Lung function and atherosclerosis: a cross-sectional study of multimorbidity in rural Uganda

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of global mortality. In high-income settings, the presence of cardiovascular disease among people with COPD increases mortality and complicates longitudinal disease management. An estimated 26 million people are living with...

Full description

Bibliographic Details
Main Authors: Bibangambah, P. (Author), Christiani, D.C (Author), Cichowitz, C. (Author), Gilbert, R.F (Author), Hemphill, L.C (Author), Kakuhikire, B. (Author), Kim, J.-H (Author), North, C.M (Author), Okello, S. (Author), Sentongo, R.N (Author), Siedner, M.J (Author), Tsai, A.C (Author), Yang, I.T (Author)
Format: Article
Language:English
Published: BioMed Central Ltd 2022
Subjects:
Online Access:View Fulltext in Publisher
LEADER 04567nam a2200865Ia 4500
001 10-1186-s12890-021-01792-0
008 220420s2022 CNT 000 0 und d
020 |a 14712466 (ISSN) 
245 1 0 |a Lung function and atherosclerosis: a cross-sectional study of multimorbidity in rural Uganda 
260 0 |b BioMed Central Ltd  |c 2022 
856 |z View Fulltext in Publisher  |u https://doi.org/10.1186/s12890-021-01792-0 
520 3 |a Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of global mortality. In high-income settings, the presence of cardiovascular disease among people with COPD increases mortality and complicates longitudinal disease management. An estimated 26 million people are living with COPD in sub-Saharan Africa, where risk factors for co-occurring pulmonary and cardiovascular disease may differ from high-income settings but remain uncharacterized. As non-communicable diseases have become the leading cause of death in sub-Saharan Africa, defining multimorbidity in this setting is critical to inform the required scale-up of existing healthcare infrastructure. Methods: We measured lung function and carotid intima media thickness (cIMT) among participants in the UGANDAC Study. Study participants were over 40 years old and equally divided into people living with HIV (PLWH) and an age- and sex-similar, HIV-uninfected control population. We fit multivariable linear regression models to characterize the relationship between lung function (forced expiratory volume in one second, FEV1) and pre-clinical atherosclerosis (cIMT), and evaluated for effect modification by age, sex, smoking history, HIV, and socioeconomic status. Results: Of 265 participants, median age was 52 years, 125 (47%) were women, and 140 (53%) were PLWH. Most participants who met criteria for COPD were PLWH (13/17, 76%). Median cIMT was 0.67 mm (IQR: 0.60 to 0.74), which did not differ by HIV serostatus. In models adjusted for age, sex, socioeconomic status, smoking, and HIV, lower FEV1 was associated with increased cIMT (β = 0.006 per 200 mL FEV1 decrease; 95% CI 0.002 to 0.011, p = 0.01). There was no evidence that age, sex, HIV serostatus, smoking, or socioeconomic status modified the relationship between FEV1 and cIMT. Conclusions: Impaired lung function was associated with increased cIMT, a measure of pre-clinical atherosclerosis, among adults with and without HIV in rural Uganda. Future work should explore how co-occurring lung and cardiovascular disease might share risk factors and contribute to health outcomes in sub-Saharan Africa. © 2021, The Author(s). 
650 0 4 |a adult 
650 0 4 |a Adult 
650 0 4 |a aged 
650 0 4 |a Aged 
650 0 4 |a atherosclerosis 
650 0 4 |a Atherosclerosis 
650 0 4 |a Cardiovascular disease 
650 0 4 |a Carotid Arteries 
650 0 4 |a carotid artery 
650 0 4 |a chronic obstructive lung disease 
650 0 4 |a cIMT 
650 0 4 |a cohort analysis 
650 0 4 |a Cohort Studies 
650 0 4 |a complication 
650 0 4 |a COPD 
650 0 4 |a Cross-Sectional Studies 
650 0 4 |a cross-sectional study 
650 0 4 |a diagnostic imaging 
650 0 4 |a female 
650 0 4 |a Female 
650 0 4 |a FEV1 
650 0 4 |a forced expiratory volume 
650 0 4 |a Forced Expiratory Volume 
650 0 4 |a HIV infection 
650 0 4 |a HIV Infections 
650 0 4 |a human 
650 0 4 |a Human immunodeficiency virus infection 
650 0 4 |a Humans 
650 0 4 |a lung 
650 0 4 |a Lung 
650 0 4 |a Lung Diseases, Obstructive 
650 0 4 |a lung function test 
650 0 4 |a male 
650 0 4 |a Male 
650 0 4 |a middle aged 
650 0 4 |a Middle Aged 
650 0 4 |a Multimorbidity 
650 0 4 |a multiple chronic conditions 
650 0 4 |a pathophysiology 
650 0 4 |a Respiratory Function Tests 
650 0 4 |a risk factor 
650 0 4 |a Risk Factors 
650 0 4 |a smoking 
650 0 4 |a Smoking 
650 0 4 |a spirometry 
650 0 4 |a Spirometry 
650 0 4 |a Uganda 
650 0 4 |a Uganda 
650 0 4 |a Uganda 
700 1 0 |a Bibangambah, P.  |e author 
700 1 0 |a Christiani, D.C.  |e author 
700 1 0 |a Cichowitz, C.  |e author 
700 1 0 |a Gilbert, R.F.  |e author 
700 1 0 |a Hemphill, L.C.  |e author 
700 1 0 |a Kakuhikire, B.  |e author 
700 1 0 |a Kim, J.-H.  |e author 
700 1 0 |a North, C.M.  |e author 
700 1 0 |a Okello, S.  |e author 
700 1 0 |a Sentongo, R.N.  |e author 
700 1 0 |a Siedner, M.J.  |e author 
700 1 0 |a Tsai, A.C.  |e author 
700 1 0 |a Yang, I.T.  |e author 
773 |t BMC Pulmonary Medicine