Racial differences in central hemodynamic burden in men with HIV: Preliminary findings

Kevin S Heffernan, Christine A. Wanke, Kimberly Dong, Patrick J. Warner, Paul E. Anskat, Richard H. Karas, Jeffrey T. Kuvin

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objectives: African Americans infected with HIV are almost 3 times more likely to die from cardiovascular disease (CVD) than their White HIV-infected counterparts. The purpose of this study was to examine racial differences in novel measures of vascular function and CVD risk in African American and White men infected with HIV. Design: Our study uses a cross-sectional approach. Setting: Participants were recruited from the nutrition/infectious disease clinic at a large metropolitan hospital. Participants: African American men (n521) and White men (n521) with HIV on stable anti-retroviral therapy were included in this study. Main Outcome Measures: High resolution ultrasound was used to assess brachial artery flow mediated dilation (FMD). Applanation tonometry was used to measure carotidfemoral and carotid-radial pulse wave velocity (PWV), carotid augmentation index (AIx) and carotid-brachial pulse pressure (PP) amplification. Left ventricular (LV) pressure effort was derived from the contour of the central BP waveform. Results: There were no racial differences in brachial FMD (African American: 4.9 ± 1.1 vs White: 5.4 ± 1.0%; P>.05) or carotid-femoral PWV (African American: 8.9 ± .6 vs White: 8.7 ± .4 m/s; P>.05). African American men with HIV had significantly higher carotid-radial PWV (11.3 ± .4 vs 9.8 ± .3 m/s; P<.05), higher carotid AIx (6 ± 3 vs -1 ± 2%; P<.05), higher LV pressure effort (2262 ± 369 vs 1030±140 dyne sec/cm 2; P,.05) and lower PP amplification (1.10 ± .03 vs 1.24 ± .03; P<.05) compared to White men with HIV. Conclusion: Elevated CVD risk in African American men with HIV may be partially mediated by increased central hemodynamic burden and not endothelial dysfunction or increased aortic stiffness.

Original languageEnglish (US)
Pages (from-to)217-222
Number of pages6
JournalEthnicity and Disease
Volume23
Issue number2
StatePublished - Mar 2013

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Keywords

  • African American
  • Arterial Stiffness
  • Blood Pressure
  • Human Immunodeficiency Virus
  • Wave Reflection

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)

Cite this

Heffernan, K. S., Wanke, C. A., Dong, K., Warner, P. J., Anskat, P. E., Karas, R. H., & Kuvin, J. T. (2013). Racial differences in central hemodynamic burden in men with HIV: Preliminary findings. Ethnicity and Disease, 23(2), 217-222.