ECG Abnormalities and Arterial Stiffness by HIV Status among High-Risk Populations in Rakai, Uganda: A Pilot Study
Rocio Enriquez,
Robert Ssekubugu,
Godfrey Kigozi,
Dorean Nabukalu,
Gaetano Marrone,
Susanne Rautiainen,
Bruna Gigante,
Steven J. Reynolds,
Fred Nalugoda,
Larry W. Chang,
Anna Mia Ekström,
Nelson K. Sewankambo,
David Serwadda,
Helena Nordenstedt
Affiliations
Rocio Enriquez
Department of Global Public Health, Karolinska Institutet, Stockholm
Robert Ssekubugu
Department of Global Public Health, Karolinska Institutet, Stockholm, SE; Rakai Health Sciences Program, Kalisizo
Godfrey Kigozi
Rakai Health Sciences Program, Kalisizo
Dorean Nabukalu
Rakai Health Sciences Program, Kalisizo
Gaetano Marrone
Department of Global Public Health, Karolinska Institutet, Stockholm
Susanne Rautiainen
Department of Global Public Health, Karolinska Institutet, Stockholm
Bruna Gigante
Department of Medicine, Karolinska Institutet, Stockholm
Steven J. Reynolds
Rakai Health Sciences Program, Kalisizo, UG; Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
Fred Nalugoda
Rakai Health Sciences Program, Kalisizo
Larry W. Chang
Rakai Health Sciences Program, Kalisizo, UG; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
Anna Mia Ekström
Department of Global Public Health, Karolinska Institutet, Stockholm; Venhälsan, Södersjukhuset, Stockholm
Nelson K. Sewankambo
Rakai Health Sciences Program, Kalisizo; Department of Medicine, Makerere University School of Medicine, Kampala
David Serwadda
Rakai Health Sciences Program, Kalisizo; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala
Helena Nordenstedt
Department of Global Public Health, Karolinska Institutet, Stockholm; Division of Internal Medicine, Danderyd University Hospital, Karolinska Institute, Stockholm
Background: People living with HIV are at increased risk for cardiovascular disease (CVD). In sub-Saharan Africa, population-based data on major CVD events such as stroke and myocardial infarction are difficult to collect. The use of proxy measures could be a feasible way to better study CVD in such settings. This study aimed to determine the acceptance of incorporating ECG and arterial function measurements into a population-based cohort study and to assess the prevalence of ECG abnormalities and arterial stiffness. Methods: A pilot study was conducted within the Rakai Community Cohort Study in Uganda on two high-risk CVD populations; one determined by age (35–49) and Framingham CVD risk scores and the other by age alone (50+). Data on ECG, arterial function, blood pressure, and HIV status were collected. The acceptability of incorporating ECG and arterial function measurements was established as an acceptance rate difference of no more than 5% to blood pressure measurements. Results: A total of 118 participants were enrolled, 57 participants living with HIV and 61 HIV-negative participants. Both ECG measurements and arterial function were well accepted (2% difference). Left ventricular hypertrophy (LVH) and arterial stiffness (>10 m/s) were common in both participants living with HIV and HIV-negative participants across the two high-risk populations. Prevalence rates ranged from 30% to 53% for LVH and 25% to 58% for arterial stiffness. Arterial stiffness at the 11 m/s cutoff (p = 0.03) was found to be more common among participants living with HIV in the 35–49 population. Conclusions: The incorporation of ECG and arterial function measurements into routine activities of a population-based cohort was acceptable and incorporating these proxy measures into cohort studies should be explored further. LVH and arterial stiffness were both common irrespective of HIV status with arterial stiffness potentially more common among people living with HIV.
