Prevalence, Incidence of Hypertension High Among HIV Population in Some Regions

HIV-positive patients living in sub-Saharan Africa have a higher prevalence and incidence of hypertension compared with the United States or Europe.

In a study published in PLOS One, investigators sought to examine the prevalence, incidence, and risk factors for incident hypertension among patients enrolled in a rural HIV cohort in Tanzania, Africa.

The incidence of hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg on 2 consecutive visits. Cox proportional hazard models were used to assess the association of baseline characteristics and incident hypertension.

Among 955 antiretroviral therapy (ART)-naive patients, 111 were hypertensive at recruitment, and 10 women were excluded due to pregnancy. After starting ART, 80 HIV-positive patients developed hypertension.

The results of the study found that the incidence of hypertension after ART initiation was more than 1.5 times higher than incidence observed in a large multinational study of Europe, Australia, and the United States.

The development of hypertension was not linked to the level of immunosuppression or any particular ART regimen, according to the study. But rather, predicted by traditional cardiovascular risk factors such as age, body mass index, and renal function.

The authors hypothesize that the effect of ART on body mass and the restoration of immunity could be potential drivers of hypertension during treatment.

“We have seen that such routine screening is a feasible and effective strategy to diagnose hypertension within an HIV program,” said investigator Dr Emilio Letang. “Moving forward, however, we need to make sure that leveraging such synergies does not compromise the efficiency of existing HIV programs.”

The findings suggest the implementation of routine hypertension screening in HIV clinics in rural sub-Saharan Africa, the authors concluded.

“In many countries across sub-Saharan Africa, there is still a lack of access to drugs against major non-communicable diseases,” said Dr Christoph Hatz, chief medical officer at Swiss Tropical and Public Health Institute. “In order for such integrated care programs to work successfully, ensuring better availability and affordability of drugs as well as implementing comprehensive, preventive, and curative measures will be key.”