The contribution of syndemic conditions to cardiovascular disease risk

ABSTRACT

The syndemic conditions of low education, childhood maltreatment, depression, HIV, alcohol and cocaine use, and obesity have been established as independent risk factors for cardiovascular risk, but research examining the association between syndemic conditions and cardiovascular risk in high-risk populations is lacking. A total of N = 503 participants underwent an ultrasound of the carotid artery to assess for atherosclerotic plaque. Participants, HIV-infected (n = 202) and HIV-uninfected (n = 301) with and without a history of cocaine use, were a mean age of 36.13 years (SD = 9.51); 50% were male, and 62% were African-American. Each syndemic condition was associated with 8% greater odds of atherosclerotic plaque (OR = 1.08), 9% greater odds of systolic blood pressure (OR = 1.09), and 10% greater odds of diastolic blood pressure (OR = 1.10). Multilevel research, interventions, and public policy initiatives are needed to activate stakeholders at each level to maximize their impact at a community level among populations with high rates of syndemic conditions.

KEYWORDS:

• HIV
• cardiovascular disease
• subclinical atherosclerosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

M. K., D. L. J., and S. M. W. conceived the study and drafted the first manuscript with V. J. R., A. C., M. S. P., M. L. A., T. K. L., and M. S. T. K. L. and V. J. R. conducted all analyses. M. K., D. L. J., S. M. W., V. J. R., M. S. P., A. C., M. L. A., T. K. L., B. H., and M. S. participated in study execution, coordination and assisted in editing and finalizing the manuscript and gave critical review. All authors read and approved the final manuscript.

Additional information

Funding

This study was funded by a grant from National Institute on Drug Abuse from the National Institutes of Health [grant number R01DA034589], and with support from the Miami Center for AIDS Research, National Institute of Allergy and Infectious Diseases/NIH [grant number P30AI073061]. This work was also partially funded by a Ford Foundation Fellowship to Violeta J. Rodriguez, administered by the National Academies of Sciences, Engineering, and Medicine.