scholarly journals Evaluation of Biochemical Markers of Cardiac Risk in ART-Treated HIV-Infected Adults in Rwanda

2021 ◽  
Author(s):  
Marcus Bushaku ◽  
Caleb Nyamwange ◽  
Arthur Kwena ◽  
Marc Twagirumukiza ◽  
Jean Nepo Utumatwishima ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Hiv Infection ◽  
Total Cholesterol ◽  
Biochemical Markers ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiac Risk ◽  
People Living With Hiv ◽  
African Countries ◽  
Cvd Risk

Abstract Background Life expectancy of people living with HIV infection has improved due to access to antiretroviral therapy (ART) in Rwanda like other African countries. However, both HIV infection and use of ART are associated with cardiovascular disease (CVD) risks, due to adverse changes in some biochemical markers, causing dyslipidemia and other metabolic imbalances. The CVD risk associated with metabolic biomarkers that may affect cardiac function with use of the ART, has not been well characterized in Rwanda. We evaluated the association between the use and duration of ART and abnormal changes in biochemical markers of CVD risk among HIV infected adults in Rwanda. Methods Participants were enrolled from HIV Clinics Public Health Centers in a cross-sectional study in Kigali. A total of 150 participants between 18-45 years included 30 HIV-Uninfected (HIV-) and 120 HIV-infected (HIV+) adults. Among the HIV+ adults, 40 participants were ART-naïve. Data were collected on health-related behaviors and biochemical markers of CVD risk. We compared changes in CVD-related biochemical markers between HIV-, HIV+ ART-naïve and HIV+ on ART treatment groups. Results Majority of participants were women (60%), and HIV- were younger (35±6 vs. 31±6 years). We observed differences in levels of cholesterol and triglycerides in HIV+ ART-treated and HIV+ ART-naïve groups. Total cholesterol and triglycerides were associated with use of ART. Serum triglycerides were lower in HIV+ ART-naïve compared to HIV+ on ART treatment (61.20±18.30 mg/dl vs. 85.00±38.30 mg/dl; p< 0.01). While total cholesterol was higher in HIV+ on ART than HIV+ ART-naïve (136.00±45.00 mg/dl vs. 119.00±36.00 mg/dl; p<0.04), HDL-C was associated with longer exposure to ART (68.70±30.00 mg/dl vs. 54.90±25.70 mg/dl; p=0.02) among HIV+ on ART for 0-6 months and 7-12 months respectively. Conclusion Changes in serum total cholesterol and triglycerides were associated with use of ART. Although these changes were within the upper limits of normal ranges, our findings suggest early increases in both biochemical biomarkers of cardiac risk associated. These findings underscore the need for early evaluation of lipid profiles as biomarkers of cardiovascular disease risk, to effectively monitor how ART may contribute to cardiovascular disease and deter treatment programs in African countries.

Proportion of patients eligible for statin therapy substantially varies between different cardiovascular disease risk calculators and guidelines used

2021 ◽  
pp. 095646242110293
Author(s):  
Matthias C Mueller ◽  
Susanne Usadel ◽  
Winfried V Kern ◽  
Andreas Zirlik ◽  
Qian Zhou
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Statin Therapy ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hiv Care ◽  
Risk Scores ◽  
People Living With Hiv ◽  
Cvd Risk ◽  
Cross Sectional

Because people living with HIV (PLWH) have an elevated risk for cardiovascular disease (CVD), prevention of CVD should be integrated in to HIV care. In this study, we compared the agreement between three risk scores and evaluated the indication for statin therapy based on guidelines of the American Heart Association and European AIDS Clinical Society. This study is a cross-sectional, single-center study. All PLWH ≥ 30 years without CVD and statin therapy were consecutively enrolled. Agreement between CVD risk estimates was assessed using Cohen’s kappa coefficient. Of 488 PLWH, 41.2% were female with a median age of 47.8 years. D:A:D-R classified the highest proportion of patients in the categories of high/very high risk for CVD (17.8%) compared to SCORE (4.7%) and FRS (13.7%). D:A:D-R and SCORE (κ = 0.11) as well as D:A:D-R and FRS (κ = 0.33) showed poor agreement. Based on different CVD risk equations and guidelines, indication for statin therapy ranged from 34.8% to 92.0% of patients. In conclusion, a high proportion of PLWH is at high risk for CVD likely underestimated by treating physicians. Inconsistencies in the evaluation of CVD risk and primary prophylaxis should be tackled by an interdisciplinary approach.

scholarly journals Effects of HIV Infection on Arterial Endothelial Function

2020 ◽  
Author(s):  
James H. Stein ◽  
Noah Kime ◽  
Claudia E. Korcarz ◽  
Heather Ribaudo ◽  
Judith S. Currier ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Endothelial Function ◽  
Hiv Infection ◽  
Brachial Artery ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Covariate Adjustment ◽  
People Living With Hiv ◽  
Hiv Serostatus ◽  
Living With Hiv

Objective: To determine the effects of HIV serostatus and disease severity on endothelial function in a large pooled cohort study of people living with HIV infection and HIV− controls. Approach and Results: We used participant-level data from 9 studies: 7 included people living with HIV (2 treatment-naïve) and 4 had HIV− controls. Brachial artery flow-mediated dilation (FMD) was measured using a standardized ultrasound imaging protocol with central reading. After data harmonization, multiple linear regression was used to examine the effects of HIV− serostatus, HIV disease severity measures, and cardiovascular disease risk factors on FMD. Of 2533 participants, 986 were people living with HIV (mean 44.4 [SD 11.8] years old) and 1547 were HIV− controls (42.9 [12.2] years old). The strongest and most consistent associates of FMD were brachial artery diameter, age, sex, and body mass index. The effect of HIV+ serostatus on FMD was strongly influenced by kidney function. In the highest tertile of creatinine (1.0 mg/dL), the effect of HIV+ serostatus was strong (β=−1.59% [95% CI, −2.58% to −0.60%], P =0.002), even after covariate adjustment (β=−1.36% [95% CI, −2.46% to −0.47%], P =0.003). In the lowest tertile (0.8 mg/dL), the effect of HIV+ serostatus was strong (β=−1.90% [95% CI, −2.58% to −1.21%], P <0.001), but disappeared after covariate adjustment. HIV RNA viremia, CD4+ T-cell count, and use of antiretroviral therapy were not meaningfully associated with FMD. Conclusions: The significant effect of HIV+ serostatus on FMD suggests that people living with HIV are at increased cardiovascular disease risk, especially if they have kidney disease.

scholarly journals Hot Flashes and Cardiovascular Disease Risk Indices Among Women With HIV

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Mabel Toribio ◽  
Evelynne S Fulda ◽  
Sarah M Chu ◽  
Zsofia D Drobni ◽  
Magid Awadalla ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
General Population ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hot Flashes ◽  
Cvd Risk ◽  
Hot Flash ◽  
Risk Indices ◽  
Women With Hiv

Abstract Women with HIV (WWH) transitioning through menopause have heightened cardiovascular disease (CVD) risk. In the general population, hot flash burden relates to CVD risk indices. We found higher hot flash burden among women with vs without HIV. Further, among WWH, hot flash burden related to select CVD risk indices. ClinicalTrials.gov Registration NCT02874703.

scholarly journals Consumption of dairy products and cardiovascular disease risk: results from the French prospective cohort NutriNet-Santé

2021 ◽  
pp. 1-37
Author(s):  
Laury Sellem ◽  
Bernard Srour ◽  
Kim G. Jackson ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dairy Products ◽  
Disease Risk ◽  
Heart Diseases ◽  
Cardiovascular Disease Risk ◽  
Dietary Intakes ◽  
Cvd Risk ◽  
Dairy Consumption ◽  
Fermented Dairy ◽  
The Impact

Abstract In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for cardiovascular disease (CVD) prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥ 18 years from the NutriNet-Santé cohort (2009–2019). Daily dietary intakes were collected using 24h-dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n=1,952) included cerebrovascular (n=878 cases) and coronary heart diseases (CHD, n=1,219 cases). Multivariable Cox models were performed to investigate associations. This analysis included n=104,805 French adults (mean age at baseline 42.8 years (SD 14.6)), mean follow-up 5.5 years (SD 3.0, i.e. 579,155 persons years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared to intakes below 57 g/d (HR=0.81 [0.66-0.98], p-trend=0.01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomized controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.

scholarly journals Improvements in cholesterol efflux capacity of HDL and adiponectin contribute to mitigation in cardiovascular disease risk after bariatric surgery in a cohort with morbid obesity

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Himani Thakkar ◽  
Vinnyfred Vincent ◽  
Sakshi Sukhla ◽  
Manraj Sra ◽  
Uma Kanga ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Insulin Sensitivity ◽  
Cholesterol Efflux ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk ◽  
Cholesterol Efflux Capacity ◽  
Post Surgery ◽  
Inflammatory Status

Abstract Background Bariatric surgery can alleviate cardiovascular risk via effects on cardiovascular disease (CVD) risk factors such as diabetes mellitus, hypertension, and dyslipidemia. Our study aimed to assess the cholesterol efflux capacity (CEC) of HDL as a negative risk factor for CVD in individuals with obesity and identify the factors associated with improvement in CEC 3 months following bariatric surgery. Methods We recruited 40 control individuals (mean BMI of 22.2 kg/m2) and 56 obese individuals (mean BMI of 45.9 kg/m2). The biochemical parameters, inflammatory status and CEC of HDL was measured for the obese individuals before bariatric surgery and at 3 months after surgery. The CEC was measured using a cell-based cholesterol efflux system of BODIPY-cholesterol-labelled THP-1 macrophages. Results A significant reduction in BMI (− 17%, p < 0.001), resolution of insulin sensitivity (HOMA2-IR = − 23.4%, p = 0.002; Adipo IR = − 16%, p = 0.009) and inflammation [log resistin = − 6%, p = 0.07] were observed 3 months post-surgery. CEC significantly improved 3 months after surgery [Pre: 0.91 ± 0.13; Post: 1.02 ± 0.16; p = 0.001] despite a decrease in HDL-C levels. The change in CEC correlated with the change in apo A-I (r = 0.39, p = 0.02) and adiponectin levels (r = 0.35, p = 0.03). Conclusion The results suggest that improvements in CEC, through improvement in adipose tissue health in terms of adipokine secretion and insulin sensitivity could be an important pathway in modulating obesity-related CVD risk.

scholarly journals Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy?

2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Waist Circumference ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Naïve

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.

scholarly journals Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ali A. Weinstein ◽  
Preetha Abraham ◽  
Guoqing Diao ◽  
Stacey A. Zeno ◽  
Patricia A. Deuster
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African American ◽  
Depressive Symptoms ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Regression Analyses ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

scholarly journals Time-of-day and Meal Size Effects on Clinical Lipid Markers

2020 ◽  
Author(s):  
Leilah K Grant ◽  
Charles A Czeisler ◽  
Steven W Lockley ◽  
Shadab A Rahman
Keyword(s):  
Cardiovascular Disease ◽  
Total Cholesterol ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Density Lipoprotein ◽  
Time Of Day ◽  
Lipoprotein Cholesterol ◽  
Shift Workers ◽  
Postprandial Lipid Metabolism ◽  
Lipid Panel

Abstract Context Dyslipidemia and cardiovascular disease are common in shift workers and eating at night may contribute to this pathophysiology. Objective To examine the effects of eating at different times of day on lipid profiles. Design Two 24-hour baseline days with 8 hours of sleep, 3 meals (breakfast, lunch, dinner) and a snack, followed by a 40-hour constant routine (CR) with hourly isocaloric meals. Setting Intensive Physiological Monitoring Unit, Brigham and Women’s Hospital. Participants Twenty-one healthy adults [23.4 ± 2.7 years, 5F] Intervention Forty-hour CR. Main Outcome Measures A standard clinical lipid panel, consisting of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), was assayed in blood samples collected 4-hourly across ~4 days. Results When participants ate at night, levels of TG were similar to eating during the day, however, these levels at night were reached with consuming approximately half the calories. Additionally, 24-hour levels of TG were 10% higher when meals were consumed hourly across 24 hours compared to consuming a typical 3-meal schedule while awake during the day and sleeping at night. The endogenous circadian rhythms of TG, which peaked at night, were shifted earlier by ~10 hours under baseline conditions, whereas the rhythms in total cholesterol, HDL-C, and LDL-C remained unchanged and peaked in the afternoon. Conclusions The time-of-day dependency on postprandial lipid metabolism, which leads to hypersensitivity in TG responses when eating at night, may underlie the dyslipidemia and elevated cardiovascular disease risk observed in shift workers.

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