Table 1
Definitions of CVHI metrics.
| POOR CVH | INTERMEDIATE CVH | IDEAL CVH | |
|---|---|---|---|
| Smoking | Current smoker or have quit ≤12 months ago | Have quit >12 months ago | Never smoked |
| BMI | ≥30 kg/m2 | 25.0–29.9 kg/m2 | <25 kg/m2 |
| Physical activity | None | 1–149 min per week of moderate intensity activity and/or 1–74 min per week of vigorous intensity physical activity | ≥150 min per week of moderate intensity activity and/or ≥75 min per week of vigorous intensity physical activity |
| Diet* | None—total servings of fruits and vegetables weekly as the cutoff for ideal intake | 1–20 total servings of fruits and vegetables weekly as the cutoff for ideal intake | ≥20 total servings of fruits and/or vegetables weekly as the cutoff for ideal intake |
| Blood pressure | SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg | SBP 120–139 mmHg or DBP 80–89 mmHg and/or on treatment for antihypertensive | SBP < 120 mmHg and DBP < 80 mmHg |
| Blood glucose (RBG) | ≥11.1mmol/L | 7.8–11 mmol/L | <7.8 mmol/L |
| Blood cholesterol | ≥6mmol/L | 5–5.9 mmol/L | <5mmol/L |
[i] BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; * Fruit and vegetables intake.
Table 2
Characteristics of the study population.
| VARIABLE | TOTAL POPULATION (N = 629) | FEMALE (n = 448, 71.2%) | MALE (n = 181, 28.8%) | p-VALUE |
|---|---|---|---|---|
| Age (mean, SD) | 43.5 (±11.2) | 42.3 (±10.5) | 46.7 (±12.0) | <0.001* |
| Level of education (n,%) No school attended Primary education Secondary education Beyond secondary | 41 (6.5) 418 (66.5) 127 (20.2) 43 (6.8) | 36 (8.0) 309 (69) 81 (18.1) 22 (4.9) | 5 (2.8) 109 (60.2) 46 (25.4) 21 (11.6) | 0.03** |
| Occupation status (n,%) Retired or unemployed Self-employed Employed | 87 (13.8) 429 (68.2) 113 (18) | 69 (15.4) 310 (69.2) 69 (15.4) | 18 (9.9) 119 (65.8) 44 (24.3) | 0.07** |
| Relationship status (n,%) Single/never married Married/cohabiting Widowed | 117 (18.6) 256 (40.7) 152 (24.2) | 87 (19.4) 158 (35.3) 119 (26.6) | 30 (16.6) 98 (54.1) 33 (18.2) | 0.41** |
| Insurance status (n,%) Yes | 90 (14.3) | 57 (12.7) | 33 (18.2) | 0.07** |
| Facility name (n,%) Amana Sinza Temeke Mnazi Mmoja Bunju Vijibweni | 110 (17.5) 121 (19.2) 115 (18.3) 135 (21.5) 66 (10.5) 82 (13.0) | 84 (18.8) 84 (18.8) 79 (17.7) 97 (21.7) 52 (11.6) 52 (11.6) | 26 (14.4) 37 (20.4) 36 (19.9) 38 (21) 14 (7.7) 30 (16.6) | 0.19** |
| ART regimen (n,%) TDF+3TC+DTG (TLD) Other | 559 (89) 69 (11) | 396 (88.4) 52 (11.6) | 163 (90.6) 17 (9.4) | 0.43** |
| HIV viral load (n,%) ≤50 copies >50 copies | 544 (86.6) 84 (13.4) | 395 (88.2) 53 (11.8) | 149 (82.8) 31 (17.2) | 0.07** |
| Years lived with HIV infection (median, IQR) | 6 (3–11) | 6 (3–11) | 5 (2–10) | 0.31* |
| Duration on ART (median, IQR) in years | 5 (3–10) | 5 (3–10) | 4 (2–10) | 0.35* |
| Adherence to ART (n,%) Poor adherence (score < 10) Good adherence | 77 (12.2) 552 (87.8) | 57 (12.7) 391 (87.3) | 20 (11.1) 161 (89) | 0.56** |
| Alcohol use (past 30 days) (n,%) | 158 (25.1) | 108 (24.1) | 50 (27.6) | 0.34** |
| Prevalent comorbidities (self-reported) (n,%) Cardiovascular diseases (MI or stroke) Hypertension Diabetes Hyperlipidemia | 69 (10.9) 67 (10.7) 19 (3.0) 7 (1.1) | 57 (12.7) 55 (12.3) 12 (2.7) 5 (1.1) | 12 (6.6) 12 (6.6) 7 (3.9) 2 (1.1) | 0.03** 0.04** 0.43** 1.0*** |
| Medication use (Hypertension, diabetes, dyslipidemia) (n,%) Any treatment Antihypertensive medication Glucose lowering medication Lipid lowering medication | 31 (4.9) 22 (3.5) 10 (1.6) 2 (0.3) | 24 (5.4) 16 (3.6) 7 (1.6) 2 (0.5) | 7 (3.9) 6 (3.3) 3 (1.7) 0 (0.0) | 0.43* |
| Lifestyle modification (n,%) Yes | 163 (25.8) | 11 (24.8) | 52 (28.7) | 0.31** |
| Family history of CVD (n,%) Yes | 166 (26.4) | 136 (30.4) | 30 (16.6) | <.001** |
| Self-reported health status (medina, IQR) | 20 (19–22.5) | 20.3 (19–22.5) | 20.6 (19–22.5) | 0.40* |
[i] CVD: cardiovascular disease, SD: Standard deviation, TDF: Tenofovir, 3TC: Lamivudine, DTG: Dolutegravir, TLD: Tenofovir, Lamivudine, Dolutegravir.
Self-reported health status possible range 5–25.
* Student t-test, ** Chi-square test, *** Fisher’s exact test.
Table 3
Distribution of CVHI metrics and overall score.
| VARIABLE | TOTAL POPULATION (N = 629) | FEMALE (n = 448, 71.2%) | MALE (n = 181, 28.8%) | p-VALUE |
|---|---|---|---|---|
| Ideal CVH metrics | ||||
| Smoking Poor (Current smoker or quit smoking ≤12 months ago) Intermediate (Have quit >12 months ago) Ideal (not current) smoking status n (%) | 44 (7.0) 55 (8.74) 530 (84.3) | 10 (2.2) 14 (3.1) 424 (94.6) | 34 (18.8) 41 (22.7) 106 (58.6) | <0.001* |
| BMI BMI (Mean, SD) Poor (≥ 30 kg/m2) Intermediate (25.0–29.9 kg/m2) Ideal BMI (<25), n (%) | 27.3 (±17.9) 153 (24.9) 166 (26.9) 296 (48.1) | 26.6(±7.9) 130 (29.6) 110 (25.1) 199 (45.3) | 28.9 (±31) 23 (13.1) 56 (31.8) 97 (55.1) | 0.15* <0.001* |
| Physical activity Minutes of vigorous activity per week (mean, SD) Minutes of moderate activity per week (mean, SD) Poor Intermediate Ideal Physical activity, n (%) | 229.4 (±618.3) 884 (±1226.2) 139 (22.1) 26 (4.13) 464 (73.8) | 126.4 (±398.9) 974 (±1261.6) 103 (23) 19 (4.2) 326 (72.8) | 484.4 (±920.2) 661.7 (±1106.1) 36 (19.9) 7 (3.9) 138 (76.24) | <0.001* <0.01* 0.37** |
| Diet Servings of vegetables per week (mean, SD) Servings of fruit per week Poor Intermediate Ideal diet, n (%) | 9.8 (±5.9) 7.3 (±6.6) 2 (0.32) 578 (91.9) 49 (7.8) | 9.9 (±6.1) 7.1 (±7.0) 1 (0.2) 416 (92.9) 31 (6.9) | 9.5 (±5.3) 7.8 (±5.4) 1 (0.6) 162 (89.5) 18 (9.9) | 0.25* 0.48* 0.51** |
| Cholesterol**** Total cholesterol (mean, SD) Poor Intermediate Ideal cholesterol, n (%) | 4.3 (±0.9) 22 (4.9) 71 (15.8) 357 (79.3) | 4.4 (±0.9) 15 (4.5) 55 (16.6) 262 (78.9) | 4.2 (±1.0) 7 (5.9) 16 (13.6) 95 (80.5) | 0.15* 0.54** |
| BP SBP (mean, SD) DBP (mean, SD) Poor Intermediate Ideal BP, n (%) | 123.5 (±21.2) 78.9 (±15.9) 87 (14.3) 254 (41.8) 267 (43.9) | 121.8 (±20.3) 78.8 (16.8) 56 (12.8) 181 (41.5) 199 (45.6) | 127.9 (±22.8) 79.1 (±13.7) 31 (18) 73 (42.4) 68 (39.6) | 0.001* 0.84* 0.10** |
| Blood glucose/diabetes**** RBG (mean, SD) Poor Intermediate Ideal glucose status, n (%) | 5.2 (±1.7) 7 (1.2) 15 (2.6) 560 (96.2) | 5.2 (±1.6) 4 (0.9) 13 (3.1) 399 (95.9) | 5.2 (±2.0) 3 (1.8) 2 (1.2) 161 (97) | 0.88* 0.40** |
| Overall score (mean,SD) Poor CVH (<3) Intermediate CVH (3–4) Ideal CVH (5–7) | 4.8 (1.1) 22 (5.2) 198 (47.1) 200 (47.6) | 4.4 (1.1) 12 (3.9) 149 (48.1) 149 (48.1) | 4.3 (1.2) 10 (9.09) 49 (44.6) 51 (46.4) | 0.25* 0.10** |
[i] BMI: kg/m2, SBP: Systolic blood pressure (mmHg), DBP: Diastolic blood pressure (mmHg), Total cholesterol (mmol/L), RBG: Random Blood Glucose (mmol/L).
* Student t-test, ** Chi-square test, *** Fisher’s exact test.
**** Missing values: 28.5% for cholesterol levels, 7.4% for blood glucose levels, 3.3% for BP levels, 2.2% for BMI measurements.
Table 4
Determinants of ideal CVH.
| BIVARIATE MODELS | MULTIVARIABLE MODELS | |||
|---|---|---|---|---|
| COR (95% CI) | p-VALUE | AOR (95% CI) | p-VALUE | |
| Age | 0.97 (0.95–0.98) | <0.001 | 0.96 (0.95–0.97) | <0.001 |
| Sex Female Male | Ref. 0.84 (0.53–1.35) | 0.48 | – | – |
| Level of education Primary education Secondary education Beyond secondary No school attended | Ref. 1.32 (0.78–2.23) 0.83 (0.28–2.42) 0.76 (0.29–1.98) | 0.31 0.73 0.58 | – | – |
| Occupation status Self-employed Retired or unemployed Employed | Ref. 0.63 (0.42–0.96) 0.81 (0.68–0.97) | 0.03 0.02 | Ref. 0.59 (0.43–0.81) 0.76 (0.62–0.94) | <0.01 0.01 |
| Relationship status Married/cohabiting Single/never married Widowed | Ref. 1.28 (1.08–1.53) 0.94 (0.73–1.21) | 0.01 0.66 | Ref. 1.07 (0.91–1.27) 1.03 (0.85–1.25) | 0.41 0.71 |
| Insurance status No Yes | Ref. 0.66 (0.37–1.17) | 0.16 | Ref 0.85 (0.44–1.66) | 0.64 |
| ART regimen TDF+3TC+DTG (TLD) Other | Ref. 0.76 (0.43–1.36) | 0.36 | – | – |
| HIV viral load ≤50 >50 | Ref. 1.10 (0.76–1.60) | 0.61 | – | – |
| Years lived with HIV infection | 1.02 (1.00–1.04) | 0.11 | 1.02 (0.98–1.06) | 0.27 |
| Duration of ART (years) | 1.02 (1.01–1.05) | 0.09 | 1.01 (0.98–1.05) | 0.37 |
| Adherence to ART Good adherence Poor adherence | Ref. 0.97 (0.56–1.68) | 0.92 | ||
| Alcohol use No Yes | Ref. 0.16 (0.24–0.85) | 0.01 | Ref. 0.41 (0.21–0.80) | 0.01 |
| Presence of comorbidities No Yes | Ref. 0.65 (0.47–0.92) | 0.01 | Ref. 0.68 (0.48–0.97) | 0.04 |
| NCD Medication use (HTN, diabetes, dyslipidemia) (n,%) No Yes | Ref. 0.84 (0.50–1.42) | 0.53 | – | – |
| Lifestyle modification (n,%) No Yes | Ref. 0.92 (0.60–1.40) | 0.71 | – | – |
| Family history of CVD (n,%) No Yes | Ref. 1.05 (0.64–1.71) | 0.84 | – | – |
[i] Lifestyle modification to control hypertension, diabetes, hyperlipidemia, obesity, obesity, smoking, diet and increase physical activity.
Comorbidities include self-reports of myocardial infraction (heart attacks), stroke, hypertension, diabetes or hyperlipidemia.