Epidemiol Health.  2021;43(1):e2021002. 10.4178/epih.e2021002.

Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea

  • 1School of Nursing, Cheju Halla University, Jeju, Korea
  • 2Institute for Health and Society, Hanyang University, Seoul, Korea
  • 3School of Nursing, Hanyang University, Seoul, Korea
  • 4Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
  • 5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 6Division of Infectious Disease, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 7Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
  • 8Division of AIDS, Center for Immunology and Pathology, Korea National Institute of Health, Cheongju, Korea


As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk.
Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety.
Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD.
Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.


Acquired immunodeficiency syndrome; Anxiety; Cardiovascular disease; Depressive disorder; Human immunodeficiency virus
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