Characterization of Cardiovascular Risk Factors in Tuberculosis Survivors in a Ugandan Cohort

Abstract RATIONALE: An estimated 155 million tuberculosis (TB) survivors exist worldwide. People treated for TB have significantly increased morbidly and mortality compared to the general population. The pooled standardized mortality ratio (SMR) for people with confirmed completion of treatment or cure from TB is 3.76 times higher than that of the general population with cardiovascular disease being the leading cause of death.METHODS: Adults with new microbiological TB diagnosis were enrolled in a prospective study investigating TB outcomes from a consortium of 5 rural and urban TB clinics in Uganda. At enrollment patient's completed demographic questionnaires and anthropometric measurements. After treatment completion patients returned for an after treatment visit to complete questionnaires. Cardiovascular risk factors assessed at diagnosis included self-reported tobacco use and diabetes, overweight (defined as BMI > 25 mg/kg2) as well as hypertension measured during after treatment visits. Descriptive statistics were utilized to present epidemiological data on cardiovascular risk factors in this Ugandan cohort.RESULTS: 111 subjects with baseline enrollment and after treatment visits completed were included. 71% (n=91/111) subjects were male and 29% (n=32/11) were female. 3% (n=3/111) subjects self-reported DM. 23% (n=25/111) subjects reported tobacco use. 6% (n=7/111) subjects were categorized as overweight. At after treatment visits 17% (n=19/111) people had hypertensive blood pressures. Presence of multiple risk factors among subjects was also assessed. 32% (n=26/111) had at least one risk factor, 5% (n=6/111) had two risk factors and 2% (n=2/111) had three risk factors. DISCUSSION:TB survivors face increased mortality compared to the general population. In this cohort, tobacco use, obesity, and hypertension were prevalent, with nearly one-third of participants having at least one cardiovascular risk factor. The prevalence of diabetes and tobacco use in this group was slightly higher than national estimates, while hypertension rates matched the national average, and rates of overweight or obesity were lower—an expected finding given the association between TB and weight loss. Improved characterization of cardiovascular risk in TB survivors and the early integration of CVD prevention strategies could improve long-term cardiovascular outcomes for these individuals. Further investigation into the link between prior TB infection and cardiovascular risk in this cohort is ongoing.