Highlights
- •Population of study men, 50.5 years old and with a moderate-high cardiovascular risk.
- •Lifestyle intervention improved lipids the first two years and tobacco consumption.
- •Decrease in cardiovascular risk estimation was achieved with lifestyle intervention.
- •Most patients had subclinical atherosclerosis at baseline that worsened over the study.
- •A proinflammatory environment found at baseline did not improve over the study.
Abstract
Objective
To assess the impact of a multidisciplinary lifestyle intervention on cardiovascular
risk and carotid intima-media thickness (c-IMT) in HIV-infected patients with Framingham
scores (FS) > 10%.
Design
Randomized pilot study; follow-up 36 months.
Methods
Virologically suppressed adult HIV-1-infected patients with FS >10% were randomized
1:1 to the intervention group (multidisciplinary lifestyle intervention) or control
group (routine care). At baseline and months 12, 24 and 36, lipid parameters were
analyzed and carotid ultrasound was performed to determine c-IMT and presence of plaques.
Biomarkers were measured at baseline and month 36. The primary endpoints were lipid
and FS changes at 36 months.
Results
Fifty-four patients were included, 27 in each arm. Median age was 50.5 years, all
patients but one were men, and FS was 16.5%. Relative to controls, total and LDL cholesterol
had significantly decreased in the intervention group at 24 months (p = 0.039, p = 0.011,
respectively). However, no differences between groups were found at month 36 in lipid
variables, neither in FS. Tobacco use decreased in the intervention group (p = 0.031).
At baseline, 74.5% of patients had subclinical atherosclerosis, and at month 36, we
observed a progression in c-IMT that was greater in the intervention group (p = 0.030).
D-dimer increased (p = 0.027) and soluble intercellular adhesion molecule-1 decreased
(p = 0.018) at 36 months.
Conclusions
In this cohort of HIV-infected patients with FS>10% and a high percentage of subclinical
atherosclerosis, a multidisciplinary lifestyle intervention resulted in a slight improvement
in some cardiovascular risk factors and the FS during the first 2 years, but did not
prevent c-IMT progression.
Keywords
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Article info
Publication history
Published online: January 11, 2016
Accepted:
January 9,
2016
Received in revised form:
December 29,
2015
Received:
July 8,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
