Abstract P264: Excess Heart Age in HIV Outpatient Study Participants

Cardiovascular disease (CVD) is an important cause of morbidity and mortality among HIV-infected adults. Calculating an individual’s excess heart age, or the difference between their chronological age and predicted heart age, can be useful in describing their risk for developing CVD and motivating behavior change to decrease their CVD risk. The overall mean excess heart age is 7.8 and 5.4 years among U.S. men and women, respectively. We evaluated excess heart age among HIV-infected adults in medical care using sex-specific, cholesterol-based models developed from Framingham general CVD risk prediction equations. Included were HIV Outpatient Study (HOPS) participants aged 30-74 y, who had ≥2 HOPS clinic visits during 2010-2014, had no prior CVD at the start of observation, had >1 y of follow-up, and had non-missing data for all covariates. Age-standardized (2010 U.S. census) and weighted means, prevalence and 95% confidence intervals (CIs) were calculated for participant chronological age, predicted heart age, and excess heart age. From 5,088 HOPS participants assessed for eligibility, 1905 men and 584 women were included in the analysis. Heart age exceeded chronological age by 11.3 and 11.9 y among men and women, respectively (Table). Excess heart age was greatest among non-Hispanic Blacks, persons aged 50-59 y, those with less than high school education, and women with a median CD4+ count ≥500 cells/μL. Predicted heart age was higher than chronological age among HIV-infected men and women and surpassed excess heart age estimates observed in the general U.S. population. Greater excess heart age among HIV-infected adults might result from demographic differences, higher frequency of CVD risk factors including smoking, diabetes, HIV-associated excess chronic inflammation, and possibly lower use rates of antihypertensive or statin drugs. Routine clinical use of heart age calculation may help optimize CVD risk communication and interventions for aging HIV-infected persons.