Soni Manasi, Rodriguez Violeta J, Babayigit Suat, Jones Deborah L, Kumar Mahendra
From the Departments of Medicine and Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.
South Med J. 2018 Nov;111(11):643-648. doi: 10.14423/SMJ.0000000000000893.
Racial minorities are at greater risk of cardiovascular disease (CVD), and CVD is the primary cause of mortality among human immunodeficiency virus (HIV)-infected individuals. Cocaine use also has been associated with hypertension. This study examined the contribution of lifestyle factors to systolic, diastolic, and mean arterial pressure (MAP) among people living with HIV and cocaine users from racially and ethnically diverse backgrounds.
Participants (N = 401: 213 men, 188 women) aged 18 to 50 years with no history of CVD were recruited from South Florida. A total of 200 participants were HIV-cocaine-infected, 100 were HIV-infected individuals with no history of cocaine use, and 101 were HIV-uninfected individuals with cocaine abuse or dependence. Carotid intima-media thickness and plaque, blood pressure (BP), and lifestyle risk were assessed.
Mean age was 36 years (standard deviation 9.33); the majority (62%) were African American. Carotid plaques were identified in 23% of participants; 42% were obese, 68% engaged in ≥150 minutes of weekly exercise, and 68% were smokers. Sex, body mass index (BMI), and diet were associated with systolic BP. Age, BMI, cannabis use, and diet were associated with diastolic BP and MAP.
Age, BMI, cannabis use, and diet were associated with increased diastolic BP and MAP. Cocaine did not emerge as a significant predictor of CVD after controlling for cannabis dependence. Cocaine and HIV lacked significant association with CVD, possibly because the majority of the sample was younger than age 40. Lifestyle modifications and substance abuse counseling may be important in preventing CVD among those without a history of CVD.
少数族裔患心血管疾病（CVD）的风险更高，且CVD是感染人类免疫缺陷病毒（HIV）个体的主要死亡原因。使用可卡因也与高血压有关。本研究调查了生活方式因素对来自不同种族和族裔背景的HIV感染者及可卡因使用者的收缩压、舒张压和平均动脉压（MAP）的影响。
从南佛罗里达招募了401名年龄在18至50岁之间且无CVD病史的参与者（213名男性，188名女性）。其中200名参与者为HIV合并可卡因感染，100名是无可卡因使用史的HIV感染者，101名是有可卡因滥用或依赖的未感染HIV个体。评估了颈动脉内膜中层厚度和斑块、血压（BP）及生活方式风险。
平均年龄为36岁（标准差9.33）；大多数（62%）为非裔美国人。23%的参与者发现有颈动脉斑块；42%肥胖，68%每周进行≥150分钟的锻炼，68%为吸烟者。性别、体重指数（BMI）和饮食与收缩压有关。年龄、BMI、使用大麻和饮食与舒张压及MAP有关。
年龄、BMI、使用大麻和饮食与舒张压及MAP升高有关。在控制大麻依赖后，可卡因并未成为CVD的显著预测因素。可卡因和HIV与CVD缺乏显著关联，可能是因为大多数样本年龄小于40岁。对于无CVD病史的人群，改变生活方式和进行药物滥用咨询可能对预防CVD很重要。
