Itai M Magodoro1, Samson Okello2, Mongiwethu Dungeni3, Alison C Castle4, Shakespeare Mureyani5, Goodarz Danaei6. 1. Department of Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, 7925, South Africa; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 67 Huntingdon St, Boston, MA 02115, USA. Electronic address: itai.magodoro@uct.ac.za. 2. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 67 Huntingdon St, Boston, MA 02115, USA; Department of Internal Medicine, Mbarara University of Science and Technology, 1410 University Road, Mbarara District, Uganda; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC, 27599, USA. 3. School of Medicine, Cavendish University Zambia, Alick Nkhata Rd, Lusaka, Zambia. 4. Africa Health Research Institute, 719 Umbilo Off Ramp, Durban, 4001, South Africa; Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA. 5. Gweru District Hospital, 7th Street, Gweru, Zimbabwe. 6. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 67 Huntingdon St, Boston, MA 02115, USA.
Abstract
OBJECTIVES: Cardiovascular disease (CVD) burden is increasing among persons living with HIV (PLWH) in sub-Saharan Africa. It is unclear whether this reflects absolute increase in HIV-related CVD risk or unmasking by improved survival. Therefore, we examined whether HIV is associated with adverse cardiometabolic profiles among South African adults. METHODS: We analyzed a nationally representative dataset (n=6420), estimating the weighted prevalence of hypertension, diabetes, and 10-year predicted risk of incident fatal/nonfatal CVD (if aged ≥40 years). Associations between HIV and cardiometabolic indices were assessed using log-binomial regression models adjusted for sociodemographic factors. RESULTS: HIV population prevalence was 18.9%, with a median age of 36 years. Hypertension (44.2% vs 45.4%), diabetes (18.6% vs 20.4%), and overweight/obesity (body mass index ≥25 kg/m2: 54.9% vs 52.0%) prevalence did not substantially differ by HIV status, although PLWH had a lower 10-year predicted CVD risk (median: 5.1% vs 13.5%). In adjusted models, females who are HIV-negative had a 5 mm Hg higher median systolic blood pressure (128 vs 123 mmHg) than female PLWH. CONCLUSIONS: PLWH in South Africa have better cardiometabolic disease profiles than the general population, and social determinants, rather than HIV, may have a greater influence on cardiometabolic risk. Designating PLWH a CVD high-risk group in South Africa is likely unwarranted.
OBJECTIVES: Cardiovascular disease (CVD) burden is increasing among persons living with HIV (PLWH) in sub-Saharan Africa. It is unclear whether this reflects absolute increase in HIV-related CVD risk or unmasking by improved survival. Therefore, we examined whether HIV is associated with adverse cardiometabolic profiles among South African adults. METHODS: We analyzed a nationally representative dataset (n=6420), estimating the weighted prevalence of hypertension, diabetes, and 10-year predicted risk of incident fatal/nonfatal CVD (if aged ≥40 years). Associations between HIV and cardiometabolic indices were assessed using log-binomial regression models adjusted for sociodemographic factors. RESULTS: HIV population prevalence was 18.9%, with a median age of 36 years. Hypertension (44.2% vs 45.4%), diabetes (18.6% vs 20.4%), and overweight/obesity (body mass index ≥25 kg/m2: 54.9% vs 52.0%) prevalence did not substantially differ by HIV status, although PLWH had a lower 10-year predicted CVD risk (median: 5.1% vs 13.5%). In adjusted models, females who are HIV-negative had a 5 mm Hg higher median systolic blood pressure (128 vs 123 mmHg) than female PLWH. CONCLUSIONS: PLWH in South Africa have better cardiometabolic disease profiles than the general population, and social determinants, rather than HIV, may have a greater influence on cardiometabolic risk. Designating PLWH a CVD high-risk group in South Africa is likely unwarranted.
Authors: Ravi V Shah; Venkatesh L Murthy; Siddique A Abbasi; Ron Blankstein; Raymond Y Kwong; Allison B Goldfine; Michael Jerosch-Herold; João A C Lima; Jingzhong Ding; Matthew A Allison Journal: JACC Cardiovasc Imaging Date: 2014-11-05
Authors: A Prioreschi; R J Munthali; L Soepnel; J A Goldstein; L K Micklesfield; D M Aronoff; S A Norris Journal: BMJ Open Date: 2017-03-29 Impact factor: 2.692
Authors: Dominic Chow; Beau K Nakamoto; Katherine Sullivan; David M Sletten; Satomi Fujii; Sari Umekawa; Morgan Kocher; Kalpana J Kallianpur; Cecilia M Shikuma; Phillip Low Journal: Open Forum Infect Dis Date: 2015-07-08 Impact factor: 3.835
Authors: Alinda G Vos; Roos E Barth; Kerstin Klipstein-Grobusch; Hugo A Tempelman; Walter L J Devillé; Caitlin Dodd; Roel A Coutinho; Diederick E Grobbee Journal: J Am Heart Assoc Date: 2020-03-30 Impact factor: 5.501