Abstract 16100: Investigating the Risk of Cardiovascular Disease in Women Living With HIV: Perspectives From a Large Clinical Cohort in Miami, FL

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Louis T Vincent ◽  
Bertrand Ebner ◽  
Jelani Grant ◽  
Quentin Loyd ◽  
Alexis Powell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Laboratory Data ◽  
Retrospective Chart Review ◽  
Art Adherence ◽  
Cvd Risk ◽  
Men And Women ◽  
Women Living With Hiv ◽  
Persons Living With Hiv ◽  
Living With Hiv

Background: Cardiovascular disease (CVD) is the leading cause of death in persons living with HIV (PLWH). CVD risk in PLWH is often underestimated, and sex stratified analyses are lacking. We sought to investigate the prevalence of CVD and associated viremic and metabolic risk factors in a cohort of men and women living with HIV (MLWH and WLWH respectively). Methods: A retrospective chart review of PLWH seen at the University of Miami/Jackson Memorial Hospital outpatient HIV clinics between 2017-2019 was performed. Demographic, clinical, and laboratory data along with diagnostic studies were obtained from electronic health records. Results: A total of 985 patient charts were reviewed, among which 102 patients had one or more manifestations of CVD. Among WLWH and MLWH, overall prevalence of CVD was comparable (9.6% vs 11.0%, p=0.49). Compared to MLWH, WLWH had lower prevalence of atrial fibrillation (0.7% vs 2.2%, p=0.04) but comparable coronary artery disease, peripheral arterial disease, heart failure, and history of stroke or myocardial infarction. Among patients with CVD, WLWH and MLWH were similar in age (61.2±8.4 vs. 58.7±9.8 years, p=0.18) and had no significant differences in race or ethnicity. No differences were noted between genders in systolic blood pressure or LDL-C, although WLWH showed a trend of increased hemoglobin A1c (6.7±1.7 vs. 6.1±1.2, p=0.07), and BMI (29.9±7.6 vs. 27.3±6.2, p=0.06). Of note, WLWH had a higher average CD4 count compared to MLWH (613±335 vs 460±330 cells/mm 3 , p=0.01), but comparable antiretroviral therapy (ART) adherence (90.7% vs 84.7%, p=0.39), and presence of undetectable viral load (64.3% vs 67.2%, p=0.76). On multivariate logistic regression adjusted for age, race, viremia, and comorbidities, having diabetes was associated with increased CVD risk (OR=1.69, 95% CI [1.03-2.79], p=0.04). ART treatment was associated with decreased CVD risk (OR=0.30, 95% CI [0.14-0.65], p=0.002), while female gender was not (OR=0.76, 95% CI [0.48-1.20], p=0.24). Conclusion: Men and women living with HIV had comparable prevalence of CVD. This may be associated with a trend towards increased traditional risk factors among WLWH. Improving ART adherence and viremic control is vital to reducing CVD risk in this population.

scholarly journals Obesity in young South African women living with HIV: A cross-sectional analysis of risk factors for cardiovascular disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0255652
Author(s):  
Sherika Hanley ◽  
Dhayendre Moodley ◽  
Mergan Naidoo
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
South African ◽  
African Women ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Women Living With Hiv ◽  
South African Women ◽  
Living With Hiv

Background Young South African women are faced with a dual epidemic of HIV and obesity, placing them at a high risk of developing atherosclerotic cardiovascular disease (CVD). We sought to determine the prevalence of CVD risk factors in a cohort of reproductive-aged South African women living with HIV (WLHIV). Methods While the main purpose of an ongoing intervention study is the reduction of cardiovascular disease through the integration of CVD screening and prevention in the HIV management plan for women of reproductive age (ISCHeMiA trial), we present the prevalence of risk factors for CVD in this cohort of young women at baseline. Sociodemographic, conventional CVD risk factors, HIV-related factors and self body image perception were assessed through study questionnaires and standardized clinical and laboratory procedures. Results Of the 372 WLHIV enrolled from November 2018 to May 2019, 97% had received efavirenz-based antiretroviral treatment (ART) for at least 1 year and 67.5% (248/367) of women were overweight or obese at the time of enrolment. The prevalence of metabolic syndrome was 17.6% (95%CI 11.6–22.8) at a median age of 35 years (IQR 30.5–40.5). A significant proportion of women had abnormally low levels of high-density lipoprotein (43.2%, 80/185) and elevated levels of high sensitivity C-reactive protein (59.5%, 110/185). Seventy five percent of overweight women with an increased waist circumference reported to be satisfied with their body image. Conclusions The high prevalence of metabolic syndrome, obesity and elevated markers of inflammation in young South African WLHIV, underscores the need for a proactive integrated management approach to prevent atherosclerotic cardiovascular disease in low and middle income settings.

scholarly journals Risk factors for cardiovascular disease among Mexican-American adults in the United States and Mexico: a comparative study

2014 ◽  
Vol 56 (2) ◽  
pp. 197 ◽  
Author(s):  
Leo S Morales ◽  
Yvonne N Flores ◽  
Mei Leng ◽  
Noémie Sportiche ◽  
Katia Gallegos-Carrillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mexican American ◽  
Hdl Cholesterol ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Men And Women ◽  
The Us ◽  
Low Hdl

 Objective. To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with repre­sentative samples of US-born and Mexico-born Mexican-Americans living in the US. Materials and methods. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. Results. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and ab­dominal obesity. Conclusions. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

scholarly journals Tools for Assessing Cardiovascular Disease Risk Factors in Underserved Young Adult Populations: A Systematic Review

2021 ◽  
Vol 18 (24) ◽  
pp. 13305
Author(s):  
Audrey A. Opoku-Acheampong ◽  
Richard R. Rosenkranz ◽  
Koushik Adhikari ◽  
Nancy Muturi ◽  
Cindy Logan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Heart Disease ◽  
Young Adult ◽  
Disease Risk ◽  
Laboratory Data ◽  
Assessment Tools ◽  
Cvd Risk ◽  
Risk Assessment Tools

Cardiovascular disease (CVD, i.e., disease of the heart and blood vessels) is a major cause of death globally. Current assessment tools use either clinical or non-clinical factors alone or in combination to assess CVD risk. The aim of this review was to critically appraise, compare, and summarize existing non-clinically based tools for assessing CVD risk factors in underserved young adult (18–34-year-old) populations. Two online electronic databases—PubMed and Scopus—were searched to identify existing risk assessment tools, using a combination of CVD-related keywords. The search was limited to articles available in English only and published between January 2008 and January 2019. Of the 10,383 studies initially identified, 67 were eligible. In total, 5 out of the 67 articles assessed CVD risk in underserved young adult populations. A total of 21 distinct CVD risk assessment tools were identified; six of these did not require clinical or laboratory data in their estimation (i.e., non-clinical). The main non-clinically based tools identified were the Heart Disease Fact Questionnaire, the Health Beliefs Related to CVD-Perception measure, the Healthy Eating Opinion Survey, the Perception of Risk of Heart Disease Scale, and the WHO STEPwise approach to chronic disease factor surveillance (i.e., the STEPS instrument).

The association between obesity and cardiovascular disease mortality in different strata of socioeconomic position: evidence from pooled Norwegian health surveys

2019 ◽  
Vol 29 (6) ◽  
pp. 1160-1166
Author(s):  
Marte Kjøllesdal ◽  
Eirik Degerud ◽  
Øyvind Næss
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Socioeconomic Position ◽  
Health Surveys ◽  
Census Data ◽  
Socioeconomic Indicators ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Men And Women ◽  
Cvd Mortality

Abstract Background Socioeconomic position (SEP) is related to both obesity and cardiovascular disease (CVD). There is little evidence on whether SEP modifies the relation between obesity and CVD. The aim of the study was to investigate whether the association between obesity and CVD mortality is stronger among people with disadvantaged than among people with advantaged life course SEP. Methods Data from Norwegian population-based cardiovascular health surveys (1985–2003), including body mass index and CVD risk factors (cholesterol, blood pressure, smoking, current treatment for hypertension) were linked to socioeconomic indicators from register and census data (1960–90), and to the Cause of Death Registry (up until 2014). The total number of participants was 398 297. Results In comparison with normal weight, the age-adjusted hazard ratios and 95% confidence intervals of CVD mortality among obese participants were 2.39 (2.07–2.75) and 2.08 (1.70–2.53) among men and women with high SEP, respectively and 1.88 (1.60–2.21) and 1.75 (1.43–2.14) among men and women with low SEP. Adjustment for CVD risk factors attenuated the results in a similar manner in all SEP groups, and among both women and men. Conclusion Obesity was consistently associated with a higher risk of CVD mortality, with only minor variation according to SEP. This means that preventing or treating obesity is, for the purpose of reducing CVD risk, equally important for an individual with high or low SEP.

Cardiovascular Disease Risk in a Semirural Community in Malaysia

2009 ◽  
Vol 21 (4) ◽  
pp. 410-420 ◽  
Author(s):  
Chia Yook Chin ◽  
Srinivas Pengal
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Survey Methods ◽  
Cardiovascular Disease Risk ◽  
Epidemiological Survey ◽  
Cvd Risk ◽  
Men And Women ◽  
The Mean

Background and aim. It has been argued that cardiovascular disease (CVD) is not very prevalent in developing countries, particularly in a rural community. This study examined the prevalence of CVD risk of a semirural community in Malaysia through an epidemiological survey. Methods. Subjects were invited to a free health screening service carried out over a period of 6 weeks. Then, a follow-up study of the initial nonresponders was done in the villages that showed a poorer response. The survey was conducted using a standardized questionnaire. Hypertension was defined as blood pressure ≥140/90 mm Hg. The Framingham Coronary Disease Risk Prediction Score (FRS) was used as a measure of CVD risk. Results. A total of 1417 subjects participated in this survey. The response rate was 56%. A follow-up survey of the nonresponders did not show any differences from the initial responders in any systematic way. The prevalence of CVD risk factors was high in both men and women. The mean (±SD) FRS was 9.4 (±2.5) and 11.3 (±4.1) for men and women, respectively. The mean predicted coronary heart disease (CHD) risk was high at 20% to 25% for men and medium at 11% to 13% for women. Overall, 55.8% of the men had >20% risk of having a CHD event in the next 10 years whereas women’s risk was lower, with 15.1% having a risk of ≥20%. Conclusion. The prevalence of CVD risk even in a semirural community of a developing country is high. Every effort should be made to lower these risk factors.

Abstract 613: Cardiovascular Disease Prevalence and Risk Factors in Japanese and American Populations

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Hiroaki Ikezaki ◽  
Masumi Ai ◽  
Ernst Schaefer ◽  
Seiko Otokozawa ◽  
Bela Asztalos ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Density Lipoprotein ◽  
The United States ◽  
Prevalence Rates ◽  
Cvd Risk ◽  
Men And Women

Cardiovascular disease (CVD) prevalence is known to be lower in Japan than in the United States. In this international cohort-comparative study, we compared CVD prevalence rates and risk factors in Fukuoka, Japan and in Framingham, United States. Using plasma samples obtained after an overnight fast from men and women in Fukuoka (n=1108) and age (median, 53 years), gender and menopausal status matched subjects in Framingham (n=1101), we measured plasma glucose, insulin, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C), and triglycerides. Blood pressure, body mass index (BMI), use of medications, and history of CVD were also assessed. CVD prevalence rates were 2.1% and 1.0%, respectively, in Fukuoka men and women, and were more than 6 folder higher (both P<0.001) at 13.2% and 8.6%, respectively, in Framingham men and women. Median BMI, LDL-C, insulin levels and insulin resistance in men and women in Fukuoka were all significantly (P<0.01) lower than those in their Framingham counterparts. However the diabetes prevalence in Fukuoka men was significantly (P<0.01) higher than that observed in Framingham men, while female rates were similar, as were levels of systolic blood pressure. Smoking rates were lower in Fukuoka women, but were higher in Fukuoka men as compared to their Framingham counterparts. HDL-C and surprisingly sdLDL-C levels were significantly (P<0.001) higher in Fukuoka subjects than in Framingham subjects. Based on the results, the estimated 10 year risk of atherosclerotic cardiovascular disease, using the new American College of Cardiology/American Heart Association risk calculator, were 6.9% and 2.3%, respectively, for Framingham men and women, while these values for Fukuoka men and women were 7.4% and 1.7%, respectively. Only the risk estimates in women were significantly different (P<0.001). Our data are consistent with prior studies indicating that CVD prevalence rates in Japan are lower than those in the United States, and that CVD risk algorithms for the United States markedly overestimate CVD risk in Japan. The markedly lower levels of insulin and insulin resistance in Japanese subjects may account for some of the population differences in CVD prevalence and risk.

Cardiovascular Disease and HIV: Pathophysiology, Treatment Considerations, and Nursing Implications

2016 ◽  
Vol 36 (5) ◽  
pp. 37-46 ◽  
Author(s):  
Justin M. Cournoyer ◽  
Aven P. Garms ◽  
Kimberly N. Thiessen ◽  
Margaret T. Bowers ◽  
Melissa D. Johnson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Hiv Infection ◽  
Treatment Options ◽  
Critical Care Nurses ◽  
Manage Care ◽  
Persons Living With Hiv ◽  
Treatment Considerations ◽  
Traditional Risk Factors ◽  
Living With Hiv

HIV infection has progressed from an acute, terminal disease to a chronic illness with cardiovascular disease as the leading cause of death among persons living with HIV. As persons living with HIV infection continue to become older, traditional risk factors for atherosclerosis compounded by the pathophysiological effects of HIV infection and antiretroviral therapy markedly increase the risk for cardiovascular disease. Further, persons living with HIV are also at high risk for cardiomyopathy. Critical care nurses must recognize the risk factors for cardiovascular disease and the pathophysiology and complex treatment options in order to manage care of these patients and facilitate multidisciplinary collaboration. Two case studies are used to highlight the treatment options and nursing considerations associated with cardiovascular disease among persons living with HIV.

scholarly journals Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies

2021 ◽  
Vol 14 ◽  
pp. 117954412110287
Author(s):  
Mir Sohail Fazeli ◽  
Vadim Khaychuk ◽  
Keith Wittstock ◽  
Boris Breznen ◽  
Grace Crocket ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Literature Review ◽  
Rheumatoid Factor ◽  
Qualitative Evidence Synthesis ◽  
Cvd Risk ◽  
Rheumatoid Arthritis Risk ◽  
Published Evidence ◽  
Increased Risk

Objective: To scope the current published evidence on cardiovascular risk factors in rheumatoid arthritis (RA) focusing on the role of autoantibodies and the effect of antirheumatic agents. Methods: Two reviews were conducted in parallel: A targeted literature review (TLR) describing the risk factors associated with cardiovascular disease (CVD) in RA patients; and a systematic literature review (SLR) identifying and characterizing the association between autoantibody status and CVD risk in RA. A narrative synthesis of the evidence was carried out. Results: A total of 69 publications (49 in the TLR and 20 in the SLR) were included in the qualitative evidence synthesis. The most prevalent topic related to CVD risks in RA was inflammation as a shared mechanism behind both RA morbidity and atherosclerotic processes. Published evidence indicated that most of RA patients already had significant CV pathologies at the time of diagnosis, suggesting subclinical CVD may be developing before patients become symptomatic. Four types of autoantibodies (rheumatoid factor, anti-citrullinated peptide antibodies, anti-phospholipid autoantibodies, anti-lipoprotein autoantibodies) showed increased risk of specific cardiovascular events, such as higher risk of cardiovascular death in rheumatoid factor positive patients and higher risk of thrombosis in anti-phospholipid autoantibody positive patients. Conclusion: Autoantibodies appear to increase CVD risk; however, the magnitude of the increase and the types of CVD outcomes affected are still unclear. Prospective studies with larger populations are required to further understand and quantify the association, including the causal pathway, between specific risk factors and CVD outcomes in RA patients.

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