Trends in Cardiovascular Disease Mortality among Persons with HIV in New York City, 2001-2012

David B. Hanna, Chitra Ramaswamy, Robert C. Kaplan, Jorge R. Kizer, Kathryn Anastos, Demetre Daskalakis, Regina Zimmerman, Sarah L. Braunstein

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Background. Cardiovascular disease (CVD) has become more prominent among human immunodeficiency virus (HIV)-infected individuals. The extent to which CVD mortality rates are changing is unclear. Methods. We analyzed surveillance data for all persons aged ≥13 years with HIV infection between 2001 and 2012 reported to the New York City HIV Surveillance Registry. We examined age-specific and age-standardized mortality rates due to major CVDs. We compared mortality time trends among persons with HIV with the general population, and examined differences among HIV-infected persons by RNA level. Results. There were 29 588 deaths reported among 145 845 HIV-infected persons. Ten percent of deaths were attributed to CVD as the underlying cause, including chronic ischemic heart disease (42% of CVD deaths), hypertensive diseases (27%), and cerebrovascular diseases (10%). While proportionate mortality due to CVD among persons with HIV increased (6% in 2001 to 15% in 2012, P <. 001), the CVD mortality rate decreased from 5.1 to 2.7 per 1000 person-years. After controlling for sex, race/ethnicity, borough of residence, and year, those with HIV had significantly higher CVD mortality than the general population in all age groups through age 65. The CVD mortality rate was highest among viremic persons (adjusted rate ratio [RR], 3.53 [95% confidence interval {CI}, 3.21-3.87]) but still elevated among virally suppressed (<400 copies/mL) persons (adjusted RR, 1.53 [95% CI, 1.41-1.66]) compared with the general population. Conclusions. Our findings support continued emphasis by HIV care providers on both viremic control and preventive measures including smoking cessation, blood pressure control, and lipid management.

Original languageEnglish (US)
Pages (from-to)1122-1129
Number of pages8
JournalClinical Infectious Diseases
Issue number8
StatePublished - Oct 15 2016


  • Cardiovascular disease
  • HIV infection
  • Mortality
  • Surveillance
  • Viral load

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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