Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study
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 we...
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BMJ Publishing Group
2022-06-01
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| Online Access: | https://bmjopen.bmj.com/content/12/6/e062352.full |
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| author | Pablo Perel Kuan Ken Lee Anoop SV Shah Mohammed K Ali Shirjel R Alam Jasmit Shah Hassan Adan Ahmed Jeilan Mohamed Isaiah G Akuku Sherry Eskander Michael H Chung |
| author_facet | Pablo Perel Kuan Ken Lee Anoop SV Shah Mohammed K Ali Shirjel R Alam Jasmit Shah Hassan Adan Ahmed Jeilan Mohamed Isaiah G Akuku Sherry Eskander Michael H Chung |
| author_sort | Pablo Perel |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-0e9ecd548f9d4b748f97e72bb2e08bfc |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-0e9ecd548f9d4b748f97e72bb2e08bfc2025-01-27T18:35:08ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2022-062352Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional studyPablo Perel0Kuan Ken Lee1Anoop SV Shah2Mohammed K Ali3Shirjel R Alam4Jasmit Shah5Hassan Adan Ahmed6Jeilan Mohamed7Isaiah G Akuku8Sherry Eskander9Michael H Chung10Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKBHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UKDepartment of Cardiovascular Medicine, Imperial College Healthcare NHS Trust, London, UKDepartment of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, USADepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKDepartment of Internal Medicine, Aga Khan University Hospital, Nairobi, KenyaInternal Medicine, The Aga Khan University Hospital Nairobi, Nairobi, KenyaInternal Medicine, The Aga Khan University Hospital Nairobi, Nairobi, KenyaInstitute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, KenyaDepartment of Medicine, Coptic Hospital and Coptic Hope Center for Infectious Diseases, Nairobi, KenyaDepartment of Medicine, Emory University, Atlanta, Georgia, USAObjectives 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.https://bmjopen.bmj.com/content/12/6/e062352.full |
| spellingShingle | Pablo Perel Kuan Ken Lee Anoop SV Shah Mohammed K Ali Shirjel R Alam Jasmit Shah Hassan Adan Ahmed Jeilan Mohamed Isaiah G Akuku Sherry Eskander Michael H Chung Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study BMJ Open |
| title | Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study |
| title_full | Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study |
| title_fullStr | Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study |
| title_full_unstemmed | Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study |
| title_short | Cardiovascular risk factors and markers of myocardial injury and inflammation in people living with HIV in Nairobi, Kenya: a pilot cross-sectional study |
| title_sort | cardiovascular risk factors and markers of myocardial injury and inflammation in people living with hiv in nairobi kenya a pilot cross sectional study |
| url | https://bmjopen.bmj.com/content/12/6/e062352.full |
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