Many patients with HIV could benefit from aspirin to reduce cardiovascular risk

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Almost a third of HIV-positive patients could benefit from aspirin treatment to reduce their risk of cardiovascular disease, Spanish investigators argue in the August 15th edition of the Journal of Acquired Immune Deficiency Syndromes.

Researchers from the Hospital Gandia, applied recently published guidance on aspirin use for primary prevention of diseases such as heart attack and stroke to their clinic population. They found that “aspirin would be indicated in 30.8% of the patients…yet only 2 patients were taking the medication.”

Aspirin can prevent blood clotting, and for that reason daily treatment with the drug has been used to help reduce the risk of cardiovascular disease in some patients.

Glossary

cardiovascular

Relating to the heart and blood vessels.

cardiovascular disease

Disease of the heart or blood vessels, such as heart attack (myocardial infarction) and stroke.

lipid

Fat or fat-like substances found in the blood and body tissues. Lipids serve as building blocks for cells and as a source of energy for the body. Cholesterol and triglycerides are types of lipids.

diabetes

A group of diseases characterized by high levels of blood sugar (glucose). Type 1 diabetes occurs when the body fails to produce insulin, which is a hormone that regulates blood sugar. Type 2 diabetes occurs when the body either does not produce enough insulin or does not use insulin normally (insulin resistance). Common symptoms of diabetes include frequent urination, unusual thirst and extreme hunger. Some antiretroviral drugs may increase the risk of type 2 diabetes.

stroke

An interruption of blood flow to the brain, caused by a broken or blocked blood vessel. A stroke results in sudden loss of brain function, such as loss of consciousness, paralysis, or changes in speech. Stroke is a medical emergency and can be life-threatening.

Updated guidance concerning the use of aspirin to prevent cardiovascular disease was published in the US in 2009.

These guidelines endorse aspirin treatment for men aged between 45-79 and women aged between 55-79 who have risk factors for cardiovascular disease.

Rates of such disease are increasing in patients with HIV, and Dr Carlos Tornero and his colleagues wished to see how their patients would be potential candidates for therapy with aspirin.

They therefore reviewed the records of 120 patients. Information was gathered on their demographics - including age and sex – together with data on established risk factors for cardiovascular disease, such as smoking, diabetes, lipids, and blood pressure.

Their analysis showed that according to the revised US guidance overall 31% of their patients, including 40% of men, would be candidates for aspirin therapy.

Despite this only two individuals were receiving the drug.

Due to the ageing of their patients, the researchers projected that a further 15% of patients would benefit for aspirin therapy within the next five years.

 “Application of the recently published recommendations on the use of aspirin in HIV-infected patients could help reduce the rise in cardiovascular events described in some studies”, comment the investigators.

They conclude, “in the management of CVR [cardiovascular risk] among HIV-infected patients, it is therefore necessary to also consider aspirin as primary prevention treatment.”

References

Tornero C et al. Aspirin is indicated for primary prevention of cardiovascular events in HIV-infected patients. J Acquir Immune Defic Syndr 54: 560, 2010.