Magande Pamela Nyaradzai, Chirundu Daniel, Gombe Notion Tafara, Mungati More, Tshimanga Mufuta
Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
Kadoma City Health Department, Kadoma City, Zimbabwe.
Clin Hypertens. 2017 Jul 4;23:14. doi: 10.1186/s40885-017-0070-4. eCollection 2017.
Clients on anti-retroviral therapy (ART) are living longer and have risk of hypertension. Side effects of medicines and aging increase this risk. Hypertension prevalence among clients on ART in Kadoma City was estimated to be 30% in 2015. Of these, 61% had uncontrolled hypertension. This was high compared to 46% of hypertensives in the general population who had uncontrolled hypertension. We determined factors associated with uncontrolled hypertension among clients on ART.
A 1.1 unmatched case control study was conducted. Interviews, anthropometric measurements and record reviews were to collect data on demography and medical history. Epi Info 7 was used for univariate, bivariate analysis and logistic regression.
One hundred and fifty-two cases and 152 controls were recruited into the study. Adding salt to dishes regularly aOR = 5.69 (3.19-10.16), body mass index (BMI) above 25 kg/m aOR = 2.81 (1.60-4.91) and history of elevated blood pressure in previous year aOR = 2.34 (1.33-4.13) were independent risk factors. Independent protective factors were duration more than 2 years since HIV diagnosis aOR = 0.58 (0.35-0.95), duration less than 5 years since hypertension diagnosis aOR = 0.50 (0.30-0.83) and walking or cycling as a means of transport aOR = 0.27 (0.16-0.48).
Adding salt to dishes regularly, BMI above 25 kg/m, history of elevated blood pressure in the previous year, duration more than 2 years since HIV diagnosis, duration less than 5 years since hypertension diagnosis and walking or cycling as a means of transport were independently associated with uncontrolled hypertension. Health education on lifestyle changes like walking and cycling as transport and dietary modification such as salt intake reduction were recommended.
接受抗逆转录病毒疗法（ART）的患者寿命延长，但有患高血压的风险。药物副作用和衰老会增加这种风险。2015年，卡多马市接受ART治疗的患者中高血压患病率估计为30%。其中，61%的患者高血压未得到控制。与普通人群中46%的高血压未得到控制的患者相比，这一比例较高。我们确定了ART治疗患者中与高血压未得到控制相关的因素。
进行了一项1.1配比的病例对照研究。通过访谈、人体测量和记录审查收集人口统计学和病史数据。使用Epi Info 7进行单变量、双变量分析和逻辑回归。
该研究招募了152例病例和152例对照。经常在菜肴中加盐调整后的比值比（aOR）=5.69（3.19 - 10.16），体重指数（BMI）高于25kg/m²调整后的比值比（aOR）=2.81（1.60 - 4.91），以及上一年有血压升高病史调整后的比值比（aOR）=2.34（1.33 - 4.13）是独立危险因素。独立保护因素为自确诊HIV以来病程超过2年调整后的比值比（aOR）=0.58（0.35 - 0.95），自确诊高血压以来病程少于5年调整后的比值比（aOR）=0.50（0.30 - 0.83），以及以步行或骑自行车作为出行方式调整后的比值比（aOR）=0.27（0.16 - 0.48）。
经常在菜肴中加盐、BMI高于25kg/m²、上一年有血压升高病史、自确诊HIV以来病程超过2年、自确诊高血压以来病程少于5年以及以步行或骑自行车作为出行方式与高血压未得到控制独立相关。建议开展关于生活方式改变的健康教育，如以步行和骑自行车作为出行方式，以及饮食调整，如减少盐的摄入量。
