In a three-year study of 700 Baltimore patients with HIV/AIDS, Johns Hopkins University School of Nursing (JHUSON) assistant professor Jason Farley, PhD, MPH, CRNP, will explore the effectiveness of healthcare clinicians in preventing cardiovascular disease (CVD) in HIV/AIDS patients.
“In an HIV/AIDS clinic population, we’re very focused on treating HIV,” said Farley. “But we’re also involved in providing primary care. The question of the study is: How good are we at preventing cardiovascular conditions when we have another life-threatening condition were paying attention to?”
Farley believes that early intervention would help greatly. Untreated HIV/AIDS has been known to increase cardiovascular problems; on the other hand, anti-retroviral therapy on HIV/AIDS patients carries risks, including of heart attacks, he explained.
Through the study, he will examine the degree to which the clinicians screen their HIV/AIDS patients’ cardiovascular health by advising them on such matters as proper diet and weight, regular exercise, and smoking cessation. He also will evaluate how well they control such conditions as hypertension and diabetes that affect CVD and that may be affected by HIV/AIDS or its treatment.
Healthcare professionals being “strapped for time” during appointments means less opportunity to address HIV/AIDS patients’ overall health, including cardiovascular health, Farley said. Meanwhile, CVD — the leading cause of morbidity and mortality in the United States – is an increasing, non-AIDS-related cause of morbidity and mortality in people with HIV/AIDS.
The pilot project also will develop an automated system for tracking the screening procedures and assessing providers’ adherence to the American Heart Associations CVD-prevention guidelines. The Automated System to Prevent Cardiovascular Disease in HIV CaRE Settings (ASPIRE) “has significant potential to improve HIV providers adherence to evidence-based primary prevention practices, a result that should translate into reductions in CVD morbidity and mortality among vulnerable patient populations with HIV/AIDS,” Farley said.
“I want to see how good we are at putting patients on lipid therapy, keeping their blood pressure under control, using prophylactic aspirin — at preventing heart disease among patients with HIV/AIDS,” Farley said.
The study is being funded through a National Institutes of Health’s National Institute of Nursing Research (NIH-NINR) grant to JHUSONs Center for Excellence for Cardiovascular Health in Vulnerable Populations.