Prevalence and correlates of hypertension in HIV-positive adults from the Livingstone Central Hospital, Zambia

Musekwa, Robert; Hamooya, Benson M.; Koethe, John R.; Nzala, Selestine; Masenga, Sepiso K.

doi:10.11604/pamj.2021.39.237.29718

Cited by 14 publications

(13 citation statements)

References 21 publications

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“…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 .…”

Section: Discussionsupporting

confidence: 67%

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

Harimenshi

Niyongabo

Preux

et al. 2022

Sci Rep

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Currently, the life expectancy of people living with the human immunodeficiency virus (HIV) and the general population are similar. Hypertension is a major public health issue in Africa and is largely underdiagnosed. Most HIV-infected individuals, especially those on Anti-Retroviral Therapy (ART) have hypertension. Our project aims to determine the prevalence of hypertension and associated factors amongst HIV-infected adults treated by ART in Burundi. A cross-sectional study was conducted among HIV-infected subjects over the age of 20, managed in five healthcare centers for people living with HIV (PLWH). The World Health Organization STEPWISE survey and anthropometric measurements were employed. Blood pressure was measured according to the ESC 2018 recommendations. 1 250 HIV-infected patients aged between 35.4 and 50.2 years were included (18.4% men). The prevalence of hypertension was 17.4% (95% CI 13.2–22.1). Approximately 47.25% of HIV patients with hypertension were previously undiagnosed. Other factors were associated with HTN, such as being overweight (OR 2.88; 95% CI 1.46–5.62), obesity (OR 2.65; 95% CI 1.27–5.55), longer duration of HIV infection: ≥ 10 years (OR 1.04; 95% CI 1.14–3.20), diabetes (OR 2.1; 95% CI 1.37–3.32) and age (OR 1.13; 95% CI 1.09–1.14). Despite their young age, almost 20% of HIV-ART treated patients had hypertension, 50% of these were undiagnosed. Blood pressure monitoring is crucial in these patients, especially those identified as high-risk, with prompt life and disability-saving interventions.

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Section: Discussionsupporting

confidence: 67%

“…The duration of ART and types of ART were reported, in particular protease inhibitors 32 , 38 . No association was found in our study.…”

Section: Discussionmentioning

confidence: 99%

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

Harimenshi

Niyongabo

Preux

et al. 2022

Sci Rep

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“…Some reports link ART use with increased prevalence of hypertension among PLHIV in Africa (7,34,35). Although we could not assess this relationship in this study that was confined to PLHIV on ART, longer ART duration was not associated with hypertension, which is in contrast to findings from several other studies from countries in Africa (17,36).…”

Section: Discussionmentioning

confidence: 99%

“…In Zambia, a country in southern Africa, cerebrovascular accidents (CVAs) and ischemic heart disease are among most common causes of death (2,3). With widespread availability of antiretroviral therapy (ART), non-communicable diseases are increasingly a major cause of morbidity among persons living with HIV (PLHIV) (4,5), including in Zambia (6,7). Hypertension is a known major risk factor for CVA and other cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

“…In the 2018 Zambia Demographic and Health Survey, self-reported hypertension prevalence among women was 8.8% (this information was not ascertained from male participants) (21). Studies that objectively measure blood pressure have been limited geographically and/or conducted in special populations (7,(22)(23)(24)(25)(26). For instance, in one study among PLHIV in Lusaka, hypertension prevalence was 6.4%, of which only one-half of persons were aware of their hypertension diagnosis (23).…”

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confidence: 99%

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Hypertension among persons living with HIV — Zambia, 2021; A cross-sectional study of a national electronic health record system

Hines¹,

Prieto

Itoh³

et al. 2023

Preprint

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Background Hypertension is a major risk factor for cardiovascular disease, which is a common cause of death in Zambia. Data on hypertension prevalence in Zambia are scarce and limited to specific geographic areas and/or populations. We measured hypertension prevalence among persons living with HIV (PLHIV) in Zambia using a national electronic health record (EHR) system. Methods We did a cross-sectional study of hypertension prevalence among PLHIV aged >=18 years in Zambia during 2021. Data were extracted from the SmartCare EHR, which covers ~90% of PLHIV on treatment in Zambia. PLHIV with >=2 recorded blood pressure (BP) readings in 2021 were included. Hypertension was defined as >=2 elevated BP readings (i.e., systolic BP of >=140 mmHg or diastolic BP of >=90 mmHg) during 2021 and/or on anti-hypertensive medication recorded in their EHR in the past five years. Multivariable logistic regression was used to assess associations between hypertension and independent variables. Results Among 750,098 PLHIV aged >=8 years with >=2 visits in SmartCare during 2021, 101,363 (13.5%) had >=2 blood pressure readings recorded in their EHR. Among these PLHIV, 14.7% (95% confidence interval [CI]: 14.5-14.9) had hypertension during 2021. Only 8.9% of PLHIV with hypertension had an anti-hypertensive medication recorded in their EHR. The odds of hypertension were greater in older age groups compared to PLHIV aged 18-29 years (adjusted odds ratio [aOR] for 30-44 years: 2.6 [95% CI: 2.4-2.9]; aOR for 45-49 years: 6.4 [95% CI: 5.8-7.0]; aOR for >=60 years: 14.5 [95% CI: 13.1-16.1]), urban areas (aOR: 1.9 [95% CI: 1.8-2.1]), and persons prescribed ART for >=6-month at a time (aOR: 1.1 [95% CI: 1.0-1.2]). Discussion Hypertension was common among a cohort of PLHIV in Zambia, with few having documentation of being on antihypertensive treatment. Most PLHIV were excluded from the analysis because of missing BP measurements in their EHR. Strengthening integrated management of non-communicable diseases in ART clinics might help to diagnose and treat hypertension in Zambia. Data completeness needs to be improved to routinely capture cardiovascular disease risk factors, including blood pressure readings consistently for PHLIV in their EHRs.

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Body weight and blood pressure changes on dolutegravir‐, efavirenz‐ or atazanavir‐based antiretroviral therapy in Zimbabwe: a longitudinal study

Shamu,

Egger,

Mudzviti

et al. 2024

J Int AIDS Soc.

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IntroductionDolutegravir (DTG) is widely used for antiretroviral therapy (ART). We compared weight and blood pressure trends and examined the association between high blood pressure and weight gain among people living with HIV (PLHIV) switching to or starting DTG‐based, efavirenz (EFV)‐based and ritonavir‐boosted atazanavir (ATV/r)‐based ART in Zimbabwe.MethodsPLHIV aged 18 years or older who started or switched to DTG, EFV or ATV/r‐based ART between January 2004 and June 2022 at Newlands Clinic in Harare, Zimbabwe, were eligible. Weight was measured at all visits (Seca floor scales); blood pressure only at clinician‐led visits (Omron M2 sphygmomanometer). We used Bayesian additive models to estimate trends in weight gain and the proportion with high blood pressure (systolic >140 mmHg or diastolic >90 mmHg) in the first 2 years after starting or switching the regimen. Finally, we examined whether trends in the proportion with high blood pressure were related to weight change.ResultsWe analysed 99,969 weight and 35,449 blood pressure records from 9487 adults (DTG: 4593; EFV: 3599; ATV/r: 1295). At 24 months after starting or switching to DTG, estimated median weight gains were 4.54 kg (90% credibility interval 3.88−5.28 kg) in women and 3.71 kg (3.07−4.45 kg) in men, around twice that observed for ATV/r and over four‐times the gain observed for EFV. Prevalence of high blood pressure among PLHIV receiving DTG‐based ART increased from around 5% at baseline to over 20% at 24 months, with no change in PLHIV receiving EFV‐ or ATV/r‐based ART. High blood pressure in PLHIV switching to DTG was associated with weight gain, with stronger increases in the proportion with high blood pressure for larger weight gains.ConclusionsAmong PLHIV starting ART or switching to a new regimen, DTG‐based ART was associated with larger weight gains and a substantial increase in the prevalence of high blood pressure. Routine weight and blood pressure measurement and interventions to lower blood pressure could benefit PLHIV on DTG‐based ART. Further studies are needed to elucidate the mechanisms and reversibility of these changes after discontinuation of DTG.

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Prevalence and correlates of hypertension in HIV-positive adults from the Livingstone Central Hospital, Zambia

Cited by 14 publications

References 21 publications

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

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

Hypertension among persons living with HIV — Zambia, 2021; A cross-sectional study of a national electronic health record system

Body weight and blood pressure changes on dolutegravir‐, efavirenz‐ or atazanavir‐based antiretroviral therapy in Zimbabwe: a longitudinal study

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