March 28, 2012
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Vitamin D deficiency associated with coronary artery disease in blacks with HIV

Lai H. Clin Infect Dis. 2012;doi:10.1093/cid/cis306.

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Vitamin D deficiency was associated with silent coronary artery disease in black people with HIV, according to researchers from Johns Hopkins School of Medicine.

From August 2003 to June 2011, 674 black patients with HIV were enrolled in an observational study that investigated the effects of antiretroviral therapy regimens on subclinical atherosclerosis. Computed tomography coronary angiography was performed and vitamin D levels were obtained from participants with no symptoms or clinical evidence of coronary artery disease.

The median vitamin D level was 17 ng/dL; the prevalence of vitamin D deficiency was 20%. Significant coronary stenosis was present in 9.5% of participants. A multiple logistic regression analysis showed that the following factors were independently associated with significant coronary stenosis: male gender, diastolic blood pressure of 85 mm Hg or more, LDL cholesterol of 100 mg/dL or more, cocaine use for 15 or more years, use of ART for 6 months or more and vitamin D deficiency.

The researchers said the study has several limitations, including that most participants were smokers, and they were unable to investigate the independent effect of cigarette smoking on the outcome.

“Despite its limitations, this study’s findings of a high rate of silent coronary artery disease in cardiovascularly asymptomatic HIV-infected African Americans have disturbing but important implications for the early prevention of coronary artery disease and the management of clinically silent coronary artery disease in this population,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.