The role of substance use in structural heart disease among women living with HIV.
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
19 Dec 2023
19 Dec 2023
Historique:
received:
06
09
2023
accepted:
30
11
2023
medline:
22
12
2023
pubmed:
22
12
2023
entrez:
22
12
2023
Statut:
aheadofprint
Résumé
People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances. We recruited WWH from San Francisco shelters, free meal programs, street encampments and a safety net HIV clinic. Between 2016 and 2019, participants completed six monthly interviews, specimen collection, and a transthoracic echocardiogram. We assessed associations between three echocardiographic indices of cardiac hypertrophy (concentric hypertrophy, concentric remodeling, and eccentric hypertrophy) and study factors, including cardiovascular risk factors, substance use, and HIV-specific factors (CD4+ count, viral load, HIV medication). Among 62 participants, the average age was 53 years and 70% were ethnic minority women. Just over 70% had elevated blood pressure (BP). Toxicology-confirmed substance use included tobacco (63%), cannabis (52%), cocaine (51%), methamphetamine (29%), and alcohol (26%). Concentric hypertrophy was detected in 26% of participants. It was positively associated with cocaine use (adjusted Relative Risk [aRR]= 32.5, p<0.01) and negatively associated with cannabis use (aRR=0.07, p<0.01). Concentric remodeling was detected in 40% of participants. It was positively associated with cocaine use (aRR=11.2, p<0.01) and negatively associated with cannabis use (aRR=0.17, p=0.02). Eccentric hypertrophy was not significantly associated with factors studied here. Routine evaluation of stimulant use as a contributing factor to cardiovascular risk may improve risk assessment in WWH. Whether cannabis use mitigates the impact of cocaine use on structural heart disease among WWH merits further investigation.
Sections du résumé
BACKGROUND
BACKGROUND
People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances.
SETTING
METHODS
We recruited WWH from San Francisco shelters, free meal programs, street encampments and a safety net HIV clinic.
METHODS
METHODS
Between 2016 and 2019, participants completed six monthly interviews, specimen collection, and a transthoracic echocardiogram. We assessed associations between three echocardiographic indices of cardiac hypertrophy (concentric hypertrophy, concentric remodeling, and eccentric hypertrophy) and study factors, including cardiovascular risk factors, substance use, and HIV-specific factors (CD4+ count, viral load, HIV medication).
RESULTS
RESULTS
Among 62 participants, the average age was 53 years and 70% were ethnic minority women. Just over 70% had elevated blood pressure (BP). Toxicology-confirmed substance use included tobacco (63%), cannabis (52%), cocaine (51%), methamphetamine (29%), and alcohol (26%). Concentric hypertrophy was detected in 26% of participants. It was positively associated with cocaine use (adjusted Relative Risk [aRR]= 32.5, p<0.01) and negatively associated with cannabis use (aRR=0.07, p<0.01). Concentric remodeling was detected in 40% of participants. It was positively associated with cocaine use (aRR=11.2, p<0.01) and negatively associated with cannabis use (aRR=0.17, p=0.02). Eccentric hypertrophy was not significantly associated with factors studied here.
CONCLUSIONS
CONCLUSIONS
Routine evaluation of stimulant use as a contributing factor to cardiovascular risk may improve risk assessment in WWH. Whether cannabis use mitigates the impact of cocaine use on structural heart disease among WWH merits further investigation.
Identifiants
pubmed: 38133589
doi: 10.1097/QAI.0000000000003366
pii: 00126334-990000000-00346
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIDA NIH HHS
ID : R01 DA037012
Pays : United States
Organisme : NIDA NIH HHS
ID : K24 DA039780
Pays : United States
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest and Sources of Funding Outside of grant funding, authors declare no conflicts of interest.