Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection.
Alcohol
Cardiovascular
Depression
HIV
Smoking
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
accepted:
27
05
2021
pubmed:
9
6
2021
medline:
21
8
2021
entrez:
8
6
2021
Statut:
ppublish
Résumé
Unhealthy alcohol use, smoking, and depressive symptoms are risk factors for cardiovascular disease (CVD). Little is known about their co-occurrence - termed a syndemic, defined as the synergistic effect of two or more conditions-on CVD risk in people with HIV (PWH). We used data from 5621 CVD-free participants (51% PWH) in the Veteran's Aging Cohort Study-8, a prospective, observational study of veterans followed from 2002 to 2014 to assess the association between this syndemic and incident CVD by HIV status. Diagnostic codes identified cases of CVD (acute myocardial infarction, stroke, heart failure, peripheral artery disease, and coronary revascularization). Validated measures of alcohol use, smoking, and depressive symptoms were used. Baseline number of syndemic conditions was categorized (0, 1, ≥ 2 conditions). Multivariable Cox Proportional Hazards regressions estimated risk of the syndemic (≥ 2 conditions) on incident CVD by HIV-status. There were 1149 cases of incident CVD (52% PWH) during the follow-up (median 10.1 years). Of the total sample, 64% met our syndemic definition. The syndemic was associated with greater risk for incident CVD among PWH (Hazard Ratio [HR] 1.87 [1.47-2.38], p < 0.001) and HIV-negative veterans (HR 1.70 [1.35-2.13], p < 0.001), compared to HIV-negative with zero conditions. Among those with the syndemic, CVD risk was not statistically significantly higher among PWH vs. HIV-negative (HR 1.10 [0.89, 1.37], p = .38). Given the high prevalence of this syndemic combined with excess risk of CVD, these findings support linked-screening and treatment efforts.
Identifiants
pubmed: 34101074
doi: 10.1007/s10461-021-03327-4
pii: 10.1007/s10461-021-03327-4
pmc: PMC8376776
mid: NIHMS1716154
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2852-2862Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NIAAA NIH HHS
ID : K01 AA029042
Pays : United States
Organisme : NIDA NIH HHS
ID : P30 DA011041
Pays : United States
Organisme : NIAAA NIH HHS
ID : U10 AA013566
Pays : United States
Organisme : NIAAA NIH HHS
ID : K01AA029042
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI110527
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01AA02201
Pays : United States
Organisme : NHLBI NIH HHS
ID : K12 HL143956
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01AA020790
Pays : United States
Organisme : NIAAA NIH HHS
ID : U10AA013566
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020790
Pays : United States
Organisme : NIAAA NIH HHS
ID : U24AA020794
Pays : United States
Organisme : NHLBI NIH HHS
ID : K12HL143956
Pays : United States
Organisme : NIAAA NIH HHS
ID : U24 AA020794
Pays : United States
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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