Prevalence and determinants of hypertension in people living with HIV/AIDS in Fako Division, southwest region of Cameroon

Article type
Authors
Tanue EA1, Nsagha DS1, Laban MN1, Kibu OD1, Ayima CW1
1Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea
Abstract
Background: The advent of highly active antiretroviral therapy (HAART) has greatly reduced the morbidity and mortality of HIV/AIDS patients but has also been associated with increased metabolic complications and cardiovascular diseases (CVD). Pre-hypertension elevates the risk of CVD and that of end-stage renal disease.

Objectives: Primarily to determine the prevalence of hypertension in HIV/AIDS patients in Fako Division, Cameroon; and secondarily to assess the predictors of hypertension in this population.

Methods:A cross-sectional study was conducted at the Buea and Limbe Regional Hospital HIV treatment centers between March and August 2014, involving 209 HIV/AIDS patients (157 on HAART regimens for at least 6 months and 52 HAART-naïve patients). In addition to the self-reported information on risk factors, height and weight, and blood pressure were measured during routine health checks at the centres. Blood pressure was measured using digital blood pressure measurement devices. The averages of two measurements at the right arm at heart level after a period of 5 minutes of rest were recorded and used in the analysis. HTN was defined as a systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg.

Results: The prevalence of pre-hypertension and hypertension was 51.7% (95% CI, 44.9-58.5) and 20.1% (95% CI, 14.7-25.5), respectively. The prevalence of hypertension in patients on HAART (22.3%; 95% CI, 15.8-28.8) and that of the HAART-naïve patients (13.5%; 95% CI, 4.2-22.8), p = 0.1710 was recorded. Multivariate analyses were done for age, gender, family history of hypertension, BMI-defined overweight, HAART use, physical activity and alcohol use. The adjusted odds ratio of the male versus female gender was 3.73 (95% CI: 1.49–9.35), p = 0.005. Hypertension was associated with BMI-defined overweight, family history, physical activity level and male gender.

Conclusions: The prevalence of hypertension in HIV/AIDS patients in Fako Division is elevated in both patients on HAART and those not on treatment. Blood pressure and cardiovascular risk factors should be routinely monitored. Other factors should also be considered.