Assessment of cardiovascular risk factors among HIV-infected patients aged 50 years and older in Cameroon

Henri Olivier Tatsilong Pambou; Amandine Gagneux-Brunon; Bertrand Tatsinkou Fossi; Frederic Roche; Jessica Guyot; Elisabeth Botelho-Nevers; Caroline Dupre; Bienvenu Bongue; Celine Nguefeu Nkenfou; Henri Olivier Tatsilong Pambou; Amandine Gagneux-Brunon; Bertrand Tatsinkou Fossi; Frederic Roche; Jessica Guyot; Elisabeth Botelho-Nevers; Caroline Dupre; Bienvenu Bongue; Celine Nguefeu Nkenfou

doi:10.3934/publichealth.2022034

AIMS Public Health

2022, Volume 9, Issue 3: 490-505. doi: 10.3934/publichealth.2022034

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Research article Special Issues

Assessment of cardiovascular risk factors among HIV-infected patients aged 50 years and older in Cameroon

1.
University of Buea, Faculty of Sciences, Buea, Cameroon
2.
INSERM, UMR 1059, SAINBIOSE, University Jean Monnet, Saint-Etienne, France
3.
CIRI-Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Inserm, U1111, CNRS, UMR530, F42023 Saint-Etienne, France
4.
Chantal Biya International Reference Centre, System Biology Laboratory, Yaoundé, Cameroon
5.
University of Yaoundé I, Higher Normal School of Yaoundé, Yaoundé Cameroon

Received: 17 January 2022 Revised: 19 March 2022 Accepted: 27 March 2022 Published: 08 June 2022

Background
Increasing the longevity of people living with HIV (PLHIV) around the world has been accompanied by an increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity. The impact of these trends on the epidemiology of CVD among PLHIV is less clear. The aim of this study was to assess the risk factors for CVD, and to estimate these risks at 10 years in PLHIV aged 50 and above.

Methods
This was a descriptive and analytical study carried out at Mvog Ada District Hospital in Yaounde, Cameroon from January 2020 to January 2021. Descriptive bivariate analyses were used to present the data. The data are presented as frequencies and percentages for categorical variables, and in terms of means and standard deviations for continuous variables where appropriate. The 10-year CVD risk score was calculated using two tools: the validated Framingham risk score (FRS) (low < 10%, moderate 10–20% and high ≥ 20%) and SCORE score (SSC) (low < 3%, moderate 3–4% and high ≥ 5%). Multiple logistic regression models were constructed to examine the respective relationships between the binary dependent variable high CVD risk (FRS ≥ 20%) and the population group, alcohol consumption (more than 10 glasses of beer per week, or more than 35.7 cl/day) and hypertriglyceridemia (independent variables). A p-value less than or equal to 0.05 was considered statistically significant.

Results
A total of 112 people aged 50 and above were enrolled in the study out of 180 people registered at the HIV care unit, that is a participation rate of 62.22%. The average age of the participants was 57.3 ± 6.4 years, and the female/male ratio was 1.6. The majority of participants (53.57%) had normal glycaemia levels (<1.10 g/L), 4.46% were diabetic and 46.40% had high blood pressure. The adherence rate for ARV treatment was 98.20%; most participants (77.20%) were alcohol consumers, and 28.10% of participants had hypertriglyceridemia. The estimates of overall cardiovascular risk in 10 years presented 50.90% of participants with low risk, 33% with moderate risk and 16.10% with high risk.

Conclusions
Our study indicated an overall risk of cardiovascular events in 10 years is 16.10%, with the main conditional risk factor being hypertriglyceridemia and alcohol consumption, which appeared to triple the risk of CVD among PLHIV.
- HDL cholesterol,
- risk of cardiovascular events,
- PLHIV
Citation: Henri Olivier Tatsilong Pambou, Amandine Gagneux-Brunon, Bertrand Tatsinkou Fossi, Frederic Roche, Jessica Guyot, Elisabeth Botelho-Nevers, Caroline Dupre, Bienvenu Bongue, Celine Nguefeu Nkenfou. Assessment of cardiovascular risk factors among HIV-infected patients aged 50 years and older in Cameroon[J]. AIMS Public Health, 2022, 9(3): 490-505. doi: 10.3934/publichealth.2022034

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Abstract

Background

Increasing the longevity of people living with HIV (PLHIV) around the world has been accompanied by an increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity. The impact of these trends on the epidemiology of CVD among PLHIV is less clear. The aim of this study was to assess the risk factors for CVD, and to estimate these risks at 10 years in PLHIV aged 50 and above.

Methods

This was a descriptive and analytical study carried out at Mvog Ada District Hospital in Yaounde, Cameroon from January 2020 to January 2021. Descriptive bivariate analyses were used to present the data. The data are presented as frequencies and percentages for categorical variables, and in terms of means and standard deviations for continuous variables where appropriate. The 10-year CVD risk score was calculated using two tools: the validated Framingham risk score (FRS) (low < 10%, moderate 10–20% and high ≥ 20%) and SCORE score (SSC) (low < 3%, moderate 3–4% and high ≥ 5%). Multiple logistic regression models were constructed to examine the respective relationships between the binary dependent variable high CVD risk (FRS ≥ 20%) and the population group, alcohol consumption (more than 10 glasses of beer per week, or more than 35.7 cl/day) and hypertriglyceridemia (independent variables). A p-value less than or equal to 0.05 was considered statistically significant.

Results

A total of 112 people aged 50 and above were enrolled in the study out of 180 people registered at the HIV care unit, that is a participation rate of 62.22%. The average age of the participants was 57.3 ± 6.4 years, and the female/male ratio was 1.6. The majority of participants (53.57%) had normal glycaemia levels (<1.10 g/L), 4.46% were diabetic and 46.40% had high blood pressure. The adherence rate for ARV treatment was 98.20%; most participants (77.20%) were alcohol consumers, and 28.10% of participants had hypertriglyceridemia. The estimates of overall cardiovascular risk in 10 years presented 50.90% of participants with low risk, 33% with moderate risk and 16.10% with high risk.

Conclusions

Our study indicated an overall risk of cardiovascular events in 10 years is 16.10%, with the main conditional risk factor being hypertriglyceridemia and alcohol consumption, which appeared to triple the risk of CVD among PLHIV.

Abbreviations

ART

Antiretroviral therapy

BMI

Body mass index

Confident interval

CVD

Cardiovascular disease

DAD

Data collection on adverse effects of anti-HIV drugs

DBP

Diastolic blood pressure

FRS

Framingham Risk Score

HDL-C

High density lipoproteins-cholesterol

HIV

Human immunodeficiency virus

LDL-C

Low-density lipoproteins-cholesterol

PLHIV

People Living with HIV

SBP

Systolic blood pressure

SCORE

Systemic coronary risk evaluation

SSC

Score of SCORE

Standard deviation

Acknowledgments

Gratitude is given to the coordinator and psychosocial guides of the HIV outpatient clinic of the Yaoundé, Mvog Ada district health hospital for their assistance during recruitment, and to the personnel of the biochemistry laboratory of the Yaoundé Medical Diagnostic Centre for their assistance during biochemical measurements. The authors are also grateful to all those who have voluntarily accepted to take part in this study. All authors have taken responsibility for all aspects of the reliability and freedom-from-bias of the data presented, and they have all discussed its interpretation.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethics approval and consent to participate

The study was approved by the Cameroon National Ethics Committee for Human Health Research (Ethical approval No. 2131/CRERSHC/2020). All participants signed a consent form.

Conflict of interest

The authors declare that they have no competing interests.

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