Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans

Matthew J. Feinstein, June Ho Kim, Prossy Bibangambah, Ruth Sentongo, Jeffrey N. Martin, Alexander C. Tsai, David Bangsberg, Linda Hemphill, Virginia A. Triant, Yap Boum, Peter W. Hunt, Samson Okello, Mark J. Siedner

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Preventable cardiovascular disease (CVD) risk factors are responsible for the majority of CVD-related deaths, and are increasingly recognized as a cause of morbidity and mortality for HIV-infected persons taking antiretroviral therapy (ART). Simplified tools such as the American Heart Association's ideal cardiovascular health (iCVH) construct may identify and prognosticate CVD risk in resource-limited settings. No studies have evaluated iCVH metrics in sub-Saharan Africa or among HIV-infected adults. Thus, the central aim of this study was to compare levels of iCVH metrics and their correlations with carotid atherosclerosis for HIV-infected adults versus uninfected controls in a well-phenotyped Ugandan cohort. We analyzed the prevalence of iCVH metrics in a mixed cohort of HIV-infected persons on stable ART and uninfected, population-based comparators in Mbarara, Uganda. We also assessed the validity of iCVH by correlating iCVH values with common carotid intima media thickness (CCIMT). HIV-infected persons had a mean of 4.9 (SD 1.1) iCVH metrics at ideal levels versus 4.3 (SD 1.2) for uninfected controls (p = .002). This difference was largely driven by differences in blood pressure, blood glucose, and diet. In multivariable-adjusted linear regression models, each additional iCVH metric at an ideal level was associated with a significant 0.024 mm decrease in CCIMT (p < .001).HIV-infected persons on ART in rural Uganda had more iCVH metrics at ideal levels than uninfected persons. The difference appeared driven by factors that are putatively influenced by access to routine medical care. Composite scores of iCVH metrics were associated with subclinical atherosclerosis and more predictive of atherosclerosis for uninfected persons.

Original languageEnglish (US)
Pages (from-to)49-56
Number of pages8
JournalAIDS Research and Human Retroviruses
Volume33
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Carotid Artery Diseases
HIV
Health
Carotid Intima-Media Thickness
Cardiovascular Diseases
Uganda
Linear Models
Atherosclerosis
American Heart Association
Africa South of the Sahara
Blood Glucose
Therapeutics
Diet
Blood Pressure
Morbidity

Keywords

  • cardiovascular disease
  • epidemiology
  • human immunodeficiency virus
  • ideal cardiovascular health
  • primary prevention
  • risk factors

ASJC Scopus subject areas

  • Immunology
  • Infectious Diseases
  • Virology

Cite this

Feinstein, M. J., Kim, J. H., Bibangambah, P., Sentongo, R., Martin, J. N., Tsai, A. C., ... Siedner, M. J. (2017). Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans. AIDS Research and Human Retroviruses, 33(1), 49-56. https://doi.org/10.1089/aid.2016.0104

Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans. / Feinstein, Matthew J.; Kim, June Ho; Bibangambah, Prossy; Sentongo, Ruth; Martin, Jeffrey N.; Tsai, Alexander C.; Bangsberg, David; Hemphill, Linda; Triant, Virginia A.; Boum, Yap; Hunt, Peter W.; Okello, Samson; Siedner, Mark J.

In: AIDS Research and Human Retroviruses, Vol. 33, No. 1, 01.01.2017, p. 49-56.

Research output: Contribution to journalArticle

Feinstein, MJ, Kim, JH, Bibangambah, P, Sentongo, R, Martin, JN, Tsai, AC, Bangsberg, D, Hemphill, L, Triant, VA, Boum, Y, Hunt, PW, Okello, S & Siedner, MJ 2017, 'Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans', AIDS Research and Human Retroviruses, vol. 33, no. 1, pp. 49-56. https://doi.org/10.1089/aid.2016.0104
Feinstein, Matthew J. ; Kim, June Ho ; Bibangambah, Prossy ; Sentongo, Ruth ; Martin, Jeffrey N. ; Tsai, Alexander C. ; Bangsberg, David ; Hemphill, Linda ; Triant, Virginia A. ; Boum, Yap ; Hunt, Peter W. ; Okello, Samson ; Siedner, Mark J. / Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans. In: AIDS Research and Human Retroviruses. 2017 ; Vol. 33, No. 1. pp. 49-56.
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