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Review
. 2022 Feb 24;23(1):1335.
doi: 10.4102/sajhivmed.23i1.1335. eCollection 2022.

Age-related differences in the vascular function and structure of South Africans living with HIV

Anisca Louwrens  1 , Carla M T Fourie  1   2 , Shani Botha-Le Roux  1   2 , Yolandi Breet  1   2
Affiliations
Review

Age-related differences in the vascular function and structure of South Africans living with HIV

Anisca Louwrens et al. South Afr J HIV Med. .

Abstract

Background: As the life expectancy of people living with the HIV increases because of antiretroviral treatment (ART), their risk for vascular co-morbidities and early vascular ageing (EVA) also increases.

Objective: We aimed to investigate whether HIV infection relates to vascular structure and function in black South African adults and whether this relationship is age dependent.

Method: This cross-sectional study carried out in urban and rural areas of North West province, South Africa, included 572 age- and sex-matched people living with HIV (PLWH) and without HIV. Participants from the EndoAfrica study and PURE study were stratified according to tertiles of age. Measures of vascular structure (carotid intima-media thickness) and function (carotid-femoral pulse wave velocity, central systolic blood pressure, central pulse pressure and pulse pressure amplification) were determined.

Results: Blood pressure measures were lower in PLWH compared with their controls (all P ≤ 0.001), especially in the younger and middle-aged groups (all P ≤ 0.031), whilst vascular measures did not differ (all P ≥ 0.611). In multivariate linear regression analyses, vascular measures were not associated with a HIV- positive status in either the total or any of the age groups.

Conclusion: Black South Africans living with HIV have a less adverse blood pressure profile than their counterparts without HIV. The HIV-positive status was not associated with measures of vascular structure or function in any age group. The results suggest that HIV does not contribute to EVA in this population; however, further longitudinal investigation is warranted.

Keywords: antiretroviral treatment; arterial stiffness; carotid intima-media thickness; early vascular ageing; multi-morbidity.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Study population of the EndoAfrica and the PURE studies.
FIGURE 2
FIGURE 2
Adjusted differences in vascular measures (cfPWV, cIMT, cSBP, cPP and PPA) between people living with HIV (HIV+) and without HIV (HIV–) according to tertiles of age (on the left), as well as across different age tertile groups within the respective HIV status groups (on the right). Confounders included for each dependent variable: cfPWV (sex and mean arterial pressure), cIMT (sex and mean arterial pressure), cSBP (sex), cPP (sex) and PPA (sex, mean arterial pressure, heart rate and height).
FIGURE 3
FIGURE 3
Associations between vascular measures and HIV status in the total group and in different age tertile groups. Models that were not significant (carotid IMT – middle and older group; central SBP – older group) were not included. Confounders included in all the models: HIV status, sex, body mass index, total cholesterol, gamma-glutamyl transferase, glycated haemoglobin, C-reactive protein, tobacco use, antiretroviral treatment use and anti-hypertensive medication use. Mean arterial pressure was additionally included in the models, with cfPWV, cIMT and PPA as the dependent variables. Heart rate was also included in the model, with PPA as the dependent variable.
See this image and copyright information in PMC

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