Abstract
Background: Anti-retroviral therapy (ART) has reduced morbidity and mortality among HIV-infected individuals over the last years. The increase in survival of HIV patients has contributed to the emergence of other chronic conditions in these individuals, such as hypertension, renal, and cardiovascular disease. Hypertension and HIV infection are both mostly asymptomatic but can lead to fatal and disabling illness. Hypertension among HIV-infected individuals, although not completely elucidated, may be explained by the aging of population, the effect of HIV on vascular tone anti-retroviral therapy and traditional risk factors such as weight gain, smoking, dyslipidemia, and drug abuse. The factors associated with hypertension among ART patients in a predominantly rural setting were studied in this paper. Methods: We conducted an analytical cross sectional study at 13 health facilities in Makonde District a rural district in Mashonaland West Province of Zimbabwe where we systematically selected 393 of 400 ART patients aged 15 years and above. Structured interviewer administered questionnaires were used to collect data on demographic characteristics. Written and informed consent was sought and obtained from all study participants. We obtained parental consent followed by assent from participants younger than 16 years. All enrolled patients had physical measurements done. Chi square test and stratified & logistic regression analysis were done using Epi info version 3.5.1. All calculations were done at 95% confidence interval. Results: Results from 393 participants were analysed. The prevalence and awareness of hypertension were 34.9% and 30% respectively. Only 9.6% were taking medication. Independent risk factors were duration of ART > 2 years (POR 2.23; 95%CI: 1.08; 4.61), waist to hip ratio (women) > 0.85 (POR 3.45; 95%CI: 1.60; 5.88), B.M.I > 25 (POR 2.18; 95%CI: 1.40; 3.8). Protective factors were: Symptomatic HIV disease (POR 0.36; 95%CI: 0.14; 0.97) and being informally employed (POR 0.67; 95%CI: 0.43; 0.96). General risk factors were smoking (POR 5.06; 95%CI: 2.20; 11.60), sedentary recreation (POR 3.16; 95%CI: 1.69; 5.85) and high salt intake (POR 2.67; 95%CI: 1.56; 4.59). Conclusions: Hypertension is common among ART clients although it is not routinely screened for in ART care settings in Makonde. Common modifiable risk factors are contributing to the burden of hypertension in Makonde District. Health service providers should routinely screen for hypertension and promote healthy lifestyles among ART clients in Makonde.
Highlights
Anti-retroviral therapy (ART) has reduced morbidity and mortality among Human Immunodeficiency Virus (HIV)-infected individuals over the last years
The increase in survival of HIV patients has contributed to the emergence of other chronic conditions in these individuals, such as hypertension, renal, and cardiovascular disease
The crude prevalence of hypertension in this study was 34.9% (30.2; 39.8). This is comparable to findings from an American study by Gazzaruso et al which looked at hypertension among ART clients
Summary
Anti-retroviral therapy (ART) has reduced morbidity and mortality among HIV-infected individuals over the last years. The increase in survival of HIV patients has contributed to the emergence of other chronic conditions in these individuals, such as hypertension, renal, and cardiovascular disease. Hypertension, a disease characterized by sustained elevation of arterial blood pressure, occurs in all geographical areas of the world [1]. It is more common in developed countries than in economically developing countries with a prevalence of 37.3% and 22.9% respectively [2]. Little is known about hypertension in the HIV-infected population [2] [6]
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