In addition, diabetes and hypertension significantly increased the risk 5-fold and 6-fold, respectively, in HIV-negative patients, but these factors did not significantly increase the risk in HIV-positive patients (Table 3). The calculated PARs resulting from Selleckchem Ku0059436 smoking, diabetes and hypertension in HIV-positive and HIV-negative patients with ACS are shown in Table 3. The combination of these three factors

accounted for approximately two-thirds of PAR in both HIV-positive and HIV-negative patients. In contrast, PARs resulting from diabetes and hypertension were 3 and 4 times lower, respectively, in HIV-positive than in HIV-negative patients. However, their individual contributions were different in HIV-positive and HIV-negative patients. The PAR resulting from smoking in HIV-positive patients was nearly double that in HIV-negative patients. In HIV-positive patients, the PAR resulting from smoking was several times higher than that resulting from diabetes or hypertension, see more and accounted for most of the PAR resulting from the combination of these three factors. In HIV-negative patients, PARs resulting from hypertension, smoking and diabetes were

more similar among each PAR value compared with the others and the contribution of each factor was substantially lower than the PAR resulting from the combination of the three factors. The most important finding of our study is that we were able to detect differences between HIV-positive and HIV-negative adults in the PARs for developing ACS resulting from

smoking, diabetes and hypertension. Smoking was the greatest contributor to ACS in HIV-positive patients, explaining 54% of the PAR compared with 60% of the PAR explained by the combination of the three factors. Smoking has been recognized as one of the major contributors to cardiovascular disease in the general population [33] and consequently active smoking is included (and has an important relative weight in comparison with other factors) in most scores estimating cardiovascular risk. In general, HIV-positive adults have a higher prevalence of smoking than HIV-negative adults, and the reasons for this are probably multifactorial. Smoking rate and characteristics in during HIV-positive adults have been associated with factors already described in the general population, such as male sex and smoking environment, but also with factors specific or more common to the HIV-infected population, such as disclosure of HIV status and reported experience of disclosure rejection, and higher rates of alcohol and illicit substance use [21]. In HIV-positive adults, major smoking-related health risks include not only cardiovascular disease but also non-AIDS neoplasia, bacterial pneumonia, and overall mortality [34]. On the plus side, smoking is a modifiable cardiovascular risk factor.