Abstract
Introduction:
Cardiovascular disease (CVD) has increased in prevalence among people with HIV (PWH) in the last decade, with the non-Hispanic Black population being disproportionately affected. There is paucity of data addressing disparities among underserved minority groups regarding CVD and its determinants. The purpose of this study was to evaluate the natural history of CVD and cardiovascular (CV) risk factors in PWH of Haitian ethnicity.
Methods:
A retrospective chart review (n=1,202) of PWH seen at the University of Miami/Jackson Memorial Hospital Special Immunology clinic between 2017-2019 was performed. Data regarding demographic, clinical, and laboratory results were obtained from medical records. Prevalence of different traditional CV risk factors and CVD among PWH who per system records, self-identified as Haitians vs non-Haitians (including Black, White, and Hispanic population) was examined. Between-group statistical comparisons were performed for continuous data using the T-test and Mann-Whitney U test was used for nonparametric variables. Categorical variables were compared using Chi-squared test. Significant p-values were α<0.05.
Results:
A total of 156 subjects (12.9%) self-identified as Haitians, with 88 (56.4%) being females. Haitians compared with non-Haitians were significantly older (54.7 ± 11.6 vs 51.8 ± 11.8 years, p=0.004), and had increased prevalence of diabetes mellitus (28.8% vs 16.7%), hypertension (48.7% vs 40.9%), heart failure with reduced ejection fraction (14.9% vs 11.0%). Haitians also had significantly lower prevalence of smoking (14.1% vs 28.2%), alcohol consumption (5.1% vs 19.6%), and drug use (0.6% vs 9.3%). In addition, Haitians had lower triglycerides (122 ± 64.0 vs 153 ± 107.2 mg/dL, p<0.001), and more elevated systolic blood pressure (139 ± 22.3 mmHg vs 132 ± 20.4 mmHg, p<0.001), with a trend for a difference in diastolic blood pressure (77 ± 10.3 mmHg vs 75 ± 12.1 mmHg, p=0.060). No statistical differences were found in terms of coronary and peripheral artery disease, myocardial infarction, angina, atrial fibrillation, and valvulopathies. Body mass index, HDL, LDL, and total cholesterol were also not significantly different between groups.
Conclusions:
The elevated presence of CV risk factors in this Haitian PWH cohort highlights the urgent need to better understand the patho-etiological basis for these differences and to develop effective and specific primary and secondary prevention strategies among this group. Further large-scale studies are needed in order to better characterize this population and respond to the emerging epidemic of CVD in underserved minority ethnic groups as Haitians in the US.
