Racial differences in central hemodynamic burden in men with HIV: preliminary findings.

OBJECTIVES

African Americans infected with HIV are almost 3 times more likely to die from cardiovascular disease (CVD) than their White HIV-infected counterparts. The purpose of this study was to examine racial differences in novel measures of vascular function and CVD risk in African American and White men infected with HIV.

DESIGN

Our study uses a cross-sectional approach.

SETTING

Participants were recruited from the nutrition/infectious disease clinic at a large metropolitan hospital.

PARTICIPANTS

African American men (n=21) and White men (n=21) with HIV on stable anti-retroviral therapy were included in this study.

MAIN OUTCOME MEASURES

High resolution ultrasound was used to assess brachial artery flow mediated dilation (FMD). Applanation tonometry was used to measure carotid-femoral and carotid-radial pulse wave velocity (PWV), carotid augmentation index (Alx) and carotid-brachial pulse pressure (PP) amplification. Left ventricular (LV) pressure effort was derived from the contour of the central BP waveform.

RESULTS

There were no racial differences in brachial FMD (African American: 4.9 +/- 1.1 vs White: 5.4 +/- 1.0%; P>.05) or carotid-femoral PWV (African American: 8.9 +/- .6 vs White: 8.7 +/- .4 m/s; P>.05). African American men with HIV had significantly higher carotid-radial PWV (11.3 +/- .4 vs 9.8 +/- .3 m/s; P<.05), higher carotid Alx (6 +/- 3 vs -1 +/- 2%; P<.05), higher LV pressure effort (2262 +/- 369 vs 1030 +/- 140 dyne sec/cm2; P<.05) and lower PP amplification (1.10 +/- .03 vs 1.24 +/- .03; P<.05) compared to White men with HIV.

CONCLUSION

Elevated CVD risk in African American men with HIV may be partially mediated by increased central hemodynamic burden and not endothelial dysfunction or increased aortic stiffness.