Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study.

Abstract

OBJECTIVES:

To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya.

DESIGN:

Pilot cross-sectional study.

SETTING:

Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020.

PARTICIPANTS:

Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD).

OUTCOME MEASURES:

Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels.

RESULTS:

Across 200 PLHIV (median age 46 years, IQR 38-53; 61% women), the prevalence of hypercholesterolaemia (total cholesterol >6.1 mmol/L) and hypertension were 19% (n=30/199) and 30% (n=60/200), respectively. Smoking and diabetes prevalence was 3% (n=5/200) and 4% (n=7/200). HscTnI was below the limit of quantification (<2.5 ng/L) in 65% (n=109/169). High (>3 mg/L), intermediate (1-3 mg/L) and low (<1 mg/L) hsCRP levels were found in 38% (n=75/198), 33% (n=65/198) and 29% (n=58/198), respectively. Framingham laboratory-based risk scores classified 83% of PLHIV at low risk with 12% and 5% at intermediate and high risk, respectively. Older age (adjusted OR (aOR) per year increase 1.05, 95% CI 1.01 to 1.08) and systolic blood pressure (140-159 mm Hg (aOR 2.96; 95% CI 1.09 to 7.90) and >160 mm Hg (aOR 4.68, 95% CI 1.55 to 14) compared with <140 mm Hg) were associated with hscTnI levels. No associations were observed between hsCRP and CVD risk factors.

CONCLUSION:

The majority of PLHIV-using traditional risk estimation systems-have a low estimated CVD risk likely reflecting a younger aged population predominantly consisting of women. Hypertension and hypercholesterolaemia were common while smoking and diabetes rates remained low. While hscTnI values were associated with increasing age and raised blood pressure, no associations between hsCRP levels and traditional cardiovascular risk factors were observed.

• Authors: Hassan Adan Ahmed, Jeilan Mohamed, Isaiah G Akuku, Kuan Ken Lee, Shirjel R Alam, Pablo Perel, Jasmit Shah, Mohammed K Ali, Sherry Eskander, Michael H Chung, Anoop Sv Shah
• Journal: BMJ open (BMJ Open) Vol. 12 Issue 6 Pg. e062352 (06 06 2022) ISSN: 2044-6055 [Electronic] England
• PMID: 35667720 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Biomarkers
• C-Reactive Protein

Topics

• Aged
• Biomarkers
• C-Reactive Protein (analysis)
• Cardiovascular Diseases (complications, etiology)
• Cross-Sectional Studies
• Diabetes Mellitus
• Female
• HIV Infections (complications, epidemiology)
• Heart Disease Risk Factors
• Humans
• Hypercholesterolemia (complications, epidemiology)
• Hypertension (complications)
• Inflammation (complications, epidemiology)
• Kenya (epidemiology)
• Male
• Middle Aged
• Prevalence
• Risk Factors