Hypertension among people living with HIV/AIDS in Cameroon: A cross-sectional analysis from Central Africa International Epidemiology Databases to Evaluate AIDS

Abstract

Background Antiretroviral therapy (ART) success has led people to live longer with HIV/AIDS (PLWH) and thus be exposed to increasing risk of cardiovascular diseases (CVD). Hypertension (HTN), the biggest contributor to CVD burden, is a growing concern among PLWH. The current report describes the prevalence and predictors of HTN among PLWH in care in Cameroon. Methods This cross-sectional study included all PLWH aged 20 years and above who received care between 2016 and 2019 at one of the three Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA) sites in Cameroon (Bamenda, Limbe, and Yaoundé). HTN was defined as blood pressure (BP) ≥140/90 mm Hg or self-reported use of antihypertensive medication. Logistic regressions models examined the relationship between HTN and clinical characteristics, and HIV-related factors. Results Among 9,839 eligible PLWH, 66.2% were women and 25.0% had prevalent HTN [age-standardized prevalence 23.9% (95% CI: 22.2–25.6)], among whom 28 (1.1%) were on BP lowering treatment, and 6 of those (21.4%) were at target BP levels. Median age (47.4 vs. 40.5 years), self-reported duration of HIV infection (5.1 vs 2.8 years years), duration of ART exposure (4.7 vs 2.3 years), and CD4 count (408 vs 359 cell/mm3) were higher in hypertensives than non-hypertensives (all p<0.001). Age and body mass index (BMI) were independently associated with higher prevalent HTN risk. PLWH starting ART had a 30% lower risk of prevalent HTN, but this advantage disappeared after a cumulative 2-year exposure to ART. There was no significant association between other HIV predictive characteristics and HTN. Conclusion About a quarter of these Cameroonian PLWH had HTN, driven among others by age and adiposity. Appropriate integration of HIV and NCDs services is needed to improve early detection, treatment and control of common comorbid NCD risk factors like hypertension and safeguard cardiovascular health in PLWH.

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 .…”

Prevalence, Awareness, Treatment, Control of Hypertension, and Availability of Hypertension Services for Patients Living With Human Immunodeficiency Virus (HIV) in Sub-Saharan Africa (SSA): A Systematic Review and Meta-analysis

“…Duration on ART at 2 years was associated with hypertension (OR 1.15 CI: 1.07, 1.24), while ART use of more than 5 years was associated with a higher increased risk of hypertension (OR 2.57, CI: 1.24, 5.21) [10].…”

“…The diamond is the pooled effect estimate at 95% confidence interval (CI). [10,15,29,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] There was no significant difference in the random effects model pooled prevalence between studies conducted in urban settings 18.7%, (95% CI, 15.4%, 21.8%) compared to those conducted in rural settings 20.8% (95% CI, 16.3%, 25.3%) (p=0.44) (Figures 2-3).…”

“…PLHIV, persons living with HIV [9-10, 15, 29, 37-44, 46-48, 50-53] There was no significant difference in the random effects model pooled prevalence between females 23.6% (95% CI, 18.1%, 29.2%) and males 23.8% (95% CI, 19.6%, 28.0%) (p=0.96) (Figure 4). Persons living with human immunodeficiency virus (PLHIV) [10,29,36,38,[40][41][42][43][44][50][51][52][53] The awareness of hypertension among hypertensive PLHIV in SSA ranged from 1.3% in the Nigerian study to 52.9% in the study from Uganda [40,53]. The median awareness was 26.5%, and the random effects model pooled awareness was 28.4% (95% CI, 15.5%, 41.3%) (Figure 5).…”

“…FIGURE 6: Treatment of hypertension among PLHIV across 15 studies in Sub-Saharan Africa.Persons living with human immunodeficiency virus (PLHIV)[10,15,29,35,37,39,41,[43][44][46][47] …”