Key result
HIV infection was an independent predictor of uncontrolled blood pressure, increasing the hazard by over 3-fold (AHR 3.06) compared to HIV-negative hypertensive patients.
Why the study?
Hypertension has emerged as a threat to people living with HIV, but data on care delivery and blood pressure control over time in Ethiopia were lacking.
Does HIV infection increase the risk of uncontrolled blood pressure in hypertensive patients?
Cohort (n=303)
No
Does HIV infection increase the risk of uncontrolled blood pressure in hypertensive patients?
Hazard Ratio: 3.06 (95% CI 1.93–11.34)
Absolute Event Rate: 60.2% vs 53%
p-value: p=0.042
HIV infection is associated with a significantly higher rate of uncontrolled blood pressure among hypertensive patients, highlighting the need for integrated hypertension care in HIV clinics.
May prompt closer BP monitoring in HIV-positive hypertensives; hypothesis-generating for targeted intervention trials.
BACKGROUND: Hypertension has emerged as a new threat to the health and well-being of people living with human immune deficiency virus (PLHIV). However, no data exist on care delivery and blood pressure control over time in Ethiopia. We assessed clinical care & level of blood pressure control among hypertensive people living with Human Immune Deficiency Virus (HIV). METHODS: We conducted a prospective cohort study among adult hypertensive PLHIV and HIV-negative patientsat chronic care clinics of Jimma University Medical Center in Ethiopia. We explored self-management practices and blood pressure control of study participants. Multivariable Cox-regression was used to identify the predictors of the outcome. RESULTS: A total of 303 eligible participants with mean age of 43.30 ± 12.55years were followed and males comprised of 52.1%. After 12 months of follow-up, 60.2% of HIV-positive and 53% of HIV-negative patients showed uncontrolled blood pressure. The overall perception of self-management behaviors was 2.10 ± 0.77 (p = 0.122), which was at moderate level. An increased waist circumference [AHR: 2.16; 95% CI: (1.58-5.18);p = 0.021],chronic disease co-morbidity[AHR:3.94;95%CI:(2.24-8.74);p = 0.046],alcohol use history[AHR:1.26; 95%CI:(1.08-2.23);p = 0.031], HIV infection[AHR:3.06;95%CI:(1.93-11.34);p=0.042], infrequent use of fruits & vegetables [AHR:3.77;95%CI: (1.34-10.57);p=0.012], infrequent engagement on physical exercise[AHR:3.48;95%CI:(1.48-8.17);p = 0.004],frequent use of high fats food [AHR:2.56;95%CI: (1.25-5.25);p = 0.011] were an independent predictors of uncontrolled blood pressure. CONCLUSION: The rate of uncontrolled blood pressure is significantly higher in the HIV- infected population. There was a gap in the clinical care of hypertension in terms of hypertension self-management among hypertensive HIV-positive patients. Our study highlights the need for better integration of hypertension care to HIV clinical setting.
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Melaku et al. (2020) conducted a cohort in Hypertension and HIV (n=303). HIV infection vs. HIV-negative was evaluated on Uncontrolled blood pressure (AHR 3.06, 95% CI 1.93-11.34, p=0.042). HIV infection was an independent predictor of uncontrolled blood pressure, increasing the hazard by over 3-fold (AHR 3.06) compared to HIV-negative hypertensive patients.
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