Lung function and atherosclerosis: a cross-sectional study of multimorbidity in rural Uganda.

Journal: BMC pulmonary medicine

Volume: 22

Issue: 1

Year of Publication: 2022

Affiliated Institutions:  Massachusetts General Hospital, Fruit Street, BUL-, Boston, MA, , USA. Mbarara University of Science and Technology, Mbarara, Uganda. Brigham and Women's Hospital, Boston, MA, USA. Geisel School of Medicine at Dartmouth, Hanover, NH, USA. Massachusetts General Hospital, Fruit Street, BUL-, Boston, MA, , USA. cnorth@mgh.harvard.edu.

Abstract summary 

Chronic obstructive pulmonary disease (COPD) is a leading cause of global mortality. In high-income settings, the presence of cardiovascular disease among people with COPD increases mortality and complicates longitudinal disease management. An estimated 26 million people are living with COPD in sub-Saharan Africa, where risk factors for co-occurring pulmonary and cardiovascular disease may differ from high-income settings but remain uncharacterized. As non-communicable diseases have become the leading cause of death in sub-Saharan Africa, defining multimorbidity in this setting is critical to inform the required scale-up of existing healthcare infrastructure.We measured lung function and carotid intima media thickness (cIMT) among participants in the UGANDAC Study. Study participants were over 40 years old and equally divided into people living with HIV (PLWH) and an age- and sex-similar, HIV-uninfected control population. We fit multivariable linear regression models to characterize the relationship between lung function (forced expiratory volume in one second, FEV) and pre-clinical atherosclerosis (cIMT), and evaluated for effect modification by age, sex, smoking history, HIV, and socioeconomic status.Of 265 participants, median age was 52 years, 125 (47%) were women, and 140 (53%) were PLWH. Most participants who met criteria for COPD were PLWH (13/17, 76%). Median cIMT was 0.67 mm (IQR: 0.60 to 0.74), which did not differ by HIV serostatus. In models adjusted for age, sex, socioeconomic status, smoking, and HIV, lower FEV was associated with increased cIMT (β = 0.006 per 200 mL FEV decrease; 95% CI 0.002 to 0.011, p = 0.01). There was no evidence that age, sex, HIV serostatus, smoking, or socioeconomic status modified the relationship between FEV and cIMT.Impaired lung function was associated with increased cIMT, a measure of pre-clinical atherosclerosis, among adults with and without HIV in rural Uganda. Future work should explore how co-occurring lung and cardiovascular disease might share risk factors and contribute to health outcomes in sub-Saharan Africa.

Authors & Co-authors:  Gilbert Rebecca F RF Cichowitz Cody C Bibangambah Prossy P Kim June-Ho JH Hemphill Linda C LC Yang Isabelle T IT Sentongo Ruth N RN Kakuhikire Bernard B Christiani David C DC Tsai Alexander C AC Okello Samson S Siedner Mark J MJ North Crystal M CM

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–1788.
Authors :  13
Identifiers
Doi : 12
SSN : 1471-2466
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
COPD;Cardiovascular disease;FEV1;HIV infection;Uganda;cIMT
Study Design
Case Control Trial,Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England