Assessment of risk factors for cardiovascular diseases among HIV infected patients attending Muhimbili national hospital care and treatment clinic.

Abstract

Background Mortality due to cardiovascular disease among HIV patients is a concern in both developed and developing countries. The increased cardiovascular events is suspected to be due to the metabolic complications atributed by HIV virus itself and antiretroviral drugs. The CVD risk factors noted to be increased among HIV patients include dyslipidemia, obesity, hypertension, diabetes,excessive alcohol intake and cigarette smoking. But the data is sparse on the magnitude and distribution of these risk factors among HIV patients in Tanzania. Objective This study was aimed at assesing the risk factors for cardiovascular diseases among HIV infected patients attending Muhimbili National Hospital Care and Treatment Clinic. Methods A hospital based cross - sectional study was conducted among HIV patients aged 30 years and above attending MNH Care and Treatment Clinic.The study was conducted between August and December 2011.Interviews were done using a structured questionaire followed by a clinical assessment. Fasting blood samples were collected for determination of fasting blood glucose and lipids parameters. Quantitative CVD risk was calculated using Q risk 2011 mathematical model. Results A total of 370 patients were analysed, with 69% being females. The mean age of the study subjets was 40years ( + 8.13) with range of 30-65 years. Seventy four percent of the patients were on HAART. The overall prevalence of dyslipidemia was 82% . The prevalence of hypertriglyceridemia, hypercholesterolemia, incresed LDL and low HDL were 36% ,42%, 53% and 50% respectively.The prevalence of dysglycermia was 16% with prevalence of impared fasting blood glucose and overt DM at 10% and 7% respectively. HAART use wassignificantly associted with increased levels of total cholestrol, triglycerides, LDL, HTN, impared fasting blood glucose and DM . Obesity and Low HDL were more prevalent among HIV patient who were not on HAART.Patients on PI containing regimes had higher prevalenc of CVD risk factors compared to patients on non PI containing regimen. Overal CVD risk of developing a cardiovascular event in 10years using 2011 mathematical model was in the low levels(<10%) with a median (IQR) of 1.2% (0.4-4). Conclusions: There is a high prevalence of risk factors for cardiovascular diseases among HIV patients at Muhimbili National Hospital Care and Treatment Clinic. HAART use was significantly associated with increased levels of total cholestrol, triglycerides, LDL, HTN, DM and impared fasting blood glucose. Using 2011 mathematical model risk for CVD is low in this study population. Recomendations Modification of these risk factors through intervention strategies including healthy education and proper management is recommended in order to reduce future cardiovascular events.