Abstract
Growing body of epidemiologic evidence suggests that there are a number of modifiable risk factors that lead to increased incidence of hypertension in low income countries. Besides non modifiable factors like age, highly active antiretroviral treatments are believed to be increase the risk of hypertension in Human Immuno Virus patients. But studies disagree as to whether there are a greater incidence of hypertension among HIV/AIDS patients and the role of antiretroviral therapy. The Study was conducted in public health institution of Gamo-Gofa zone by using Retrospective cohort study design. Simple random sampling techniques with stratified sampling with proportional to size allocation were used to select HIV patients. The data were collected by registered Anti Retroviral Treatment Provider nurses, by using structured questionnaire which was adapted from the World Health Organization STEPS instrument. The data were cleaned to check for its completeness, consistency and the presence of missed values and variables, and then it was entered into a pre-designed format in Epi-Info version 7 and transferred to SPSS version 21 and Stata for further analysis. Frequencies, mean, median, quartile and standard deviation were used to describe the data. After necessary assumption of logistic regression model was checked, bivariable and multiple logistic regression models were fitted to see the predictors of hypertension. A total of 834 HIV/AIDS infected (95.4% response rate) were included in this study. The mean systolic and diastolic BP were 115.7 mmHg (±16.1 SD) and 74.9 mmHg (±12.4 SD). The cumulative incidence of hypertension was 20% (95% CI: 19.9 - 20.03), in equal proportion in Pre-HAART (20.1%) and HAART (20.0%) receiving patients. The study revealed modifiable; monthly income (AOR; 2.26, 95% CI (1.26, 4.05)), Occupational status (AOR, 0.36, 95% CI; (0.17, 0.78)), Body mass index (AOR: 12.6, (95% CI: 5.32, 29.8)) and non-modifiable family history of hypertension (AOR: 2.18, 95% CI: 1.32, 3.58) as important predictors of hypertension among HIV infected patients. There was high incidence of hypertension among HIV infected patients which may reflect insights for intervention. The investigators accept the null hypothesis that there is association between HAART intervention and incidence of Hypertension.
Highlights
Despite little due attention; hypertension is an important public health problem accounting for 1 billion people illness, 6% of worldwide death and 7.1 million deaths peranum [1] [2]
Growing body of epidemiologic evidence suggests that there are a number of modifiable risk factors that lead to increased incidence of hypertension in low income countries
Studies disagree as to whether there are a greater incidence of hypertension among HIV/AIDS patients and the role of antiretroviral therapy
Summary
Despite little due attention; hypertension is an important public health problem accounting for 1 billion people illness, 6% of worldwide death and 7.1 million deaths peranum [1] [2]. It is responsible for 62% of cerebro-vascular disease and 49% ischemic heart disease [3]. Potent antiretroviral therapy (HAART) has resulted in lasting suppression of HIV replication, reduction of opportunistic infections and malignancies associated with AIDS, and have had a substantial impact on the survival rate and quality of life of infected individuals [6]. The potential to keep these patients under treatment for decades may be limited by a variety of metabolic and cardio-vascular abnormalities observed in patients on HAART, including dyslipidaemia, fat redistribution, insulin resistance, hypertension [4] [7], and coronary ischemia [8]
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