Cardiovascular risk factors among people with drug-resistant tuberculosis in Uganda

Abstract

Background Tuberculosis (TB) and its risk factors are independently associated with cardiovascular disease (CVD). We determined the prevalence and associations of CVD risk factors among people with drug-resistant tuberculosis (DRTB) in Uganda. Methods In this cross-sectional study, we enrolled people with microbiologically confirmed DRTB at four treatment sites in Uganda between July to December 2021. The studied CVD risk factors were any history of cigarette smoking, diabetes mellitus (DM) hypertension, high body mass index (BMI), central obesity and dyslipidaemia. We used modified Poisson regression models with robust standard errors to determine factors independently associated with each of dyslipidaemia, hypertension, and central obesity. Results Among 212 participants, 118 (55.7%) had HIV. Overall, 196 (92.5%, 95% confidence interval (CI) 88.0-95.3) had ≥ 1 CVD risk factor. The prevalence; 95% CI of individual CVD risk factors was: dyslipidaemia (62.5%; 55.4–69.1), hypertension (40.6%; 33.8–47.9), central obesity (39.3%; 32.9–46.1), smoking (36.3%; 30.1–43.1), high BMI (8.0%; 5.0–12.8) and DM (6.5%; 3.7–11.1). Dyslipidaemia was associated with an increase in glycated haemoglobin (adjusted prevalence ratio (aPR) 1.14, 95%CI 1.06–1.22). Hypertension was associated with rural residence (aPR 1.89, 95% CI 1.14–3.14) and previous history of smoking (aPR 0.46, 95% CI 0.21–0.98). Central obesity was associated with increasing age (aPR 1.02, 95%CI 1.00–1.03), and elevated diastolic blood pressure (aPR 1.03 95%CI 1.00–1.06). Conclusion There is a high prevalence of CVD risk factors among people with DRTB in Uganda, of which dyslipidaemia is the commonest. We recommend integrated services for identification and management of CVD risk factors in DRTB.

Prevalence of Risk Factors for Hypertension Among Faculty at an Urban University in Uganda

“…On the contrary, the prevalence of hypertension among patients with drug-resistant tuberculosis in Uganda was significantly higher, at 40.6%, 26 almost double our observed prevalence. This considerable variability in hypertension levels highlights differences in risk exposures.…”

“…It is a vital finding that none of the faculty were smoking at the time of the study, and this is contrary to findings from an urban Ugandan HIV clinic at 9.7%, 43 among drug-resistant tuberculosis patients in Central, Western, Northern and Eastern Uganda at 36.3% 26 and among patients in Western Kenya at 5%. 22 Tobacco cessation information is readily available in Ugandan urban settings and given that Makerere University has a zero-smoking policy, it could be the explanation for no participants being current smokers relative to studies conducted among the general population.…”

Cardiopatía coronaria isquémica y tuberculosis: una sindemia inadvertida.Revisión de la literatura y propuesta de manejo

“…Un estudio realizado en Uganda sobre factores de riesgo cardiovasculares entre personas con tuberculosis resistente a medicamentos que incluyó 212 participantes encontró que el 92% de la población con tuberculosis tenía ≥ 1 factor de riesgo de enfermedad cardiovascular: la dislipidemia (62,5%; 55,4-69,1), hipertensión (40,6%; 33,8-47,9), obesidad central (39,3%; 32,9-46,1), tabaquismo (36,3%; 30,1-43,1), indice de masa corporal (IMC) elevado (8,0%; 5,0-12,8) y diabetes mellitus (6,5%; 3,7-11,1) resaltaron como los principales (26) . Esta interrelación de factores de riesgo podría explicar la coexistencia de eventos cardiovasculares adversos y TB.…”

“…A study conducted in Uganda on cardiovascular risk factors among people with drug-resistant tuberculosis, which included 212 participants, found that 92% of the population with tuberculosis had ≥ 1 cardiovascular disease risk factor: dyslipidemia (62.5%; 95% CI [confidence interval]: 55.4-69.1), hypertension (40.6%; 95% CI: 33.8-47.9), central obesity (39.3%; 95% CI: 32.9-46.1), smoking (36.3%; 95% CI: 30.1-43.1), elevated body mass index (BMI) (8.0%; 95% CI: 5.0-12.8), and diabetes mellitus (6.5%; 95% CI: 3.7-11.1) were highlighted as the main ones 26 . This interrelation of risk factors could explain the coexistence of adverse cardiovascular events and TB.…”

Hypertension incidence among individuals successfully treated for pulmonary tuberculosis

“…2 Furthermore, cross-sectional studies have shown that people with TB have a high prevalence of risk factors for CVD among people with active TB. 3,4 However, prospective studies assessing the CVD risk trajectories among people after they have completed TB treatment are scarce as it may require a long follow-up period.…”