Abstract
BACKGROUND: People with HIV (PWH) have elevated cardiovascular risk. Underrepresented racial and ethnic groups in the southern United States are disproportionately affected, yet whether cardiology care for this at-risk group improves blood pressure and lipid control or prevents cardiovascular events is unknown. METHODS AND RESULTS: We evaluated a cohort of PWH from underrepresented racial and ethnic groups who received HIV-related care at 4 centers in the southern United States during 2015 to 2018 with follow-up through 2020. Primary outcomes were blood pressure control (<140/90 mm Hg) and lipid control (low-density lipoprotein cholesterol ≤100 mg/dL) over 2 years and time to first major adverse cardiovascular event. Statistical analyses were adjusted for cohort/site and patient sociodemographic factors, HIV measures, and comorbidities. Among 3972 included PWH (median age, 47 years; 32.6% women) without diagnosed cardiovascular disease, 276 (6.9%) had a cardiology clinic visit. Cardiology visits were not associated with subsequent blood pressure control (adjusted odds ratio, 0.78 [95% CI, 0.49-1.24]; P=0.29) or lipid control (adjusted odds ratio, 2.25 [95% CI, 0.72-7.01]; P=0.16). Over 5-year follow-up, patients who had a cardiology visit had a higher risk of a major adverse cardiovascular event, death, and falsification end points, even after adjusting for measured risk factors. CONCLUSIONS: Among PWH from underrepresented racial and ethnic groups at elevated risk for cardiovascular disease, a cardiology clinic visit was not associated with risk factor improvement or reduced risk of a major adverse cardiovascular event. Our study suggests that seeing a cardiologist is not sufficient to promote cardiovascular health or prevent cardiovascular events among PWH, but with low confidence given the higher risk among those who had a cardiology visit.