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Silent coronary artery disease, vitamin D deficiency prevalent in blacks with HIV

Issue: June 2012

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A high prevalence of vitamin D deficiency and coronary artery disease was found among black adults with HIV, according to researchers at Johns Hopkins School of Medicine. Therefore, they recommend evaluation of vitamin D deficiency, besides traditional evaluation measures, in this high-risk population.

The study included 674 black adults aged 25 to 54 years with HIV and presented with no signs or symptoms of coronary artery disease.

Besides computed tomography coronary angiography, patients had their vitamin D levels and the presence of traditional and novel risk factors for coronary artery disease assessed. Vitamin D deficiency was defined as a 25-hydroxyvitamin D level of less than 10 ng/mL.

“Recent evidence suggests that vitamin D deficiency is associated with an increased risk for clinical and subclinical coronary artery disease, and it is well known that vitamin D deficiency is highly prevalent in African Americans,” the researchers wrote.

Data indicated an overall 20% prevalence of vitamin D deficiency and 9.5% prevalence for coronary stenosis.

Being male (adjusted OR=2.19; 95% CI, 1.17-4.10); having a diastolic blood pressure of at least 85 mm Hg (AOR=1.94; 95% CI, 1.02-3.68); having a low-density lipoprotein cholesterol level of at least 100 mg/dL (AOR=1.95; 95% CI, 1.13-3.36); reporting cocaine use for 15 years or more (AOR=1.77; 95% CI, 1.01-3.10); use of ART for 6 months or more (AOR=2.26; 95% CI, 1.17-4.36); and having vitamin D deficiency (AOR=2.28; 95% CI, 1.23-4.21) were all independently associated with significant coronary stenosis, according to the researchers.

“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 concluded.

References:

Lai H. Clin Infect Dis. 2012;54:1747-1755.

Disclosures:

The researchers report no relevant financial disclosures.