Enfermedad arterial periférica y factores de riesgo vascular en pacientes infectados por el virus de la inmunodeficiencia humana: comparación entre los atendidos en el hospital y en un centro penitenciario / Peripheral arterial disease and cardiovascular risk factors among patients infected with human immunodeficiency virus: A comparison between hospital out-patients and patients in a prison

Introducción: La enfermedad cardiovascular entre los pacientes infectados por el virus de la inmunodeficiencia humana (VIH) es más frecuente que en la población general. La enfermedad arterial periférica medida mediante el índice tobillo-brazo (ITB) y los factores de riesgo cardiovascular (FRCV) no se conocen bien en todos los grupos de pacientes infectados por el VIH. Métodos: Estudio transversal de los pacientes > 45 años, infectados por el VIH, visitados el año 2008 en la consulta externa (CE) del hospital y el 2009 en los institucionalizados en un centro penitenciario (CP). Se evaluaron los FRCV, la información sobre la infección por el VIH y los hábitos de vida saludable. Se midió el ITB en reposo y se consideró patológico un valor ≤ 0,9 o ≥ 1,3. Resultados: Se incluyeron 71 pacientes (edad media de 50,6 ± 6,9 años; 86% hombres), 32 de la CE y 39 del CP. El FRCV más prevalente fue el tabaquismo (80,2%), seguido de un perfil lipídico alterado (63,3%). El tiempo de evolución de la infección por el VIH fue de 13,1 años. No seguían una dieta cardiosaludable el 74,6% de pacientes, y el 25% eran sedentarios. El ITB fue bajo en 7 (9,8%) casos y ≥ 1,3 en uno. Al comparar los pacientes de CE y del CP, estos presentaban de forma significativa (p < 0,05) menor edad media, mayor proporción de fumadores, más sujetos con cHDL bajo, más años de evolución de la infección y eran menos cumplidores de una dieta cardiosaludable. Conclusiones En nuestro estudio se ha observado una alta prevalencia de ITB alterado. El tabaquismo es el FRCV más frecuente, seguido de la alteración de los lípidos. Ambos están presentes en mayor proporción entre los pacientes ingresados en CP

Introduction: Cardiovascular disease among human immunodeficiency virus (HIV) infected patients is more frequent than in the general population. Peripheral arterial disease measured by ankle-brachial index (ABI) and cardiovascular risk factors (CVRF) is not well known in all groups of HIV-infected patients. Methods: Transversal study of HIV-infected patients > 45 years, seen as outpatients in hospital (HO) in 2008 and patients institutionalized in a prison in 2009. Cardiovascular risk factors, information on the HIV infection and healthy lifestyles were evaluated. ABI was measured at rest and was considered pathological when a value ≤ 0.9 or ≥ 1.3 was obtained. Results: We included 71 patients (mean age of 50.6 ± 6.9 years, 86% male), 32 HO and 39 in prison. The most prevalent CVRF was smoking (80.2%) followed by an altered lipid profile (63.3%). The evolution time of HIV infection was 13.1 ± 7.1 years. 74.6% of patients didn’t follow a heart-healthy diet and 25% were sedentary. The ABI was low was low in 7cases (9.8%) and ≥ 1.3 in one. Patients in prison were younger, the rate of smokers and of individuals with low HDL were higher, the time of evolution of the HIV infections was longer and they were less adherent to a heart-healthy diet than in HO, reaching in all cases statistical significance (P < .05). Conclusions: In our study there is a high prevalence of altered ABI. The most common CVRF is smoking, followed by the alteration of lipids. Patients in prison are more likely to be smokers, to have low HDL and they are less adherence to a heart-healthy diet

[Peripheral arterial disease and cardiovascular risk factors among patients infected with human immunodeficiency virus: a comparison between hospital out-patients and patients in a prison]. / Enfermedad arterial periférica y factores de riesgo vascular en pacientes infectados por el virus de la inmunodeficiencia humana: comparación entre los atendidos en el hospital y en un centro penitenciario.

INTRODUCTION: Cardiovascular disease among human immunodeficiency virus (HIV) infected patients is more frequent than in the general population. Peripheral arterial disease measured by ankle-brachial index (ABI) and cardiovascular risk factors (CVRF) is not well known in all groups of HIV-infected patients. METHODS: Transversal study of HIV-infected patients >45 years, seen as outpatients in hospital (HO) in 2008 and patients institutionalized in a prison in 2009. Cardiovascular risk factors, information on the HIV infection and healthy lifestyles were evaluated. ABI was measured at rest and was considered pathological when a value ≤ 0.9 or ≥ 1.3 was obtained. RESULTS: We included 71 patients (mean age of 50.6 ± 6.9 years, 86% male), 32 HO and 39 in prison. The most prevalent CVRF was smoking (80.2%) followed by an altered lipid profile (63.3%). The evolution time of HIV infection was 13.1 ± 7.1 years. 74.6% of patients didn't follow a heart-healthy diet and 25% were sedentary. The ABI was low in 7 cases (9.8%) and ≥ 1.3 in one. Patients in prison were younger, the rate of smokers and of individuals with low HDL were higher, the time of evolution of the HIV infections was longer and they were less adherent to a heart-healthy diet than in HO, reaching in all cases statistical significance (P<.05). CONCLUSIONS: In our study there is a high prevalence of altered ABI. The most common CVRF is smoking, followed by the alteration of lipids. Patients in prison are more likely to be smokers, to have low HDL and they are less adherence to a heart-healthy diet.