Cardiovascular risk in an HIV-infected population in India

Ivan P. Marbaniang, Dileep Kadam, Rohan Suman, Nikhil Gupte, Sonali Salvi, Sandesh Patil, Dhananjay Shere, Prasad Deshpande, Vandana Kulkarni, Andrea Deluca, Amita Gupta, Vidya Mave

Research output: Contribution to journalArticle

Abstract

Objective: To characterise prevalence of traditional cardiovascular disease (CVD) risk factors, assess CVD risk and examine the effect of simulated interventions on CVD risk among HIV-infected Asian Indians. Methods: Cross-sectional data between September 2015 and July 2016 wer used to describe the prevalence of CVD risk factors. Five risk scores (Framingham, Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D), Atherosclerotic Cardiovascular, QRISK2 and Ramathibodi - Electricity Generating Authority of Thailand were used to estimate CVD risk. The effect of seven sensitivity analyses: smoking prevention; diabetes prevention; optimal blood pressure and dyslipidaemia control (total cholesterol, high-density lipoprotein (HDL)); CD4 augmentation and a combination of the scenarios on the median cumulative D:A:D CVD scores were assessed. Results: Of 402 enrolled, 56% were women, median age was 40 years (IQR: 35-45 years) and median time-updated CD4 counts were 378 cells/μL (IQR: 246-622). Fifty-five and 28% had ever been screened for hypertension and diabetes, respectively prior to enrolment. The prevalence of diabetes, hypertension, hypercholesterolaemia, low HDL, previous and current smokers were 9%, 22%, 20%, 39%, 14% and 4%, respectively. Thirty-six per cent had intermediate-to-high 5-year CVD risk by D:A:D estimates. Thirty-two per cent were eligible for statin therapy by American College of Cardiology/American Heart Association guidelines; 2% were currently on statins. In sensitivity analyses, diabetes prevention was associated with the highest reduction of CVD risk. Conclusion: CVD at younger ages among Asian Indian people living with HIV appear to be an imminent risk for morbidity. Stepping up of preventive services including screening services and prescription of statins are important strategies that must be considered.

Original languageEnglish (US)
Article numbere010893
JournalHeart Asia
Volume9
Issue number2
DOIs
StatePublished - Jun 1 2017

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India
Cardiovascular Diseases
HIV
Population
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypertension
Anti-HIV Agents
Electricity
Thailand
HDL Lipoproteins
CD4 Lymphocyte Count
Dyslipidemias
Hypercholesterolemia
LDL Lipoproteins
HDL Cholesterol
Prescriptions
Smoking
Guidelines
Blood Pressure
Morbidity

Keywords

  • cardiovascular diseases
  • diabetes mellitus
  • HIV
  • India
  • Screening
  • statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cardiovascular risk in an HIV-infected population in India. / Marbaniang, Ivan P.; Kadam, Dileep; Suman, Rohan; Gupte, Nikhil; Salvi, Sonali; Patil, Sandesh; Shere, Dhananjay; Deshpande, Prasad; Kulkarni, Vandana; Deluca, Andrea; Gupta, Amita; Mave, Vidya.

In: Heart Asia, Vol. 9, No. 2, e010893, 01.06.2017.

Research output: Contribution to journalArticle

Marbaniang, IP, Kadam, D, Suman, R, Gupte, N, Salvi, S, Patil, S, Shere, D, Deshpande, P, Kulkarni, V, Deluca, A, Gupta, A & Mave, V 2017, 'Cardiovascular risk in an HIV-infected population in India', Heart Asia, vol. 9, no. 2, e010893. https://doi.org/10.1136/heartasia-2017-010893
Marbaniang IP, Kadam D, Suman R, Gupte N, Salvi S, Patil S et al. Cardiovascular risk in an HIV-infected population in India. Heart Asia. 2017 Jun 1;9(2). e010893. https://doi.org/10.1136/heartasia-2017-010893
Marbaniang, Ivan P. ; Kadam, Dileep ; Suman, Rohan ; Gupte, Nikhil ; Salvi, Sonali ; Patil, Sandesh ; Shere, Dhananjay ; Deshpande, Prasad ; Kulkarni, Vandana ; Deluca, Andrea ; Gupta, Amita ; Mave, Vidya. / Cardiovascular risk in an HIV-infected population in India. In: Heart Asia. 2017 ; Vol. 9, No. 2.
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AU - Marbaniang, Ivan P.

AU - Kadam, Dileep

AU - Suman, Rohan

AU - Gupte, Nikhil

AU - Salvi, Sonali

AU - Patil, Sandesh

AU - Shere, Dhananjay

AU - Deshpande, Prasad

AU - Kulkarni, Vandana

AU - Deluca, Andrea

AU - Gupta, Amita

AU - Mave, Vidya

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N2 - Objective: To characterise prevalence of traditional cardiovascular disease (CVD) risk factors, assess CVD risk and examine the effect of simulated interventions on CVD risk among HIV-infected Asian Indians. Methods: Cross-sectional data between September 2015 and July 2016 wer used to describe the prevalence of CVD risk factors. Five risk scores (Framingham, Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D), Atherosclerotic Cardiovascular, QRISK2 and Ramathibodi - Electricity Generating Authority of Thailand were used to estimate CVD risk. The effect of seven sensitivity analyses: smoking prevention; diabetes prevention; optimal blood pressure and dyslipidaemia control (total cholesterol, high-density lipoprotein (HDL)); CD4 augmentation and a combination of the scenarios on the median cumulative D:A:D CVD scores were assessed. Results: Of 402 enrolled, 56% were women, median age was 40 years (IQR: 35-45 years) and median time-updated CD4 counts were 378 cells/μL (IQR: 246-622). Fifty-five and 28% had ever been screened for hypertension and diabetes, respectively prior to enrolment. The prevalence of diabetes, hypertension, hypercholesterolaemia, low HDL, previous and current smokers were 9%, 22%, 20%, 39%, 14% and 4%, respectively. Thirty-six per cent had intermediate-to-high 5-year CVD risk by D:A:D estimates. Thirty-two per cent were eligible for statin therapy by American College of Cardiology/American Heart Association guidelines; 2% were currently on statins. In sensitivity analyses, diabetes prevention was associated with the highest reduction of CVD risk. Conclusion: CVD at younger ages among Asian Indian people living with HIV appear to be an imminent risk for morbidity. Stepping up of preventive services including screening services and prescription of statins are important strategies that must be considered.

AB - Objective: To characterise prevalence of traditional cardiovascular disease (CVD) risk factors, assess CVD risk and examine the effect of simulated interventions on CVD risk among HIV-infected Asian Indians. Methods: Cross-sectional data between September 2015 and July 2016 wer used to describe the prevalence of CVD risk factors. Five risk scores (Framingham, Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D), Atherosclerotic Cardiovascular, QRISK2 and Ramathibodi - Electricity Generating Authority of Thailand were used to estimate CVD risk. The effect of seven sensitivity analyses: smoking prevention; diabetes prevention; optimal blood pressure and dyslipidaemia control (total cholesterol, high-density lipoprotein (HDL)); CD4 augmentation and a combination of the scenarios on the median cumulative D:A:D CVD scores were assessed. Results: Of 402 enrolled, 56% were women, median age was 40 years (IQR: 35-45 years) and median time-updated CD4 counts were 378 cells/μL (IQR: 246-622). Fifty-five and 28% had ever been screened for hypertension and diabetes, respectively prior to enrolment. The prevalence of diabetes, hypertension, hypercholesterolaemia, low HDL, previous and current smokers were 9%, 22%, 20%, 39%, 14% and 4%, respectively. Thirty-six per cent had intermediate-to-high 5-year CVD risk by D:A:D estimates. Thirty-two per cent were eligible for statin therapy by American College of Cardiology/American Heart Association guidelines; 2% were currently on statins. In sensitivity analyses, diabetes prevention was associated with the highest reduction of CVD risk. Conclusion: CVD at younger ages among Asian Indian people living with HIV appear to be an imminent risk for morbidity. Stepping up of preventive services including screening services and prescription of statins are important strategies that must be considered.

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