Abstract
We assessed cardiovascular disease (CVD) risk factor prevalence and risk stratification amongst adults on antiretroviral therapy in South Africa. Of the 175 patients screened, 37.8% had high blood pressure (HBP), 15.4% were current smokers, 10.4% had elevated cholesterol, and 4.1% had diabetes, but very few (3.6%) had a 10-year CVD risk >10%. One-third of those with HBP, 40% of those with diabetes, and two-thirds of those with high cholesterol had not previously been diagnosed. Although participants were adherent with chronic HIV care, screening for and management of CVDRF were suboptimal, representing a missed opportunity to reduce non-AIDS morbidity and mortality.
Highlights
HIV remains the leading cause of death among adults in sub-Saharan Africa, the burden of non-communicable disease (NCD) is high and rising rapidly [1]
8% of participants reported missing a dose of antiretroviral therapy (ART) in the past month, and only 5.1% reported missing an appointment at the HIV clinic within the past three months
CVD risk factors (CVDRF) were common amongst people living with HIV (PLWH) on ART at this urban HIV clinic, as they are in the general population of Free State Province [22]
Summary
HIV remains the leading cause of death among adults in sub-Saharan Africa, the burden of non-communicable disease (NCD) is high and rising rapidly [1]. In many African countries, cardiovascular disease (CVD) is a leading cause of death [2,3], and the prevalence of CVD risk factors (CVDRF) such as diabetes, dyslipidemia, hypertension, and tobacco use is significant [4,5,6]. CVD causes 18% of deaths in the country, and CVDRF have been described as a “time bomb” for South Africa’s health system [8,9]. This convergence of HIV and NCDs presents both challenges and opportunities for public health. The scale-up of HIV care and treatment has led to growing survival and longevity of people living with HIV (PLWH), who are increasingly at risk for the NCDs prevalent in their
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