tailieunhanh - NEJM CARDIOVASCULAR DISEASE ARTICLES - Part 3

nỗ lực haps nên được chi hỗ trợ bệnh nhân của chúng tôi với cai nghiện thuốc lá và phòng chống bệnh tiểu đường, thay vì tập trung của chúng tôi để chăm chú vào các tác dụng dyslipidemic của liệu pháp kháng retrovirus | editorials haps more effort should be spent assisting our patients with smoking cessation and the prevention of diabetes rather than our focusing so intently on the dyslipidemic effects of antiretroviral therapy especially since uncontrolled viremia is a greater risk factor for death from cardiovascular causes than are the metabolic changes associated with such therapy. Aggressive treatment of HIV clearly is the main clinical priority and such therapy appears to reduce cardiovascular risk at least in the short term. With increased exposure to antiretroviral therapy there is increased exposure to cardiovascular risk factors. Being treated with a protease inhibitor may increase cardiovascular risk modestly however longer-term studies are needed to understand the significance of this observation and to determine which drugs within the classes of protease inhibitors and nonnucleoside reversetranscriptase inhibitors may contribute to the problem. Patients with HIV infection are living longer that s the good news. But the longer you live the more likely it is that heart disease will develop so the treatment of modifiable risk factors is prudent. Dr. Stein reports receiving consulting fees from Abbott and Bristol-Myers Squibb and grant support from Bristol-Myers Squibb. No other potential conflict of interest relevant to this article was reported. From the University of Wisconsin School of Medicine and Public Health Madison. 1. Passalaris JD Sepkowitz KA Glesby MJ. Coronary artery disease and human immunodeficiency virus infection. Clin Infect Dis 2000 31 787-97. 2. Maggi P Fiorentino G Epifani G et al. Premature vascular lesions in HIV-positive patients a clockwork bomb that will explode AIDS 2002 16 947-8. 3. Stein JH. Managing cardiovascular risk in patients with HIV infection. J Acquir Immune Defic Syndr 2005 38 115-23. 4. Bozzette SA Ake CF Tam HK Chang SW Louis TA. Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus .