Syndemic burden, menopause, and cardiovascular risk among midlife and older women with and without HIV

Each additional syndemic condition in midlife and older women (45+), including those with HIV in the MACS/WIHS cohort, is linked to a 0.40-point higher 10-year ASCVD risk score.

• Why it matters: Co-occurring social and behavioral stressors are common in this population, but their cumulative relationship to cardiovascular risk—and how menopause might change it—was unclear.
• What they did: Using MACS/WIHS Combined Cohort Study data from October 2020 to March 2025 (1,993 women; 1,446 with HIV; 4,009 visits in a virally suppressed subgroup), the authors summed six syndemic conditions and modeled estimated 10-year ASCVD risk with linear mixed-effects models and high-risk random forest classifiers (≥7.5%).
• The result: Syndemic burden and postmenopausal status were each independently and modestly associated with higher estimated risk (0.40-point per condition; postmenopause +1.3 points), with no significant overall interaction by menopause stage (p=0.2).

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