Kwarisiima Dalsone, Balzer Laura, Heller David, Kotwani Prashant, Chamie Gabriel, Clark Tamara, Ayieko James, Mwangwa Florence, Jain Vivek, Byonanebye Dathan, Petersen Maya, Havlir Diane, Kamya Moses R
Infectious Diseases Research Collaboration, Kampala, Uganda.
Harvard University, Boston, Massachusetts, United States of America.
PLoS One. 2016 May 27;11(5):e0156309. doi: 10.1371/journal.pone.0156309. eCollection 2016.
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.
撒哈拉以南非洲地区抗逆转录病毒疗法的扩大使用，导致感染艾滋病毒且年龄不断增长的人群数量增加，他们面临高血压等非传染性疾病的风险。然而，该人群中高血压的患病率和风险因素仍未完全明确。
我们测量了乌干达20个农村社区参加多病种社区健康活动的65000多名成年人的血压，并收集了他们的人口统计学数据（SEARCH研究：NCT01864603）。我们的目标是确定：（i）艾滋病毒是否为高血压的独立风险因素；（ii）艾滋病毒呈阳性的成年人及总体人群中高血压的知晓率和控制情况。
总体高血压患病率为14%，艾滋病毒呈阳性者中为11%。79%的患者此前未被诊断，85%未接受治疗，接受治疗的患者中有50%血压未得到控制。高血压的多变量预测因素包括年龄较大、男性、体重指数较高、未受过教育、饮酒以及居住在乌干达东部。艾滋病毒阴性状态与高血压几率较高独立相关（比值比1.2，95%置信区间：1.1 - 1.4）。艾滋病毒的病毒抑制在艾滋病毒呈阳性者中对高血压并无显著预测作用。
无论是艾滋病毒呈阳性者还是总体人群，高血压负担都很沉重且控制不足。通用的艾滋病毒筛查项目可为撒哈拉以南非洲地区的高血压提供咨询、检测和治疗。
