An Exploration the Risk of Cardiovascular Disease in HIV-Positive Persons in Indonesia using Heart Rate Variability

Cardiovascular disease is the highest cause of death in HIV patients compared to the general population. The number of HIV patients suffering from cardiovascular disease is almost twice as high as patients who are not HIV-positive.The purpose of this study was to identify the risk of cardivascular disease in patients with HIV using ECG short term. This study was used a descriptive comparative to patients with HIV and healthy people as controls in West Java. The inclusion criteria are patients with HIV over the age of 30 years. The exclusion criteria were people with HIV diagnosed with heart disease or being treated for the heart disease. While the inclusion criteria for healthy people as controls are over 30 years of age, do not suffer from cardivascular disease or under treatment of cardiovascular disease. The measurement of heart rate variability is carried out in a supine position in a quiet temperature-controlled room (25-270 C), a 5-minute electrocardiograph (ECG) is recorded using lead II. Differences of heart rate variability indicator were measure using man-whitney test. A total of 20 patients with HIV and 20 healthy people recruited using convinience sampling. The majority of people with HIV were male and aged range between 27 to 51 years old. The results of heart rate variability based on time domain analysis showed that the means normal to normal (NN) was significantly lower in HIV patients compared to controls (978 vs ?? vs 902 ms; p<0.05). No differences were found between groups regarding Standard deviation of NN (SDNN), Square root of the mean squared difference of successive NN-intervals (RMSSD) and Percent of differences between adjacent NN intervals greater than 50 ms (pNN50). This study presence of autonomic dysfunction as showed in heart rate variability indicator in a group of HIV compared to the healthy group. Eearly identification of the risk of CVD is important and may inform the implementation of preventive measure by identification of high-risk people who may be candidate for intervention.

[1]  S. Lockman,et al.  Cardiovascular disease risk prediction by the American College of Cardiology (ACC)/American Heart Association (AHA) Atherosclerotic Cardiovascular Disease (ASCVD) risk score among HIV-infected patients in sub-Saharan Africa , 2017, PloS one.

[2]  S. Grundy.  Metabolic syndrome update. , 2016, Trends in cardiovascular medicine.

[3]  A. Hoepelman,et al.  Cardiovascular risk prediction in HIV‐infected patients: comparing the Framingham, atherosclerotic cardiovascular disease risk score (ASCVD), Systematic Coronary Risk Evaluation for the Netherlands (SCORE‐NL) and Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) risk prediction models , 2016, HIV medicine.

[4]  M. Freiberg,et al.  HIV and Cardiovascular Disease: We Need a Mechanism, and We Need a Plan , 2016, Journal of the American Heart Association.

[5]  M. Ngowe,et al.  Risk Factors of Cardiovascular Diseases in HIV/AIDS Patients on HAART , 2015, The open AIDS journal.

[6]  R. Kronmal,et al.  HIV and coronary artery calcium score: comparison of the Hawaii Aging with HIV Cardiovascular Study and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts , 2015, HIV clinical trials.

[7]  Danai Tavonga Zhou,et al.  Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe , 2015, HIV/AIDS.

[8]  A. Phillips,et al.  Baseline cardiovascular risk in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial , 2015, HIV medicine.

[9]  P. Melillo,et al.  Automatic Prediction of Cardiovascular and Cerebrovascular Events Using Heart Rate Variability Analysis , 2015, PloS one.

[10]  K. Višković,et al.  Comparison of four international cardiovascular disease prediction models and the prevalence of eligibility for lipid lowering therapy in HIV infected patients on antiretroviral therapy , 2015, Croatian medical journal.

[11]  B. Chi,et al.  Cardiometabolic risk factors among HIV patients on antiretroviral therapy , 2013, Lipids in Health and Disease.

[12]  L. Køber,et al.  Decreased Nighttime Heart Rate Variability Is Associated With Increased Stroke Risk , 2011, Stroke.

[13]  J. Mehlsen,et al.  Decreased Heart Rate Variability in HIV Positive Patients Receiving Antiretroviral Therapy: Importance of Blood Glucose and Cholesterol , 2011, PloS one.

[14]  R. Napoli,et al.  Human immunodeficiency virus per se exerts atherogenic effects. , 2009, Atherosclerosis.

[15]  C. Gundy,et al.  Carotid Intima-Media Thickness and Arterial Stiffness in HIV-Infected Patients: The Role of HIV, Antiretroviral Therapy, and Lipodystrophy , 2009, Journal of acquired immune deficiency syndromes.

[16]  Hang Lee,et al.  Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. , 2007, The Journal of clinical endocrinology and metabolism.

[17]  H. Sørensen,et al.  Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[18]  A. Jaryal,et al.  Heart rate variability and autonomic function tests in HIV positive individuals in India , 2007, Clinical Autonomic Research.

[19]  John T Brooks,et al.  Mortality in the Highly Active Antiretroviral Therapy Era: Changing Causes of Death and Disease in the HIV Outpatient Study , 2006, Journal of acquired immune deficiency syndromes.

[20]  A. Prata,et al.  Power Spectral Analysis of Heart Rate Variability in HIV‐Infected and AIDS Patients , 2006, Pacing and clinical electrophysiology : PACE.

[21]  T. Pickering.  Do We Really Need a New Definition of Hypertension? , 2005, Journal of clinical hypertension.

[22]  M. Gill,et al.  Changing mortality rates and causes of death for HIV‐infected individuals living in Southern Alberta, Canada from 1984 to 2003 , 2005, HIV medicine.

[23]  R. Berger,et al.  Relationship between age and heart rate variability in supine and standing postures: A study of spectral analysis of heart rate , 2004, Pediatric Cardiology.