Distribution and Performance of Cardiovascular Risk Scores in a Mixed Population of HIV-Infected and Community-Based HIV-Uninfected Individuals in Uganda

Anthony N. Muiru, Prossy Bibangambah, Linda Hemphill, Ruth Sentongo, June Ho Kim, Virginia A. Triant, David R. Bangsberg, Alexander C. Tsai, Jeffrey N. Martin, Jessica E. Haberer, Yap Boum, Jorge Plutzky, Peter W. Hunt, Samson Okello, Mark J. Siedner

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared and correlated CVD risk scores with carotid intima media thickness (c-IMT) among HIV-infected and uninfected people in Uganda. METHODS: We first calculated CVD risk using the (1) Framingham laboratory-based score; (2) Framingham nonlaboratory score (FRS-BMI); (3) Reynolds risk score; (4) American College of Cardiology and American Heart Association score; and (5) the Data collection on Adverse Effects of Anti-HIV Drugs score. We then compared absolute risk scores and risk categories across each score using Pearson correlation and kappa statistics, respectively. Finally, we fit linear regression models to estimate the strength of association between each risk score and c-IMT. RESULTS: Of 205 participants, half were females and median age was 49 years [interquartile range (IQR) 46-53]. Median CD4 count was 430 cells/mm (IQR 334-546), with median 7 years of antiretroviral therapy exposure (IQR 6.4-7.5). HIV-uninfected participants had a higher median systolic blood pressure (121 vs. 110 mm Hg), prevalent current smokers (18% vs. 4%, P = 0.001), higher median CVD risk scores (P < 0.003), and greater c-IMT (0.68 vs. 0.63, P = 0.003). Overall, FRS-BMI was highly correlated with other risk scores (all rho >0.80). In linear regression models, we found significant correlations between increasing CVD risk and higher c-IMT (P < 0.01 in all models). CONCLUSIONS: In this cross-sectional study from Uganda, the FRS-BMI correlated well with standard risk scores and c-IMT. HIV-uninfected individuals had higher risk scores than HIV-infected individuals, and the difference seemed to be driven by modifiable factors.

Original languageEnglish (US)
Pages (from-to)458-464
Number of pages7
JournalJournal of acquired immune deficiency syndromes (1999)
Volume78
Issue number4
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

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Uganda
HIV
Population
Carotid Intima-Media Thickness
Cardiovascular Diseases
Linear Models
Implosive Therapy
Blood Pressure
Anti-HIV Agents
Africa South of the Sahara
CD4 Lymphocyte Count
Individuality
Cross-Sectional Studies

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Distribution and Performance of Cardiovascular Risk Scores in a Mixed Population of HIV-Infected and Community-Based HIV-Uninfected Individuals in Uganda. / Muiru, Anthony N.; Bibangambah, Prossy; Hemphill, Linda; Sentongo, Ruth; Kim, June Ho; Triant, Virginia A.; Bangsberg, David R.; Tsai, Alexander C.; Martin, Jeffrey N.; Haberer, Jessica E.; Boum, Yap; Plutzky, Jorge; Hunt, Peter W.; Okello, Samson; Siedner, Mark J.

In: Journal of acquired immune deficiency syndromes (1999), Vol. 78, No. 4, 01.08.2018, p. 458-464.

Research output: Contribution to journalArticle

Muiru, AN, Bibangambah, P, Hemphill, L, Sentongo, R, Kim, JH, Triant, VA, Bangsberg, DR, Tsai, AC, Martin, JN, Haberer, JE, Boum, Y, Plutzky, J, Hunt, PW, Okello, S & Siedner, MJ 2018, 'Distribution and Performance of Cardiovascular Risk Scores in a Mixed Population of HIV-Infected and Community-Based HIV-Uninfected Individuals in Uganda', Journal of acquired immune deficiency syndromes (1999), vol. 78, no. 4, pp. 458-464. https://doi.org/10.1097/QAI.0000000000001696
Muiru, Anthony N. ; Bibangambah, Prossy ; Hemphill, Linda ; Sentongo, Ruth ; Kim, June Ho ; Triant, Virginia A. ; Bangsberg, David R. ; Tsai, Alexander C. ; Martin, Jeffrey N. ; Haberer, Jessica E. ; Boum, Yap ; Plutzky, Jorge ; Hunt, Peter W. ; Okello, Samson ; Siedner, Mark J. / Distribution and Performance of Cardiovascular Risk Scores in a Mixed Population of HIV-Infected and Community-Based HIV-Uninfected Individuals in Uganda. In: Journal of acquired immune deficiency syndromes (1999). 2018 ; Vol. 78, No. 4. pp. 458-464.
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T1 - Distribution and Performance of Cardiovascular Risk Scores in a Mixed Population of HIV-Infected and Community-Based HIV-Uninfected Individuals in Uganda

AU - Muiru, Anthony N.

AU - Bibangambah, Prossy

AU - Hemphill, Linda

AU - Sentongo, Ruth

AU - Kim, June Ho

AU - Triant, Virginia A.

AU - Bangsberg, David R.

AU - Tsai, Alexander C.

AU - Martin, Jeffrey N.

AU - Haberer, Jessica E.

AU - Boum, Yap

AU - Plutzky, Jorge

AU - Hunt, Peter W.

AU - Okello, Samson

AU - Siedner, Mark J.

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N2 - BACKGROUND: The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared and correlated CVD risk scores with carotid intima media thickness (c-IMT) among HIV-infected and uninfected people in Uganda. METHODS: We first calculated CVD risk using the (1) Framingham laboratory-based score; (2) Framingham nonlaboratory score (FRS-BMI); (3) Reynolds risk score; (4) American College of Cardiology and American Heart Association score; and (5) the Data collection on Adverse Effects of Anti-HIV Drugs score. We then compared absolute risk scores and risk categories across each score using Pearson correlation and kappa statistics, respectively. Finally, we fit linear regression models to estimate the strength of association between each risk score and c-IMT. RESULTS: Of 205 participants, half were females and median age was 49 years [interquartile range (IQR) 46-53]. Median CD4 count was 430 cells/mm (IQR 334-546), with median 7 years of antiretroviral therapy exposure (IQR 6.4-7.5). HIV-uninfected participants had a higher median systolic blood pressure (121 vs. 110 mm Hg), prevalent current smokers (18% vs. 4%, P = 0.001), higher median CVD risk scores (P < 0.003), and greater c-IMT (0.68 vs. 0.63, P = 0.003). Overall, FRS-BMI was highly correlated with other risk scores (all rho >0.80). In linear regression models, we found significant correlations between increasing CVD risk and higher c-IMT (P < 0.01 in all models). CONCLUSIONS: In this cross-sectional study from Uganda, the FRS-BMI correlated well with standard risk scores and c-IMT. HIV-uninfected individuals had higher risk scores than HIV-infected individuals, and the difference seemed to be driven by modifiable factors.

AB - BACKGROUND: The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared and correlated CVD risk scores with carotid intima media thickness (c-IMT) among HIV-infected and uninfected people in Uganda. METHODS: We first calculated CVD risk using the (1) Framingham laboratory-based score; (2) Framingham nonlaboratory score (FRS-BMI); (3) Reynolds risk score; (4) American College of Cardiology and American Heart Association score; and (5) the Data collection on Adverse Effects of Anti-HIV Drugs score. We then compared absolute risk scores and risk categories across each score using Pearson correlation and kappa statistics, respectively. Finally, we fit linear regression models to estimate the strength of association between each risk score and c-IMT. RESULTS: Of 205 participants, half were females and median age was 49 years [interquartile range (IQR) 46-53]. Median CD4 count was 430 cells/mm (IQR 334-546), with median 7 years of antiretroviral therapy exposure (IQR 6.4-7.5). HIV-uninfected participants had a higher median systolic blood pressure (121 vs. 110 mm Hg), prevalent current smokers (18% vs. 4%, P = 0.001), higher median CVD risk scores (P < 0.003), and greater c-IMT (0.68 vs. 0.63, P = 0.003). Overall, FRS-BMI was highly correlated with other risk scores (all rho >0.80). In linear regression models, we found significant correlations between increasing CVD risk and higher c-IMT (P < 0.01 in all models). CONCLUSIONS: In this cross-sectional study from Uganda, the FRS-BMI correlated well with standard risk scores and c-IMT. HIV-uninfected individuals had higher risk scores than HIV-infected individuals, and the difference seemed to be driven by modifiable factors.

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