non-fatal myocardial infarction and stroke. A vanguard study of 400 patients could assess changes in cholesterol, blood pressure and other risk factors. The clinical endpoint study described would have 80% power to detect a 23% reduction in the rate of cardiovascular events in the polypill arm. SUMMARY: A study of a polypill like that proposed for the general population will provide crucial information on the risks and benefits of primary cardiovascular prevention in HIV-infected patients.
SN - 1746-6318
UR - https://www.unboundmedicine.com/medline/citation/19372850/Cardiovascular_complications_of_HIV:_an_overview_of_risk_and_a_novel_approach_to_prevention___the_HIV_polypill_study_
L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=19372850.ui
DB - PRIME
DP - Unbound Medicine
ER -
