Journal Article

Population-Based Assessment of Hypertension Epidemiology and Risk Factors among HIV-Positive and General Populations in Rural Uganda

Balzer, Laura, Jain, Vivek, Havlir, Diane, Kamya, Moses R., Kwarisiima, Dalsone, Mwangwa, Florence, Petersen, Maya, Heller, David, Byonanebye, Dathan, Kotwani, Prashant, Ayieko, James, Clark, Tamara, Chamie, Gabriel

2016

Overview

Antiretroviral therapy scale-up in Sub-Saharan Africa has created a growing, aging HIV-positive population at risk for non-communicable diseases such as hypertension. However, the prevalence and risk factors for hypertension in this population remain incompletely understood. We measured blood pressure and collected demographic data on over 65,000 adults attending multi-disease community health campaigns in 20 rural Ugandan communities (SEARCH Study: NCT01864603). Our objectives were to determine (i) whether HIV is an independent risk factor for hypertension, and (ii) awareness and control of hypertension in HIV-positive adults and the overall population. Hypertension prevalence was 14% overall, and 11% among HIV-positive individuals. 79% of patients were previously undiagnosed, 85% were not taking medication, and 50% of patients on medication had uncontrolled blood pressure. Multivariate predictors of hypertension included older age, male gender, higher BMI, lack of education, alcohol use, and residence in Eastern Uganda. HIV-negative status was independently associated with higher odds of hypertension (OR 1.2, 95% CI: 1.1-1.4). Viral suppression of HIV did not significantly predict hypertension among HIV-positives. The burden of hypertension is substantial and inadequately controlled, both in HIV-positive persons and overall. Universal HIV screening programs could provide counseling, testing, and treatment for hypertension in Sub-Saharan Africa.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adolescent / Adult / Adults / Age / Aged / Aging / AIDS / Alcohol use / Alcoholic beverages / Analysis / Antiretroviral agents / Antiretroviral therapy / Biology and Life Sciences / Blood / Blood pressure / Body mass / Cardiovascular disease / Collaboration / Complications and side effects / Demographics / Diabetes / Drugs / Epidemiology / Female / Health aspects / Health Knowledge, Attitudes, Practice / Health promotion / Health risks / HIV / HIV Infections - complications / HIV patients / Human immunodeficiency virus / Humans / Hypertension / Hypertension - complications / Hypertension - epidemiology / Hypertension - therapy / Industrialized nations / Infections / Infectious diseases / Lentivirus / Male / Measurement methods / Medicine and Health Sciences / Middle Aged / Mortality / Patient outcomes / Patients / People and Places / Physical Sciences / Population / Prevalence / Risk analysis / Risk Factors / Rural communities / Rural Population - statistics & numerical data / Rural populations / Uganda - epidemiology / Young Adult