Cohort II
2017 - 2019

Ana María del Río-González | Mariano Kanamori Nishimura
Julie Levison | Claudia Martinez

 
 

Claudia Martinez

Claudia Martinez, MD
University of Miami

CFAR Mentor:
Neil Schneiderman, Ph.D
   (Miami CFAR)

Collaborating Partner:
Joseph Piperato, MD
   (Borinquen Health System)

Is the Hispanic-HIV Community at Disproportionately Elevated Cardiovascular Risk?

Hispanics in the US are disproportionately affected by the HIV epidemic. HIV infection is now recognized as an important risk for cardiovascular disease (CVD). This is particularly concerning given the increased CVD burden already present in the Hispanic community. HIV-infected Hispanic individuals have higher rates of overall morbidity and earlier mortality compared to non-Hispanic whites living with HIV. Nevertheless, it is not known how the established increased HIV-related CVD risk impacts Hispanics. A large gap exists in our understanding of how HIV alters vascular function, and whether this alteration plays a role in further elevating CVD risk in Hispanics. Therefore, in this proposal we will identify whether Hispanic patients with HIV have a greater CVD risk indexed by early measures of CVD compared to non-Hispanic whites with HIV.

These measures will be obtained with two non-invasive tools (measures of vascular endothelial function and epicardial adipose tissue by ultrasound) that can be used in the clinical setting to detect CVD risk early on. Our hypothesis is that Hispanic men and women with HIV will demonstrate greater vascular endothelial dysfunction and increased epicardial adipose tissue when compared to non-Hispanic white adults with HIV, independent of standard demographics, cardiometabolic risk factors and HIV-related parameters.

We will test our hypothesis in Aim 1: To determine whether Hispanic men and women with HIV have more diminished vascular endothelial function indexed by flow mediated dilation, when compared to non-Hispanic whites with HIV and Aim 2: To determine whether Hispanic men and women with HIV have greater epicardial adipose tissue when compared to non-Hispanic whites with HIV.

The proposed study will enroll a total of 120 men and women, 30-50 years of age with HIV, with no previous CVD or diagnosis of diabetes to detect differences in early CVD pathophysiological indicators. Because CVD remains the leading cause of mortality among Hispanics in the US, the additional impact of the HIV epidemic is likely to escalate the prevalence of adverse CVD outcomes in this population.

This information will provide the basis for a larger investigation to identify the molecular and pathophysiological mechanisms that lead to CVD disparities among Hispanic population with HIV infection. In addition, identifying early subclinical pathophysiological changes unique to Hispanic adults will inform potential avenues of intervention to address their elevated risk burden. The State of Florida has both a high incidence of HIV infection and one of the largest Hispanic populations in the US.

CFAR Adelante program support would allow our group at the University of Miami to work with the Hispanic community to further understand the causes and mechanisms driving the increased CVD risk in this population and inform potential strategies to improve the cardiovascular health of Hispanics living with HIV.