TY - JOUR
T1 - Changes in nocturnal heart rate variability in people living with HIV during the first year of antiretroviral therapy compared to HIV-uninfected community controls
AU - Kavishe, Bazil Baltazar
AU - PrayGod, George
AU - Brage, Søren
AU - Kitilya, Brenda Wilfred
AU - Faurholt-Jepsen, Daniel
AU - Todd, Jim
AU - Jeremiah, Kidola
AU - Filteau, Suzanne
AU - Olsen, Mette Frahm
AU - Peck, Robert
N1 - Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: Higher nocturnal heart rate and lower nocturnal heart rate variability (HRV) is associated with increased cardiovascular disease mortality. Longitudinal studies on nocturnal HRV in people living with HIV (PLWH) are lacking.Methods: We conducted a one-year prospective cohort study of adult PLWH and HIV-uninfected community controls in north-western Tanzania. At enrollment, we collected data on cardiovascular risk factors and tested blood samples for hemoglobin, insulin, CD4 cell count and C-reactive protein. We measured nocturnal HRV and heart rate at baseline and first year follow-up. Mixed effect linear regression was used to determine predictors of lower HRV.Results: Of the 111 enrolled participants (74 PLWH and 37 HIV-uninfected), 57.7% were female and the median age was 40 years. Over one year of follow-up, the average nocturnal heart rate was 4.5 beats/minute higher in PLWH (p=0.006). In the fully adjusted model (with age, sex, nocturnal heart rate and diabetes), average nocturnal HRV was 10.5 milliseconds lower in PLWH compared to HIV-uninfected adults (p=0.03). Unlike with nocturnal heart rate, nocturnal HRV did not improve after one year of ART in PLWH or HIV-uninfected (fully adjusted change = -2.5 milliseconds, p=0.45). Lower educational attainment, lesser pancreatic β-cell function and anemia were associated with higher HRV.Conclusions: Nocturnal parasympathetic nervous system function was persistently lower in PLWH compared to HIV-uninfected even after antiretroviral therapy initiation. Improving nocturnal autonomic nervous system function could be a target for cardiovascular disease prevention in PLWH.
AB - Background: Higher nocturnal heart rate and lower nocturnal heart rate variability (HRV) is associated with increased cardiovascular disease mortality. Longitudinal studies on nocturnal HRV in people living with HIV (PLWH) are lacking.Methods: We conducted a one-year prospective cohort study of adult PLWH and HIV-uninfected community controls in north-western Tanzania. At enrollment, we collected data on cardiovascular risk factors and tested blood samples for hemoglobin, insulin, CD4 cell count and C-reactive protein. We measured nocturnal HRV and heart rate at baseline and first year follow-up. Mixed effect linear regression was used to determine predictors of lower HRV.Results: Of the 111 enrolled participants (74 PLWH and 37 HIV-uninfected), 57.7% were female and the median age was 40 years. Over one year of follow-up, the average nocturnal heart rate was 4.5 beats/minute higher in PLWH (p=0.006). In the fully adjusted model (with age, sex, nocturnal heart rate and diabetes), average nocturnal HRV was 10.5 milliseconds lower in PLWH compared to HIV-uninfected adults (p=0.03). Unlike with nocturnal heart rate, nocturnal HRV did not improve after one year of ART in PLWH or HIV-uninfected (fully adjusted change = -2.5 milliseconds, p=0.45). Lower educational attainment, lesser pancreatic β-cell function and anemia were associated with higher HRV.Conclusions: Nocturnal parasympathetic nervous system function was persistently lower in PLWH compared to HIV-uninfected even after antiretroviral therapy initiation. Improving nocturnal autonomic nervous system function could be a target for cardiovascular disease prevention in PLWH.
KW - Faculty of Science
KW - Heart rate variability
KW - Heart rate
KW - People living with HIV
KW - Cardiovascular disease
U2 - 10.1097/QAI.0000000000003191
DO - 10.1097/QAI.0000000000003191
M3 - Journal article
C2 - 36961954
VL - 93
SP - 208
EP - 212
JO - J A I D S
JF - J A I D S
SN - 1525-4135
IS - 3
ER -