Cardiovascular disease Multimorbidity is Associated with Decreased Health-Related Quality of Life in Haiti: Findings from a Population-based Cohort

Background Multimorbidity is increasingly prevalent in lower-and middle-income countries (LMICs). Health-related quality of life (HRQOL) has been inversely associated with multimorbidity but is understudied in LMICs. We report cardiovascular disease (CVD) multimorbidity in Haiti and its association with HRQOL. Methods We used data from the Haiti CVD Cohort, a population-based longitudinal cohort of adults. CVD multimorbidity was 2+ CVD risk factors/diseases at enrollment. HRQOL was measured using the Short Form-12, yielding physical (PCS)/mental (MCS) component summary scores between 0-100, with higher scores indicating better HRQOL. We used linear regressions to assess the association between CVD multimorbidity and HRQOL and between individual CVD comorbidities and HRQOL. Additionally, we examined how gender and education modified the main effect. Results Among 2,996 participants, the median age was 40 (IQR: 27-55), 58.0% were female, and 70.3% earned <1 USD/day. CVD multimorbidity prevalence was 24.1%; compared to those without CVD multimorbidity, those with CVD multimorbidity were older (median 56.0 [IQR: 47.0, 53.0]) and female (70.5%). Adjusted models revealed CVD multimorbidity was inversely related to PCS (-2.7 [95% CI: -3.8, -1.6]) and MCS (-1.0 [95% CI: -1.8, -0.2]). Heart failure and hypertension showed the strongest CVD morbidities associated with poor HRQOL. In the interaction analysis, among men, CVD multimorbidity was associated with a 4.3-point lower PCS score, and among those with less education, CVD multimorbidity was associated with a 4.6-point lower PCS score than no CVD multimorbidity. Conclusions Our data are among the first to describe HRQOL data with high CVD multimorbidity in a young population in urban Haiti, and CVD multimorbidity was associated with decreased HRQOL. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial ClinicalTrials.gov #[NCT03892265][1] ### Funding Statement This work is funded by The National Heart, Lung, and Blood Institute R01 grant. No contributing authors have received any external funding for any aspect of the submitted work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Weill Cornell Medicine and GHESKIO Institutional Review Boards I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Data request should be submitted to the study PI, Dr. Margaret McNairy (mam9365@med.cornell.edu) who will review the data request with Haiti GHESKIO Site PI, Dr. Jean Pape and the study?s Observational Monitoring Board for approval. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03892265&atom=%2Fmedrxiv%2Fearly%2F2024%2F05%2F10%2F2024.05.08.24307093.atom