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November 29, 2009

Standard heart disease risk factors may underestimate risk in people with HIV

"The algorithms that are used to calculate the future risk of a heart attack and to decide which patients need clinical interventions may underestimate risk in people with HIV, the European AIDS Conference was told recently.

"Dr Giovanni Guaraldi of the University of Modena in Italy said that 41% of a group of patients he studied qualified for medical interventions such as statin therapy to prevent heart disease, on the basis of a direct electron-beam tomography (CAT) scan which detected calcification and hardening of the arteries.

"In contrast two different heart disease algorithms, the European Society for Hypertension Guidelines (ESH) and the Framingham Risk Score (FRS), suggested medical intervention for 33% and 35% of patients respectively, thus omitting 6%-8% of high risk patients.

"The European and Framingham guidelines were particularly likely to miss younger and/or female patients with hardening of the arteries, Dr Guaraldi said.

"Guaraldi said: 'At present we have to stratify patients according to the Framingham algorithm, but this is not validated in HIV patients and may underestimate disease.'"

Read more in Aidsmap, November 25, 2009.