Department of Global Health, University of Washington, Seattle, WA, United States of America.
Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya.
PLoS One. 2022 Jan 10;17(1):e0262400. doi: 10.1371/journal.pone.0262400. eCollection 2022.
The burden of cardiovascular disease (CVD) is increasing in sub-Saharan Africa with untreated hypertension being a major contributing factor. Understanding the magnitude of the problem and risk factors associated with HIV and long-term antiretroviral therapy (ART) is critically important for designing effective programs for diagnosing and treating hypertension in Kenya.
In this cross-sectional study, we enrolled 300 persons with HIV (PWH) on long term ART (≥6 months) and 298 HIV-negative adults seeking care at the Kisumu County Hospital between September 2017 and May 2018. Hypertension was defined as blood pressure of ≥140/90mmHg or a previous hypertension diagnosis. Multivariate regression was used to assess the association between hypertension and HIV adjusting for age, sex, and known CVD risk factors.
Overall prevalence of hypertension was 22%. PWH had a lower prevalence of hypertension than HIV-negative persons (16% vs 27% respectively; p<0.002). In multivariate analyses, persons with HIV were 37% less likely to have hypertension compared to HIV-negative individuals (adjusted prevalence ratio 0.63; 95% confidence interval: 0.46-0.86). Other factors that were associated with hypertension in all participants included older age >40 years, body mass index (BMI) >25 kg/m2 and low-density lipoproteins ≥130mg/dL. Among PWH, being older than 40 years and higher BMI >30 kg/m2 were associated with hypertension.
Prevalence of hypertension was high, affecting nearly one in every 4 adults, and associated with older age, higher BMI and high low-density lipoproteins. PWH on long-term ART had significantly lower prevalence of hypertension compared to HIV-negative individuals, potentially due to increased access to healthcare services and interaction with prevention messaging. Interventions to increase screening for and prevention of hypertension in the community for all adults are warranted.
心血管疾病（CVD）在撒哈拉以南非洲的负担正在增加，未得到治疗的高血压是一个主要的促成因素。了解与 HIV 和长期抗逆转录病毒治疗（ART）相关的问题的严重程度和风险因素对于在肯尼亚设计有效的诊断和治疗高血压方案至关重要。
在这项横断面研究中，我们招募了 2017 年 9 月至 2018 年 5 月期间在基苏木县医院接受长期 ART（≥6 个月）的 300 名 HIV 感染者（PWH）和 298 名寻求治疗的 HIV 阴性成年人。高血压定义为血压≥140/90mmHg 或以前有高血压诊断。多变量回归用于评估在调整年龄、性别和已知心血管疾病风险因素后，高血压与 HIV 之间的关联。
总体高血压患病率为 22%。与 HIV 阴性者相比，PWH 的高血压患病率较低（分别为 16%和 27%；p<0.002）。在多变量分析中，与 HIV 阴性个体相比，HIV 感染者发生高血压的可能性降低 37%（调整后的患病率比为 0.63；95%置信区间：0.46-0.86）。所有参与者中与高血压相关的其他因素还包括年龄>40 岁、体重指数（BMI）>25kg/m2 和低密度脂蛋白≥130mg/dL。在 PWH 中，年龄>40 岁和 BMI>30kg/m2 与高血压有关。
高血压的患病率很高，每 4 个成年人中就有近 1 人受到影响，与年龄较大、BMI 较高和低密度脂蛋白较高有关。与 HIV 阴性个体相比，长期接受 ART 的 PWH 高血压的患病率显著较低，这可能是由于获得更多的医疗保健服务和与预防信息的互动。需要在社区中加强对所有成年人进行高血压筛查和预防的干预措施。
