August 18, 2022Open Access

Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: a cross-sectional study

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Why the study?

Hypertension is largely underdiagnosed in Africa and higher rates are reported in HIV-infected persons on ART, but data on its prevalence and associated factors in Burundi were needed.

Structured PICO

Population

1,250 HIV-infected adults (age ≥20 years) currently under antiretroviral therapy (ART) for ≥1 year, managed in 5 healthcare centers in Burundi. Mean age 42.8±7.4 years, 18.4% male.

Outcome

Prevalence of hypertension (defined as self-reported ongoing antihypertensive treatment, or SBP ≥140 mmHg and/or DBP ≥90 mmHg)

Nearly 20% of ART-treated HIV patients in Burundi have hypertension, half of whom are undiagnosed, highlighting the critical need to integrate routine blood pressure monitoring into HIV care.

Limitations

Cross-sectional design cannot determine chronologically the relationships between hypertension and associated factors
Lack of data in general Burundian population to compare hypertension prevalence
Definition of hypertension was limited to 'one shot' clinic measures as ambulatory or home blood pressure measurements are unavailable

Implication

May support opportunistic BP screening in similar ART clinics; leaves open causality of HIV duration versus traditional risks and broader generalizability.

Abstract

Background: Nowadays, the life expectancy of people living with the human immunodeficiency virus (HIV) and people in general population, are comparable. Hypertension is a major public health issue in Africa, largely underdiagnosed. In addition, higher rates of hypertension are reported in HIV-infected persons, especially when under anti-retroviral therapy (ART). The aim of our study was to determine the prevalence of hypertension and associated factors among HIV-infected adults in Burundi, treated by ART. Methods : A cross-sectional study was conducted among HIV-infected subjects older than age of 20, managed in 5 healthcare centers of people living with HIV (PLWH). The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured according to the ESC 2018 recommendations. Results: 1250 HIV-infected patients were included (18.4% men), mean age 42.8±7.4 years. The prevalence of hypertension was 17.4% (95% CI: 13.2-22.1). Almost 47.25 % of HIV patients with hypertension were previously undiagnosed. In multivariate analysis, factors associated with HTN were overweight (OR: 2.88; 95% CI: 1.46-5.62) and obesity (OR: 2.65; 95% CI: 1.27-5.55), longer duration of HIV infection: ≥ 10 years (OR: 1.04; 95% CI: 1.14-3.20), diabetes (OR: 2.1; 95% CI: 1.37-3. 32) and age (OR: 1.13; 95% CI: 1.09-1.14). Conclusions Despite their young age, almost 20% of patients with ART-treated HIV had hypertension, among whom 50% were undiagnosed. Blood pressure monitoring is of major importance among these patients, especially among those identified at high-risk, with prompt life- and disability-saving interventions.

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Cite This Study

Harimenshi et al. (2022) studied this question.

synapsesocial.com/papers/6a7f98c4dbe1982d147850c0 https://doi.org/10.21203/rs.3.rs-1945763/v1

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Implication

May support opportunistic BP screening in similar ART clinics; leaves open causality of HIV duration versus traditional risks and broader generalizability.