HIV, Sleep, Nocturnal Non-Dipping, and Cardiovascular Disease: A Tanzanian Cohort (Mwanza HIV&HTN Sleep Cohort)
HIV poses a significant global public health threat, with nearly 40 million people currently affected worldwide. Notably, half of these cases are in the regions of eastern and southern Africa. Since the introduction of antiretroviral therapy, there has been a decline in deaths related to infections among people living with HIV (PLWH). However, there has been a concurrent increase in deaths attributed to heart diseases in PLWH. It is not yet understood why PLWH suffer from more heart diseases than the general population.
High blood pressure is a major risk factor for heart disease and is the leading cause of premature deaths globally. Africa has the highest rates of high blood pressure of any region in the world with hypertension affecting over a quarter of the adults. Addressing high blood pressure is critical to controlling heart diseases. The Mwanza HIV&HTN Sleep Cohort was established in 2016 to study the relationships between HIV, hypertension, and heart diseases and, has evolved to include sleep and other nighttime risk factors for heart diseases. Understanding sleep patterns, nighttime blood pressure, heart rate, and nocturnal nervous system activity might help to explain and prevent heart diseases in PLWH.
To investigate the patterns and abnormalities of sleep and nighttime blood pressure, heart rate, and nervous system activity in both PLWH and HIV-uninfected adults and to investigate the relationships between these nighttime risk factors and heart disease onset. Our long-term goal is to reduce the burden of heart diseases among PLWH.
This is a longitudinal cohort study which will enroll 500 adults with HIV and 500 HIV-uninfected adults from the Bugando Medical Centre outpatient HIV clinic in Mwanza city, Tanzania. Participants will undergo repeated measurements of sleep and nighttime blood pressure, heart rate, and nervous system activity for over a period of three years. Medical tests of the heart and blood vessels will also be performed to determine the onset of heart diseases.
MITU, Tanzania/London School of Hygiene & Tropical Medicine, UK: Heiner Grosskurth, Philip Ayieko; MITU, Tanzania: Ramadhan Hashim; Kenya Medical Research Institute, Kenya: Anthony Etyang; Weill Cornell Medical College, NY, USA: Myung Hee Lee, Ana Krieger, Justin Kingery, Dick Devereux