Study Finds Flaws in Heart Disease Risk Scores for People with HIV
New Delhi: Cardiovascular disease (CVD) remains the leading global cause of illness and death, posing a significant risk to people with HIV (PWH).
Although prevention strategies rely on models like atherosclerotic cardiovascular disease (ASCVD) risk scores to estimate heart disease risk, concerns persist about the accuracy of these models for PWH, particularly in low- and middle-income countries (LMICs).
Addressing this gap, researchers from Massachusetts General Hospital, in collaboration with an international team, conducted a study evaluating how well existing ASCVD risk scores predict cardiovascular outcomes among PWH worldwide. The findings, published in Lancet HIV, reveal key insights into disparities in risk prediction.
The study analyzed data from the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE), involving individuals from low-, middle-, and high-income countries.
Results showed that existing models underestimated cardiovascular events in women and Black men in high-income countries (HICs) while overestimating risk for PWH in LMICs.
“These findings allow researchers to fine-tune cardiovascular disease prediction models for people living with HIV,” said Dr. Patrice Desvigne-Nickens, medical officer at the National Heart, Lung, and Blood Institute (NHLBI). “Assessing the accuracy of these predictions in subgroups of the population is possible because of carefully developed outreach and enrolling a diverse study population – representing all people at risk.”
Co-lead study author Dr. Steven Grinspoon, chief of the Massachusetts General Hospital Metabolism Unit, emphasized the importance of customized solutions. “This study underscores the need for nuanced, region-specific and population-specific CVD prediction models that accurately reflect cardiovascular risk for PWH, including those living in LMICs,” he said.
Highlighting the study’s practical implications, co-lead author Dr. Markella Zanni, director of Women's Health Research at the Metabolism Unit, explained, “Our team calculated correction factors for the underestimates, with future work needed to validate these values in an external cohort. We anticipate that experts on guideline committees will recognize our findings and may consider stronger treatment recommendations for women and Black or African American men living with HIV in HICs.”
This study underscores the critical need for developing equitable and accurate CVD risk prediction tools for diverse populations, aiming to improve health outcomes for PWH globally.
Rishika Verma is a graduate from Delhi University. She joined Medical Dialogues in 2023. Her interest lies in reporting health news, hospital updates, health updates, medical case studies, and advancements in healthcare, etc.