Factors associated with high cardiovascular risk in a primarily African American, urban HIV-infected population

Shashwatee Bagchi; Shana Ab Burrowes; Lori E Fantry; Mian B Hossain; Gemechis H Tollera; Shyamasundaran Kottilil; C David Pauza; Michael Miller; Mona Baumgarten; Robert R Redfield

doi:10.1177/2050312117725644

Factors associated with high cardiovascular risk in a primarily African American, urban HIV-infected population

SAGE Open Med. 2017 Aug 10:5:2050312117725644. doi: 10.1177/2050312117725644. eCollection 2017.

Authors

Shashwatee Bagchi^{1

2}, Shana Ab Burrowes³, Lori E Fantry^{1

2}, Mian B Hossain⁴, Gemechis H Tollera^{1

5}, Shyamasundaran Kottilil^{1

2}, C David Pauza¹, Michael Miller^{6

7}, Mona Baumgarten⁶, Robert R Redfield^{1

2}

Affiliations

¹ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
² Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, USA.
³ Department of Epidemiology and Human Genetics, University of Maryland School of Medicine, Baltimore, MD, USA.
⁴ Department of Statistics, School of Community Health & Policy, Morgan State University, Baltimore, MD, USA.
⁵ Aurora Sinai Medical Center, Milwaukee, WI, USA.
⁶ Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
⁷ Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Abstract

Objective: To determine factors associated with increased risk of developing cardiovascular disease in a high-risk patient population.

Design: Cross-sectional analysis of a retrospective cohort study.

Methods: One-hundred patients at an inner city HIV clinic in 2008 were reviewed. The atherosclerotic vascular disease risk score was calculated using the Pooled Cohort Equation. Chi-square test was performed to identify associations of potential risk factors with elevated atherosclerotic vascular disease risk.

Results: Eighty-one participants were included in the final analysis. In total, 95.1% were African American, and 38.3% were women. The median atherosclerotic vascular disease risk score was 8.8% and 8.1% in 2008 and 2012, respectively. The medical co-morbidities associated with increased atherosclerotic vascular disease risk were hepatitis C infection (X² = 3.93; p value = 0.048), elevated triglycerides levels (X² = 4.0; p value = 0.046), and low albumin (X² = 4.65; p value = 0.031). There were a higher number of women with known atherosclerotic vascular disease despite lower median atherosclerotic vascular disease risk score compared to men.

Conclusion: An elevated risk of developing cardiovascular disease persists in high-risk demographic groups of the HIV epidemic even in the current HIV era. There is an unexplained gender disparity and some non-traditional risk factors not accounted for in the Pooled Cohort Equation may be contributing to the excess cardiovascular disease risk observed among HIV-infected patients.

Keywords: HIV/AIDS; albumin and HIV; cardiovascular disease; cardiovascular disease and HIV women; hepatitis C; triglyceridemia and HIV.