TY - JOUR
T1 - Heart Rate Variability, HIV and the Risk of Cardiovascular Diseases in Rural South Africa
AU - Godijk, Noortje G
AU - Vos, Alinda G
AU - Jongen, Vita W
AU - Moraba, Robert
AU - Tempelman, Hugo
AU - Grobbee, Diederick E
AU - Coutinho, Roel A
AU - Devillé, Walter
AU - Klipstein-Grobusch, Kerstin
N1 - Funding Information:
The Ndlovu cohort study is funded by grants from the Dutch AIDS Foundation, Dioraphte Foundation, De Grote Onderneming and the University Medical Center Utrecht. This research received no further specific grants.
Publisher Copyright:
Copyright: © 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
PY - 2020/2/12
Y1 - 2020/2/12
N2 - Background: Antiretroviral therapy (ART) transformed human immunodeficiency virus (HIV) infection into a chronic disease. Possible HIV-associated complications have emerged including cardiovascular diseases (CVD).Objectives: This study aims to determine the heart rate variability (HRV) distribution and association between HRV and HIV treated with ART in a rural African population.Methods: This cross-sectional study included 325 participants of the Ndlovu Cohort Study, South Africa. HRV was measured using a standardized five-minute resting ECG and assessed by the standard deviation of normal RR intervals (SDNN), root of mean squares of successive RR differences (RMSSD), percentage of RR intervals greater than 50 milliseconds different from its predecessor (pNN50), total-, low- and high-frequency power. CVD risk factors were assessed using measurements (blood pressure, anthropometry, cholesterol) and questionnaires (e.g. socio-demographics, alcohol, smoking, physical activity, age, diabetes). We used a Wilcoxon rank test to assess differences in medians between HIV-infected and HIV-uninfected participants and multivariable linear regression to investigate associations between HRV and HIV treated with ART.Conclusions: Of the participants, 196 (61.4%) were HIV-infected treated with ART and 123 (38.6%) were HIV-uninfected. HIV-infected consumed less alcohol, 52% versus 35%, smoked less, were less physically active, more often attained lower education, 26% versus 14%, and had lower systolic blood pressure, 134 mmHg versus 140 mmHg, compared to HIV-uninfected. Medians of all HRV parameters were lower for HIV-infected participants. The model fully adjusted for CVD risk factors showed a significant inverse association between HIV treated with ART and log RMSSD (-0.16) and log pnn50 (-0.61). Although HIV-infected participants treated with ART presented with less CVD risk factors they had a lower HRV indicating an increased risk of CVD.Highlights: - African HIV-infected participants on ART had less conventional CVD risk factors than HIV-uninfected.- However, HIV-infected participants had lower HRV than HIV-uninfected participants.- Lower HRV of the HIV-infected participants indicates that they are at a higher risk for CVD.
AB - Background: Antiretroviral therapy (ART) transformed human immunodeficiency virus (HIV) infection into a chronic disease. Possible HIV-associated complications have emerged including cardiovascular diseases (CVD).Objectives: This study aims to determine the heart rate variability (HRV) distribution and association between HRV and HIV treated with ART in a rural African population.Methods: This cross-sectional study included 325 participants of the Ndlovu Cohort Study, South Africa. HRV was measured using a standardized five-minute resting ECG and assessed by the standard deviation of normal RR intervals (SDNN), root of mean squares of successive RR differences (RMSSD), percentage of RR intervals greater than 50 milliseconds different from its predecessor (pNN50), total-, low- and high-frequency power. CVD risk factors were assessed using measurements (blood pressure, anthropometry, cholesterol) and questionnaires (e.g. socio-demographics, alcohol, smoking, physical activity, age, diabetes). We used a Wilcoxon rank test to assess differences in medians between HIV-infected and HIV-uninfected participants and multivariable linear regression to investigate associations between HRV and HIV treated with ART.Conclusions: Of the participants, 196 (61.4%) were HIV-infected treated with ART and 123 (38.6%) were HIV-uninfected. HIV-infected consumed less alcohol, 52% versus 35%, smoked less, were less physically active, more often attained lower education, 26% versus 14%, and had lower systolic blood pressure, 134 mmHg versus 140 mmHg, compared to HIV-uninfected. Medians of all HRV parameters were lower for HIV-infected participants. The model fully adjusted for CVD risk factors showed a significant inverse association between HIV treated with ART and log RMSSD (-0.16) and log pnn50 (-0.61). Although HIV-infected participants treated with ART presented with less CVD risk factors they had a lower HRV indicating an increased risk of CVD.Highlights: - African HIV-infected participants on ART had less conventional CVD risk factors than HIV-uninfected.- However, HIV-infected participants had lower HRV than HIV-uninfected participants.- Lower HRV of the HIV-infected participants indicates that they are at a higher risk for CVD.
KW - Antiretroviral treatment
KW - Cardiovascular disease
KW - HIV
KW - Heart rate variability
KW - Sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85085853976&partnerID=8YFLogxK
U2 - 10.5334/gh.532
DO - 10.5334/gh.532
M3 - Article
C2 - 32489790
SN - 2211-8160
VL - 15
SP - 1
EP - 9
JO - Global Heart
JF - Global Heart
IS - 1
M1 - 17
ER -