Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
Phreesia, Inc, Delaware, US.
Glob Heart. 2022 Oct 12;17(1):74. doi: 10.5334/gh.1157. eCollection 2022.
Ageing adults living with HIV (ALHIV) have increased risk of cardiovascular diseases as a result of HIV-infection-related chronic immune activation and inflammatory responses. Cardiovascular health index (CVHI) is a valid and relatively simple index for assessing the cardiovascular health (CVH) of the general population. Use of this index among ALHIV in Sub Saharan Africa, a resource-restricted setting where it could be mostly beneficial, remains limited. Understanding of the distribution and associated factors may inform the design of optimal interventions to improve CVH of ALHIV.
We aimed to assess the distribution and factors associated with CVHI scores among ALHIV in an urban setting in Tanzania.
A cross-sectional study was conducted among ALHIV on antiretroviral therapy at six HIV clinics in Dar-es-Salaam, Tanzania. We summed the score of each of the seven CVHI metric to obtain the overall CVHI score and assessed the distribution of the score by sex. We then categorized the overall score into ideal (5-7), intermediate (3-4) and poor (<3) CVH categories and performed ordinal regression to identify CVHI score associated factors.
In all, 629 ALHIV [mean age of 43.5(SD ± 11.2) years] were enrolled. Most had ideal levels of blood glucose (96.2%) and smoking status (83.4%) while less than half had ideal BMI (48.1%), blood pressure (BP) (43.9%) and dietary intake (7.8%). Less than half (47.6%) showed ideal CVH, while less than 1% had all seven metrics at ideal level. Older age (0.96(95%CI:0.95-0.97), p-value < 0.001), being retired/unemployed (0.59(95%CI:0.43-0.81), p-value < 0.01), being employed (0.76(95%CI:0.62-0.94), p-value = 0.01) alcohol use (0.41(95%CI:0.21-0.80), p-value = 0.01) and presence of non-communicable disease comorbidities (0.68(95%CI:0.48-0.97), p-value = 0.04) had significant lower odds of ideal CVH.
Based on our findings, interventions to improve CVH of ALHIV should target BP management, health education on diet for BMI control and reduction in alcohol consumption, particularly among ageing ALHIV with comorbidities.
由于 HIV 感染相关的慢性免疫激活和炎症反应，艾滋病毒感染者老年人（ALHIV）患心血管疾病的风险增加。心血管健康指数（CVHI）是评估普通人群心血管健康（CVH）的有效且相对简单的指标。在资源有限的撒哈拉以南非洲，该指数在 ALHIV 中的使用仍然有限，而在那里它可能最有益。了解其分布和相关因素可以为改善 ALHIV 的 CVH 提供最佳干预措施的设计提供信息。
我们旨在评估坦桑尼亚一个城市环境中 ALHIV 的 CVHI 评分的分布和相关因素。
在坦桑尼亚达累斯萨拉姆的六个艾滋病毒诊所，对正在接受抗逆转录病毒治疗的 ALHIV 进行了一项横断面研究。我们将七个 CVHI 指标中的每个指标的分数相加，得出整体 CVHI 分数，并按性别评估分数的分布。然后，我们将整体分数分为理想（5-7）、中等（3-4）和较差（<3）CVH 类别，并进行有序回归以确定 CVHI 评分相关因素。
共有 629 名 ALHIV[平均年龄 43.5(SD ± 11.2)岁]入组。大多数人的血糖（96.2%）和吸烟状况（83.4%）处于理想水平，而不到一半的人具有理想的 BMI（48.1%）、血压（BP）（43.9%）和饮食摄入（7.8%）。不到一半（47.6%）的人表现出理想的 CVH，而不到 1%的人有所有七个指标处于理想水平。年龄较大（0.96（95%CI：0.95-0.97），p 值<0.001）、退休/失业（0.59（95%CI：0.43-0.81），p 值<0.01）、就业（0.76（95%CI：0.62-0.94），p 值=0.01）、饮酒（0.41（95%CI：0.21-0.80），p 值=0.01）和非传染性疾病合并症（0.68（95%CI：0.48-0.97），p 值=0.04）的人，其理想 CVH 的可能性显著降低。
根据我们的研究结果，改善 ALHIV 的 CVH 的干预措施应针对 BP 管理、健康饮食教育以控制 BMI 和减少饮酒，特别是在患有合并症的老年 ALHIV 中。
