Abstract

Background: People living with HIV are at increased risk of developing cardiovascular disease. Risk factors associated with cardiovascular disease negatively impact cardiovascular and muscular function. Therefore, this study aims to determine if cardiovascular disease risk factors are predictors of cardiomotor profiles in Hispanic-Latinos living with HIV. Subjects: A total of 176 participants were enrolled in this study. There were 134 males and 42 females with a mean age of 53.34 +/- 10.31 years old. Methods: Data was collected retrospectively from people living with HIV in San Juan, Puerto Rico from 2000-2020. Cardiovascular disease risk factors were collected by interview. In addition, the cardiovascular and locomotor components were collected using the Ross submaximal exercise test. Results: Hyperlipidemia was a significant predictor of treadmill time (B= -1.882, p=.034) and heart rate (B= -6.878, p<.001), whereas hypertension was a predictor of heart rate (B= -12.903, p=.026) and systolic blood pressure (B=12.263, p<.001). Hyperlipidemia was also a significant predictor of inclination (B= -1.707, p=.034). In addition, 57.4 % of the sample had at least one cardiovascular disease risk factor. Conclusion: Hyperlipidemia and hypertension should be considered in managing people living with HIV. This study indicated that hyperlipidemia and hypertension negatively affect cardiovascular and locomotor performance during exercise. Clinicians should be aware that exercise tolerance may be reduced in people with HIV and CVD risk factors; therefore, exercise prescription should be tailored and monitored accordingly.

Keywords

HIV, Cardiovascular Disease, Exercise, Hyperlipidemia, Hypertension,

References

  1. HIV/AIDS, World Health Organization, Published November 30, 2021. Accessed January 18, 2022. https://www.who.int/news-room/fact-sheets/detail/hiv-aids
  2. M. Smit, K. Brinkman, S. Geerlings, C. Smit, K. Thyagarajan, A. van Sighem, F. Wolf, T.B. Hallett, ATHENA observational cohort, Future challenges for clinical care of an aging population infected with HIV: a modeling study, Lancet Infectious Diseases, 15(7) (2015) 810-818.
  3. A.S.V. Shah, D.Stelzle, K.K. Lee, E.J. Beck, S. Alam, S. Clifford, C. T. Longenecker, F. Strachan, S. Bagchi, W. Whiteley, S. Rajagopalan, S. Kottilil, H. Nair, D.E. Newby, D. A. McAllister, N.L. Mills, Global Burden of Atherosclerotic Cardiovascular Disease in People Living With HIV: Systematic Review and Meta-Analysis, Circulation, 138 (11) (2018) 1100-1112.
  4. M.J. Feinstein, E. Bahiru, C. Achenbach, C.T. Longenecker, P. Hsue, K. So-Armah, M.S. Freiberg, D.M. Lloyd-Jones, Patterns of Cardiovascular Mortality for HIV-Infected Adults in the United States: 1999 to 2013, The American Journal of Cardiology, 117(2) (2016) 214-220.
  5. A. Alonso, A.E. Barnes, J.L. Guest A. Shah, I.Y. Shao, V. Marconi, HIV Infection and Incidence of Cardiovascular Diseases: An Analysis of a Large Healthcare Database, Journal of the American Heart Association, 8(14) (2019) e012241.
  6. J.A. Ladapo, A.K. Richards, C.M. DeWitt, N.T. Harawa, S. Shoptaw, W.E. Cunningham, J.N. Mafi, Disparities in the quality of cardiovascular care between HIV‐infected versus HIV‐uninfected adults in the United States: a cross‐sectional study, Journal of the American Heart Association, 6(11) (2017) e007107.
  7. G. Touloumi, N. Kalpourtzi, V. Papastamopoulos, V. Paparizos, G. Adamis, A. Antoniadou, M. Chini, A. Karakosta, K. Makrilakis, M. Gavana, A.Vantarakis, M. Psichogiou, S. Metallidis, N.V. Sipsas, H. Sambatakou, C. Hadjichristodoulou, P.V. Voulgari, G. Chrysos, C. Gogos, G. Chlouverakis, G. Tripsianis, Y. Alamanos, G. Stergiou, AMACS and EMENO, Cardiovascular risk factors in HIV infected individuals: Comparison with general adult control population in Greece, PLoS One, 15(3) (2020) e0230730.
  8. J.M. Grace, S.J. Semple, S. Combrink, Exercise therapy for human immunodeficiency virus/AIDS patients: Guidelines for clinical exercise therapists, Journal of Exercise Science & Fitness, 13(1) (2015) 49-56.
  9. O.M. Falusi, J.A. Aberg, HIV and cardiovascular risk factors, The AIDS Reader, 11(5) (2001) 263-268.
  10. J.J. Bigna, A.L. Ndoadoumgue, J.R. Nansseu, J. N. Tochie, U.F. Nyaga, J.R. Nkeck, A.J. Foka, A.D. Kaze, J.J. Noubiap, Global burden of hypertension among people living with HIV in the era of increased life expectancy: a systematic review and meta-analysis, Journal of Hypertension, 38(9) (2020) 1659-1668.
  11. C. Ozemek,K.M Erlandson, C.M. Jankowski, Physical activity and exercise to improve cardiovascular health for adults living with HIV, Progress in cardiovascular diseases, 63(2) (2020) 178-183.
  12. L. Richert, M. Brault, P. Mercié, F.A. Dauchy, M. Bruyand, C. Greib, F. Dabis, F. Bonnet, G. Chêne, P. Dehail, Groupe d’Epidémiologie Clinique du SIDA en Aquitaine (GECSA. Decline in locomotor functions over time in HIV-infected patients, Aids, 28(10) (2014) 1441-1449.
  13. E.M. Chisati, O. Vasseljen, Aerobic endurance in HIV-positive young adults and HIV-negative controls in Malawi, Malawi Medical Journal, 27(1) (2015) 5-9.
  14. K.K. Oursler, J.D. Sorkin, B.A. Smith, L.I. Katzel, Reduced aerobic capacity and physical functioning in older HIV-infected men, AIDS Research & Human Retroviruses, 22(11) (2006) 1113-1121.
  15. D. Vancampfort, J. Mugisha, S. Rosenbaum, J. Firth, M. De Hert, M. Probst, B. Stubbs, Cardiorespiratory fitness levels and moderators in people with HIV: A systematic review and meta-analysis, Preventive medicine, 93 (2016) 106-114.
  16. E. Orozco, M.G. Rosario, Overall fitness benefits in individuals with HIV participating in a community-based exercise program, Journal of Rehabilitation Practices and Research, 1(2) (2020) 109.
  17. A.D. Lorenzo, V. Meirelles, F. Vilela, F.C.C. Souza, Use of the exercise treadmill test for the assessment of cardiac risk markers in adults infected with HIV, Journal of the International Association of Providers of AIDS Care (JIAPAC), 12(2) (2013)110-116.
  18. V. Raso, R.J. Shephard, J. Casseb, A.J. da Silva Duarte, P.R.S. Silva, Júlia Maria D'Andréa Greve, Association between muscle strength and the cardiopulmonary status of individuals living with HIV/AIDS, Clinics, 68(3) (2013) 359-364.
  19. R. Ross, S.N. Blair, R. Arena, T.S. Church, J.P. Després, B.A. Franklin, William L Haskell, Leonard A Kaminsky, Benjamin D Levine, C.J. Lavie, J. Myers, J. Niebauer, R. Sallis, S. S. Sawada, X. Sui, U. Wisløff, Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association, Circulation, 134(24) (2016) e653-e699.
  20. A.G. Bonomi, G.A. Ten Hoor, H.M. De Morree, G. Plasqui, F. Sartor, Cardiorespiratory fitness estimation from heart rate and body movement in daily life, Journal of Applied Physiology, 128(3) (2020) 493-500.
  21. S. Kodama, K. Saito, S. Tanaka, M. Maki, Y. Yachi, M. Asumi, H. Sone, Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis, Jama, 301(19) (2009) 2024-2035.
  22. M.G. Rosario, G. Gines, L. Jamison, Lifestyle, Physical and Cardiovascular Components Associated with Immune Profile in Hispanic-Latino People Living with HIV, Journal of Health and Social Behavior, 2(1) (2020) 121.
  23. L.R.A.D. Lima, I.D.C. Back, C.C. Beck, B. Caramelli, Exercise improves cardiovascular risk factors, fitness, and quality of life in HIV+ children and adolescents: Pilot Study, International Journal of Cardiovascular Sciences, 30 (2017) 171-176.
  24. J.H. Stein, C.M. Hadigan, T.T. Brown, E. Chadwick, J. Feinberg, N. Friis-Møller, A. Ganesan, M.J. Glesby, D.Hardy, R.C. Kaplan, P. Kim, J.Lo, E. Martinez, J.M. Sosman, Working Group 6, Prevention strategies for cardiovascular disease in HIV-infected patients, Circulation, 118(2) (2008) e54-e60.
  25. K.K. O’Brien, A.M. Tynan, S.A. Nixon, R.H. Glazier, Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol, BMC infectious diseases, 16(1) (2016) 1-56.
  26. C.I. Ezema, A.A. Onwunali, S. Lamina, U.A. Ezugwu, A.A. Amaeze, M.J. Nwankwo, Effect of aerobic exercise training on cardiovascular parameters and CD4 cell count of people living with human immunodeficiency virus/acquired immune deficiency syndrome: A randomized controlled trial, Nigerian journal of clinical practice, 17(5) (2014) 543-548.
  27. S.A. Fahme, G.S. Bloomfield, R. Peck, Hypertension in HIV-infected adults: novel pathophysiologic mechanisms, Hypertension, 72(1) (2018) 44-55.
  28. L. Calza, V. Colangeli, R. Manfredi, I. Bon, M.C. Re, P. Viale, Clinical management of dyslipidaemia associated with combination antiretroviral therapy in HIV-infected patients, Journal of Antimicrobial Chemotherapy, 71(6) (2016) 1451-1465.
  29. S.J. Souza, L.A. Luzia, S.S. Santos, P.H.C. Rondó, Lipid profile of HIV-infected patients in relation to antiretroviral therapy: a review, Revista da Associação Médica Brasileira, 59(2) (2013) 186-198.
  30. L. Su, R. Mittal, D. Ramgobin, R. Jain, R. Jain, Current Management Guidelines on Hyperlipidemia: The Silent Killer, Journal of Lipids, 31 (2021) 9883352.
  31. K.J. Stewart, J. Sung, H.A Silber, J.L. Fleg, M.D, Kelemen, K.L. Turner, A.C. Bacher, D.A. Dobrosielski, J.R. DeRegis, Edward P Shapiro, P. Ouyang, (2004). Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function, American journal of hypertension, 17(4) 314-320.
  32. M.J. LaMonte, C.E. Barlow, R. Jurca, J.B. Kampert, T.S. Church, S.N. Blair, Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women, Circulation, 112(4) (2005) 505-512.
  33. M.A. Van Baak, R.O. Böhm, B.G. Arends, M.E. van Hooff, K.H. Rahn, Long-term antihypertensive therapy with beta-blockers: submaximal exercise capacity and metabolic effects during exercise, International Journal of Sports Medicine, 8(5) (1987) 342-347.
  34. B. Chant, M. Bakali, T. Hinton, A.E. Burchell, A.K. Nightingale, J.F.R. Paton, E.C. Hart, Antihypertensive Treatment Fails to Control Blood Pressure During Exercise, Hypertension, 72(1) (2018) 102-109.
  35. D. Kim, J.W. Ha, Hypertensive Response to Exercise: Mechanisms and Clinical Implication, Clinical Hypertension, 22 (2016) 17.
  36. S. Adhikari, & P.P. Patil, Effect of uphill, level, and downhill walking on cardiovascular parameters among young adults, Indian Journal of Health Sciences and Biomedical Research (KLEU), 11(2) (2018) 121-124.
  37. A.N. Lay, C.J. Hass, T. Richard Nichols, R.J. Gregor, The effects of sloped surfaces on locomotion: an electromyographic analysis, Journal of Biomechanics, 40(6) (2007) 1276-1285.
  38. W.T. Cade, L.E. Fantry, S.R. Nabar, D.K. Shaw, R.E. Keyser, Impaired oxygen on-kinetics in persons with human immunodeficiency virus are not due to highly active antiretroviral therapy, Archives of Physical Medicine and Rehabilitation, 84(12) (2003) 1831-1838.
  39. M. G. Rosario, E. Orozco, Influence of chronic pain on cardiovascular and locomotor components in Hispanic-Latinos living with HIV, Journal of Rehabilitation Practices and Research, 3 (1) (2022) 130.
  40. K.K. O'Brien, A.M. Tynan, S.A. Nixon, R.H. Glazier, Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol, BMC Infectious Diseases, 17(1) (2017) 268.
  41. T. Fiseha, W. Alemu, H. Dereje, Z. Tamir, A. Gebreweld, Prevalence of dyslipidaemia among HIV-infected patients receiving combination antiretroviral therapy in North Shewa, Ethiopia, PLoS One, 16(4) (2021) e0250328.
  42. S. Pierre, G. Seo, V.R. Rivera, K.F. Walsh, J.J. Victor, B. Charles, G. Julmiste, E. Dumont, A. Apollon, M. Cadet, A. Saint-Vil, A. Marcelin, P. Severe, M. Hee Lee, J. Kingery, S. Koenig, D. Fitzgerald, J. Pape, M.L. McNairy, Prevalence of hypertension and cardiovascular risk factors among long-term AIDS survivors: A report from the field The Journal of Clinical Hypertension, 21(10) (2019) 1558-1566.
  43. J. L. H. Romancini, D. Guariglia, N. Nardo Jr, P. Herold, G. G. D. A. Pimentel, Á. R. T. Pupulin, Levels of physical activity and metabolic alterations in people living with HIV/AIDS. Revista Brasileira de Medicina do Esporte. 18 (2021) 356-360. https://www.scielo.br/j/rbme/a/QGwqTwvP9DxfBWr64gF6V6c/?format=pdf&lang=en
  44. M.G. Rosario, G. Gines, L. Jamison, Lifestyle, Physical and Cardiovascular Components Associated with Immune Profile in Hispanic-Latino People Living with HIV, Journal of Mental Health and Social Behaviour, 2(1) (2020) 121.