Increased prevalence of hypertension among people living with HIV: where to begin?

Abstract

Introduction: Cardiovascular diseases (CDVs) have become increasingly important for progressively older people living with HIV (PLHIV). Identification of gaps requiring improvement in the care cascade for hypertension, a primary risk factor for CVDs, is of utmost importance. This study analyzed the prevalence of hypertensive status and described the care cascade for hypertension screening, diagnosis, treatment, treatment adherence, and management in PLHIV. Methods: This cross-sectional study included 298 PLHIV (age >40 years) who visited a referral center in the western Brazilian Amazon. Data were collected through a structured questionnaire interview and medical examinations. Thus, information regarding sociodemographic and clinical aspects, blood pressure, weight, height, body mass index, and laboratory profile was obtained. Descriptive and analytical statistics were performed, and results were considered significant if p <0.05. Results: In total, 132 (44.3%) participants reported that their blood pressure was never measured. The prevalence of hypertension was found to be 35.9% (107/298). Of these 107 participants, only 36 (33.6%) had prior knowledge of their hypertensive status, and 19 of 36 (52.7%) participants had visited a physician or cardiologist to seek treatment. Adherence to the BP-lowering treatment was noted in 11 (10.2%) participants. Conclusions: An increased prevalence of hypertension was found, and most of the hypertensive participants were unaware of their hypertensive status. In addition, blood pressure control was poor in the study population. This indicated that public health professionals did not sufficiently consider the full spectrum of healthcare and disease management for PLHIV.

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

“…The main finding and key message of our study is the very high prevalence of HTN in PLWH despite their young age (almost 20%), of whom almost half are unaware of their condition. The prevalence of 17.5% in our population is comparable to those reported in Nigeria 29 , Zimbabwe 30 , South Africa 31 Zambia 32 and Tanzania 33 , but lower than those reported in Uganda 34 , Cameroon 35 , Brazil 36 , China 17 , 18 Ugandan rural study 37 and Argentina 38 . Similarly, our findings are higher than those reported in Ethiopia 16 , 39 , 40 and Kenya 41 .…”

“…In our study, almost 47.25% of HIV patients with hypertension were undiagnosed. In Tanzania and Brazil, HIV infected patients were not aware of their hypertension status, respectively 67.1% and 44.3% 36,51 .…”

Hypertension Among Cohort of Persons With Human Immunodeficiency Virus Initiated on a Dolutegravir-Based Antiretroviral Regimen in Ghana

“…Traditional risk factors such as age, obesity, family history, diabetes, smoking, dyslipidemia, and a sedentary lifestyle contribute to the development of HTN [ 15 , 16 ]. In addition for PWH, the HIV infection itself contributes to the pathogenesis of HTN and CVD through viral replication, decreased CD4 + T-cell count, chronic systemic inflammation and endothelial dysfunction, and lipodystrophy [ 17 , 18 ]. Exposure to ART has also been significantly associated with increased risk of HTN among PWH [ 19–21 ].…”

Alterações metabólicas em pessoas que vivem com HIV: estudo de coorte retrospectivo

“…A Hipertensão Arterial (HA) é uma condição clínica multifatorial (fatores genéticos, epigenéticos, ambientais e sociais), que frequentemente se associa a distúrbios metabólicos, alterações funcionais e/ou estruturais de órgãos-alvo (BARROSO et al, 2021;NCD-RISC, 2021). A HA é comum entre PVHIV com prevalência que variam conforme região do Brasil há estudos que apontam 35,9% no norte, 17,3% nordeste e sudeste com 16,4% (COSTA et al, 2020(COSTA et al, , 2021aCUNHA et al, 2018).…”

“…Uma investigação transversal, realizada com 298 PVHIV na região norte do Brasil, além de apontar uma prevalecia de HA em 35,9% dos participantes, também revelou que 44,3% relataram que sua PA nunca foi medida anteriormente, e apenas 33,6% das PVHIV tinham conhecimento prévio de sua condição hipertensiva, além da dificuldade em aderir o tratamento com antihipertensivos (COSTA et al, 2020). As regiões norte e nordeste possuem características semelhantes, e esses resultados podem corresponder à realidade encontrada nos serviços da região investigada.…”