Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline.

Abstract

Data on the burden of hypertension among people living with HIV (PLWH) in Africa are limited, especially after new expert consensus hypertension guidelines were published in 2017. The authors sought to assess the prevalence and factors associated with hypertension among PLWH. This is a cross-sectional study involving PLWH on combination antiretroviral therapy (cART) (n=250) compared with sex-matched cART-naïve PLWH (n=201) in Ghana. Hypertension was defined as blood pressure≥140/90mmHg or use of antihypertensive drugs. The authors also assessed the prevalence and predictors associated with hypertension using the recent guideline recommended cutoff BP≥130/80mmHg. Multivariate logistic regression models were fitted to identify factors associated with hypertension among PLWH. The mean age of PLWH on cART was 45.7±8.6years, and 42.9±8.8years among PLWH cART-naive with 81% of study participants being women. The prevalence of hypertension among PLWH on cART and PLWH cART-naïve was 36.9% and 23.4%, P=0.002 at BP≥140/90mmHg and 57.2% and 42.3%, respectively, P=0.0009, at BP≥130/80mmHg. Factors associated with hypertension at BP≥140/90mmHg in the PLWH group with adjusted odds ratio (95% CI) were increasing age, 2.08 (1.60-2.71) per 10years, and body mass index, 1.53 (1.24-1.88) per 5kg/m2 rise. At BP≥130/80mmHg, cART exposure, aOR of 1.77 (95% CI: 1.20-2.63), family history of hypertension, aOR of 1.43 (1.12-1.83), and hypertriglyceridemia, aOR of 0.54 (0.31-0.93), were associated with hypertension. Among PLWH, cART exposure was associated with higher prevalence of hypertension per the new guideline definition, a finding which warrants further investigation and possible mitigation.