Smoking Cessation Is Associated With Short-Term Improvement of Vascular Health in a Cohort of People Living With HIV in Rio de Janeiro, Brazil.

Autor: Moreira RC; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil. Electronic address: rodrigo.moreira@fiocruz.br., Rodrigues A; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Leonardo BM; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil., Arabe D; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil., Santos R; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil., Cardoso SW; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil., Grinsztejn B; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil., Veloso V; Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil., Pacheco AG; Scientific Computing Program of Oswaldo Cruz Fundation (PROCC), Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Mar 01; Vol. 214, pp. 157-166. Date of Electronic Publication: 2023 Dec 30.
DOI: 10.1016/j.amjcard.2023.12.034
Abstrakt: Smoking is highly prevalent in people living with HIV/AIDS (PLHA), leading to detrimental effects in different tissues. We examined the effects of nicotine replacement therapy (NRT) on smoking cessation and vascular health. From December 2019 to October 2021, we prospectively enrolled PLHA who were actively smoking. The primary outcome was endothelial function measured by brachial artery flow-mediated dilatation (FMD). We evaluated the percent change in FMD compared to the baseline measure (Δ%FMD) to detect improvements among participants who quit smoking. To confirm the results, we used linear regression models to account for classical cardiovascular (CV) confounders. We included 117 participants with median age of 45.5 years (IQR= 36.4-54.8); 22 (20.4%) had hypertension, 9 (8.3%) had diabetes, almost half were smoking 20+ cigarettes/day (41.7%). After 12 weeks 30.76% participants quit smoking. Comparison of Δ%FMD change from baseline to week 12 showed that among participants adherent to therapy, there has been an increase in Δ%FMD when compared to those who relapsed (1.17% [0.29-2.98] vs -0.19% [-1.95-0.91], p<0.001). After adjustment for CV factors, multiple linear regression showed that Δ%FMD in participants who quit smoking presented a 2.54 mean increase in comparison to those who continued smoking (p=0.007). In conclusion, this study provides evidence that a strategy of NRT and counseling is modestly effective for smoking cessation in PLHA and improves vascular health in a short period of time. This reinforces the importance of the widespread anti-tobacco programs in HIV clinics and the expected impact lowering the incidence of future cardiovascular events.
Competing Interests: Declaration of competing interest Dr. Moreira reports financial support was provided by Oswaldo Cruz Foundation. The remaining authors have no competing interest to declare.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: