Assessment of cardiovascular health using the "Life's Simple 7" among the Canadian HIV and Aging Cohort study participants: a cross-sectional observational study

Title

Assessment of cardiovascular health using the "Life's Simple 7" among the Canadian HIV and Aging Cohort study participants: a cross-sectional observational study

Presenter

Madeleine Durand

Authors

K. Giguère (1), D. Talbot (2), M. Messier-Peet (1), D. Temblay-Sher (1), S. Matte (1), A. Chamberland (1), A. Charest (3), S. Harrison (3), J.-G. Baril (4), B. Conway (5), C. Fortin (1), M. Harris (6), P. MacPherson (7), M. C.M. Murray (8), N. Pick (8), R. Thomas (9), B. Trottier (4), S. Trottier (10), S. Walmsley (11), A. Wong (12), C. Tremblay (1), B. Lamarche (3), M. Durand * (1)

Institutions

(1) Centre de Recherche du CHU de Montréal, Pavillon S, Montréal, Canada, (2) Université Laval, Québec, Canada, (3) Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, Canada, (4) Clinique de Medecine Urbaine du Quartier Latin, Montréal, Canada, (5) Vancouver ID Research & Care Centre Society, Vancouver, Canada, (6) British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, (7) Ottawa Hospital Research Institute, Ottawa, Canada, (8) B.C. Women''s Hospital, Vancouver, Canada, (9) Clinique Médicale l''Actuel, Montréal, Canada, (10) Centre Hospitalier de l''Université Laval, Québec, Canada, (11) University Health Network, University of Toronto, Toronto, Canada, (12) Regina Qu''Appelle Regional Health Authority, Saskatoon, Canada

BACKGROUND: There is growing evidence that cardiovascular diseases (CVD) disproportionately affect people living with HIV (PLHIV). However, little is known about overall cardiovascular health among PLHIV.
METHODS: We assessed the American Heart Association (AHA)'s 'Life''s Simple 7' (LS7) metrics (smoking, body mass index, diet, physical activity, total cholesterol, blood pressure, blood glucose) among Canadian HIV and Aging Cohort Study, CTN 272 (CHACS) participants who completed a validated web-based food-frequency questionnaire (web-FFQ). LS7 metrics were dichotomized using a set of "ideal" cutoffs recommended by the AHA to yield an overall LS7 score ranging from 0 to 7 points. Robust Poisson regressions were used to assess the associations between HIV status and the LS7 metrics, and between HIV status and LS7 diet submetrics (fruits/vegetables, fish, fiber-rich whole grain, sugar-sweetened beverages). Analyses were adjusted for age, sex, ethnic background, education, and annual income. Effect modification by sex was also assessed.
RESULTS: A total of 279 CHACS participants (73% PLHIV) completed the web-FFQ at a median of 55 months (interquartile range [IQR]=40-64) of follow-up. Median age was 59 years (IQR=55-66), and most participants were male (82%) and White (87%). The distribution of the LS7 score was similar between PLHIV and HIV-negative groups with a median score of 3 (IQR=2-4). No participant had an ideal cardiovascular health score of 7. The LS7 metrics with the highest and lowest prevalence of ideal score overall were blood glucose (70%) and diet (0.4%), respectively. Female PLHIV were over 6 times more likely to not smoke tobacco compared to HIV-negative female participants (adjusted proportions ratio [aPR]=6.54, 95% confidence interval [95%CI]: 1.66-25.76) and less likely to have ideal blood glucose concentration (aPR=0.75, 95%CI: 0.57-0.99). Among males, PLHIV were less likely to have an ideal total cholesterol concentration compared to HIV-negative participants (aPR=0.66, 95%CI: 0.48-0.91). No statistically significant difference was observed between PLHIV and HIV-negative participants in the proportions of ideal scores for diet submetrics.
CONCLUSIONS: Our study highlights overall poor cardiovascular health among PLHIV and HIV-negative CHACS participants alike. Further public health efforts among adults aged '¥40 years are urgently needed and should focus on behavioural risk factors for CVD.

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