news release
Monday, July 24, 2023
An NIH-funded clinical trial found that cholesterol-lowering treatment reduced cardiovascular events by 35%.
A study supported by the National Institutes of Health found that statins, a type of cholesterol-lowering drug, offset the high risk of cardiovascular disease in people with HIV by more than one-third, reducing the risk of five major cardiovascular events and premature deaths. It was found that one case could be prevented. Among this population. A person living with HIV may have a 50-100% increased risk of cardiovascular disease. The survey results are New England Medical Journal.
“This study suggests that statins may be an accessible and cost-effective tool to improve cardiovascular health and quality of life in people living with HIV,” said the National Heart and Lung Research Institute. – said Gary H. Gibbons, M.D., director of the Blood Institute. (NHLBI), research funder. “Additional research will allow us to further expand on this effect while providing a roadmap to quickly translate research findings into clinical practice.”
In the double-blind Phase 3 trial, known as the Randomized Trial of Prevention of HIV Vascular Events (REPRIEVE) study, researchers placed participants in a treatment group, which received a daily statin (in this case pitavastatin calcium), or a control group. were randomly assigned to one of the following. , where they received a placebo pill containing no drug. The researchers followed the participants for about five years, but ended the trial early after finding that the benefits of the treatment outweighed the potential risks.
To understand the benefits, researchers compared how often participants in each group experienced major cardiovascular events, such as heart attacks, strokes, and surgeries to open blocked arteries. They found that participants who took pitavastatin daily had 35% fewer major cardiovascular events than those who took a placebo. The researchers also measured the number of deaths combined with major cardiovascular events during the study period and found that participants in the treatment group were 21% more likely to experience these events than participants in the placebo group. It turned out to be low. Additionally, those who took pitavastatin had their low-density lipoprotein (LDL) cholesterol levels reduced by 30%.
“Lowering LDL cholesterol levels reduces the risk of cardiovascular events such as heart attack and stroke, but these findings suggest that statin therapy may have an additional benefit and may be beneficial for people living with HIV. “We’re talking about risk reduction,” said Dr. Stephen K. Grinspoon. , Professor of Medicine at Harvard University and Research Chair and Director of the Metabolism Unit at Massachusetts General Hospital. “Ongoing research into how statin therapy affects inflammation and immune activation in people with HIV may help us better understand the additional benefits that can be gained from this therapeutic approach.”
To support optimal health among study participants, researchers required enrollees to have normal liver and kidney function. They were also required to receive antiretroviral therapy, which is itself critical to reducing the risk of HIV complications and associated comorbidities, including cardiovascular disease.
REPRIEVE began in 2015 and enrolled 7,769 adults aged 40 to 75 from 145 sites in 12 countries. The adults in the study were on average 50 years old and at low to moderate risk of cardiovascular disease, so they would not normally be prescribed statins. Women accounted for 31% of the participants. Approximately 41% of study participants identified as Black, 35% as White, 15% as Asian, and 9% as another race.
The researchers noted that further research is needed to determine how these results may impact guidelines for the care of people living with HIV.
“Our goal with REPRIEVE was to test interventions to improve the lives of people living with HIV,” said Hugh Auchincloss, Acting Director of the National Institute of Allergy and Infectious Diseases (NIAID), the study sponsor. said the M.D. Ph.D. “This study, supported by thousands of participants and researchers, highlights the global need to address the comorbidities that afflict people with HIV, such as cardiovascular disease, as HIV management becomes more successful.” It showed recognition.”
According to the World Health Organization, more than 38 million people worldwide are infected with HIV. HIV is a virus that suppresses the body’s immune system if not treated. Approximately 1.5 million people were newly diagnosed with HIV in 2021.
The REPRIEVE study was partially funded by grants from NHLBI (U01HL123336, U01HL123339) and NIAID (UM1 AI068636, UM1 AI106701).
About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is a world leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit https://www.nhlbi.nih.gov.
About the National Institute of Allergy and Infectious Diseases (NIAID): NIAID conducts and conducts research at the NIH, throughout the United States, and around the world to study the causes of infectious and immune-mediated diseases and to develop better ways to prevent, diagnose, and treat these diseases. I am supporting. News releases, fact sheets, and other NIAID-related materials are available at https://www.niaid.nih.gov.
About the National Institutes of Health (NIH):The nation’s medical research agency, NIH, has 27 institutes and centers and is part of the U.S. Department of Health and Human Services. NIH is the primary federal agency that conducts and supports basic, clinical, and translational medical research, investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, please visit www.nih.gov.
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Grinspoon S, Fitch K, Zanni M, et al. Pitavastatin for preventing cardiovascular disease in HIV-infected people. N English J Medicine. 2023; doi:10.1056/NEJMoa2304146.
