Prevalence and Risk Factors of Hypertension Stratified by HIV Status in Western Kenya

Abstract

Introduction The burden of cardiovascular disease (CVD) is increasing in sub-Saharan Africa (SSA) and untreated hypertension is a major contributing factor. The prevalence and risk factors associated with hypertension among PLWHV who are on long-term ART are not well studied and we determined these in a cohort of PLWHV and HIV negative individuals in Kisumu, Kenya. Methods In this cross-sectional study, we enrolled 300 PLWHV on long-term ART (≥6 months) and 298 HIV-negative adults seeking routine services at the Kisumu County hospital between 2017-2018. We diagnosed participants with hypertension (defined as blood pressure of ≥140/90mmHg) and used multivariate regression to evaluate the association between hypertension, HIV, other sociodemographic, and CVD risk factors. Results The overall prevalence of hypertension was 25% and PLWHV had a lower prevalence of hypertension than HIV- negative persons (18% vs 33% respectively; p<0.001). After adjusting for age, body mass index, education level, interleukin-6 and central obesity, PLWHV were 48% less likely to have hypertension (adjusted relative risk (aRR) 0.52; 95% confidence interval (CI) 0.39-0.71). Participants aged 40-50 years had a 4.19 times higher risk of hypertension (95% CI 2.59-6.79) and those >51 years had a 4.66-fold higher hypertension risk (95% CI 2.62-8.29) compared to individuals <40 years old. Individuals with BMI of <18 kg/m2 were 1.76 times more likely to have hypertension (95% CI:2.59-6.79); those with BMI 25-30 kg/m2 had 1.73 times higher likelihood of being hypertensive (95% CI 1.12-2.68), and those with BMI >30 kg/m2 had a 2.65 fold-greater risk of hypertension (95% CI 1.55-4.50) compared to those with BMI in the normal range (18-25 kg/m2). Conclusion We found a high prevalence of hypertension overall, and this was associated with advancing age and higher BMI. PLWHV on stable ART had a lower prevalence compared to HIV-negative individuals.