Journal of Postgraduate Medicine
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Year : 2014  |  Volume : 60  |  Issue : 2  |  Page : 226  

A comment on "Does first line antiretroviral therapy increase the prevalence of cardiovascular risk factors in Indian patients?: A cross sectional study"

SK Raina 
 Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India

Correspondence Address:
Dr. S K Raina
Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh
India




How to cite this article:
Raina S K. A comment on "Does first line antiretroviral therapy increase the prevalence of cardiovascular risk factors in Indian patients?: A cross sectional study".J Postgrad Med 2014;60:226-226


How to cite this URL:
Raina S K. A comment on "Does first line antiretroviral therapy increase the prevalence of cardiovascular risk factors in Indian patients?: A cross sectional study". J Postgrad Med [serial online] 2014 [cited 2023 Jan 31 ];60:226-226
Available from: https://www.jpgmonline.com/text.asp?2014/60/2/226/132392


Full Text

Sir,

I went through an article entitled, "Does first line antiretroviral therapy increase the prevalence of cardiovascular risk factors in Indian patients?: A cross sectional study" published in J Postgrad Med (2013;59:258-62). [1] The article aims to study the prevalence of cardiovascular risk factors in patients on a combination of nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs (NNRTIs) - the standard combination first-line ART regimen used in tertiary referral centers. However, the methodology used to arrive at this stated aim seems inadequate.

There are many risk factors associated with coronary heart disease and stroke. Some risk factors such as family history, ethnicity, and age, cannot be changed. Other risk factors that can be treated or changed include tobacco exposure, high blood pressure (hypertension), high cholesterol, obesity, physical inactivity, diabetes, unhealthy diets, and harmful use of alcohol. [2]

Any research planning to study the influence of first-line antiretroviral therapy on the prevalence of cardiovascular risk factors, needs to take into account the various risk factors as outlined above. Matching is an ideal way to compare the different groups, to arrive at 'risk because of a single factor'. However, matching needs to take care of all the other risk factors that may confuse the outcome of the study. This point has been overlooked in this study.

Matching is a statistical technique that is used to evaluate the effect of a treatment by comparing different study groups in an observational study (as was done in the present study, as per the authors) or quasi-experiment (i.e., when the treatment is not randomly assigned). The goal of matching is, to find one (or more) non-treated unit(s) for every treated unit, with similar observable characteristics, against whom the effect of the new observation can be assessed. By matching the treated units to similar non-treated units, a comparison of outcomes among different groups is made and the bias due to confounding is reduced.

References

1Carey R, Rupali P, Abraham OC, Kattula D. Does first line antiretroviral therapy increase the prevalence of cardiovascular risk factors in Indian patients?: A cross sectional study. J Postgrad Med 2013;59:258-62.
2Cardiovascular risk factors. World Heart Foundation. Available from: www.world-heart-federation. [Last accessed on 2013 Dec 27].

 
Tuesday, January 31, 2023
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