Assessment of arterial elasticity among HIV-positive participants with high CD4 cell counts: A substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial

International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: Both HIV infection and antiretroviral therapy (ART) may increase cardiovascular disease (CVD) risk. Assessments of vascular function and structure can be used to study the pathogenesis and progression of CVD, including the effects of ART and other interventions. The objective of this report is to understand methods to assess vascular (dys)function and report our experience in the Arterial Elasticity Substudy in the Strategic Timing of AntiRetroviral Treatment (START) trial. Methods: We review literature and analyze baseline data from the Arterial Elasticity Substudy, which estimated vascular (dys)function through analysis of the diastolic blood pressure (BP) waveform. Linear regression was used to study cross-sectional associations between baseline clinical factors and small or large arterial elasticity. Results: Arterial elasticity measurement was chosen for its improved measurement reproducibility over other methodologies and the potential of small arterial elasticity to predict clinical risk. Analysis of baseline data demonstrates that small artery elasticity is impaired (lower) with older age and differs by race and between geographical regions. No HIV-specific factors studied remained significantly associated with arterial elasticity in multivariate models. Conclusions: Longitudinal analyses in this substudy will provide essential randomized data with which to study the effects of early ART initiation on the progression of vascular disease among a diverse global population. When combined with future biomarker analyses and clinical outcomes in START, these findings will expand our understanding of the pathogenesis of HIV-related CVD.

Original languageEnglish (US)
Pages (from-to)109-118
Number of pages10
JournalHIV Medicine
Volume16
Issue numberS1
DOIs
StatePublished - Apr 1 2015

Fingerprint

Elasticity
CD4 Lymphocyte Count
HIV
Blood Vessels
Cardiovascular Diseases
Therapeutics
Blood Pressure
Secondary Prevention
Vascular Diseases
HIV Infections
Linear Models
Arteries
Cross-Sectional Studies
Biomarkers
Population

Keywords

  • Arterial elasticity
  • Cardiovascular disease
  • HIV infection
  • Vascular dysfunction

ASJC Scopus subject areas

  • Health Policy
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Assessment of arterial elasticity among HIV-positive participants with high CD4 cell counts : A substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. / International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group.

In: HIV Medicine, Vol. 16, No. S1, 01.04.2015, p. 109-118.

Research output: Contribution to journalArticle

International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group. / Assessment of arterial elasticity among HIV-positive participants with high CD4 cell counts : A substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. In: HIV Medicine. 2015 ; Vol. 16, No. S1. pp. 109-118.
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abstract = "Objectives: Both HIV infection and antiretroviral therapy (ART) may increase cardiovascular disease (CVD) risk. Assessments of vascular function and structure can be used to study the pathogenesis and progression of CVD, including the effects of ART and other interventions. The objective of this report is to understand methods to assess vascular (dys)function and report our experience in the Arterial Elasticity Substudy in the Strategic Timing of AntiRetroviral Treatment (START) trial. Methods: We review literature and analyze baseline data from the Arterial Elasticity Substudy, which estimated vascular (dys)function through analysis of the diastolic blood pressure (BP) waveform. Linear regression was used to study cross-sectional associations between baseline clinical factors and small or large arterial elasticity. Results: Arterial elasticity measurement was chosen for its improved measurement reproducibility over other methodologies and the potential of small arterial elasticity to predict clinical risk. Analysis of baseline data demonstrates that small artery elasticity is impaired (lower) with older age and differs by race and between geographical regions. No HIV-specific factors studied remained significantly associated with arterial elasticity in multivariate models. Conclusions: Longitudinal analyses in this substudy will provide essential randomized data with which to study the effects of early ART initiation on the progression of vascular disease among a diverse global population. When combined with future biomarker analyses and clinical outcomes in START, these findings will expand our understanding of the pathogenesis of HIV-related CVD.",
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