Prevalence of Hypertension in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) Compared with HAART-Naïve Patients at the Limbe Regional Hospital, Cameroon

Abstract

BackgroundHighly 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. Data on the association between HAART and hypertension (HTN) in Africa are scarce.ObjectivesPrimarily to compare the prevalence of HTN in HIV/AIDS patients on HAART and HAART-naïve patients in Limbe, Cameroon; and secondarily to assess other socio-demographic and clinical factors associated with HTN in this population.MethodsA cross-sectional study was conducted at the Limbe Regional Hospital HIV treatment center between April and June 2013, involving 200 HIV/AIDS patients (100 on first-line HAART regimens for at least 12 months matched by age and sex to 100 HAART-naïve patients). HTN was defined as a systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg.ResultsThe prevalence of HTN in patients on HAART was twice (38%; 95% CI: 28.5–48.3) that of the HAART-naïve patients (19%; 95% CI, 11.8–28.1), p = 0.003. In multivariate analyses adjusted for age, gender, smoking, family history of HTN, and BMI-defined overweight, HAART was associated with HTN, the adjusted odds ratio of the HAART-treated versus HAART-naïve group was 2.20 (95% CI: 1.07–4.52), p = 0.032. HTN was associated with older age and male gender, in the HAART group and with BMI-defined overweight in the HAART-naïve group.ConclusionThe prevalence of hypertension in HIV/AIDS patients in Limbe stands out to be elevated, higher in patients on HAART compared to those not on treatment. Blood pressure and cardiovascular risk factors should be routinely monitored. Other factors such as diet, weight control and physical exercise should also be considered.

Hypertension and Related Risk Factors among Clients on Combined Antiretroviral Therapy in Nigeria

“…Contrarily, the findings of other studies of Agrawal et al [19] indicated no disparity in the prevalence of hypertension between patients on cART and cARTnaïve patients. Furthermore, lower hypertension prevalence was observed in patients receiving cART, as reported by Dimala et al [3]. Also, 60% prevalence rate in HIV patients on cART was documented by Kanegae et al [20].…”

“…Before the commencement of antiretroviral therapy, high blood pressures in HIV-infected subjects were frequently linked with complications including vasculopathy, renal failure, and stroke [2]. The individual cardiovascular threat, however, is influenced by myriads of risk factors such as weight gain, drug abuse, elevated blood lipids, dyslipidemia, age, diabetes, smoking and family history [3]. Cardiovascular diseases that accounted for 30% deaths worldwide are attributable to chronic and poorly controlled and uncontrolled hypertension [4].…”

Systemic Arterial Hypertension in people living with HIV/AIDS: integrative review

“…Regarding the evidence levels, the following distribution was observed: four on level IV (10,16,20,23) ; three on level V (21)(22)24) ; and ten on level VI (11)(12)(13)(14)(15)(16)(17)(18)(19)(25)(26) .…”

“…The characterization of the 17 articles showed the year of publication varied between 2001 and 2016, with six articles published in Brazil (10)(11)(12)(13)(14)(15) , five in the United States (16)(17)(18)(19)(20) , four in European countries (21)(22)(23)(24) , one article in Cameroon (25) and one in Chile (26) . Regarding the evidence levels, the following distribution was observed: four on level IV (10,16,20,23) ; three on level V (21)(22)24) ; and ten on level VI (11)(12)(13)(14)(15)(16)(17)(18)(19)(25)(26) .…”

“…Prevalence of hypertension in HIV/AIDS patients on highly active antiretroviral therapy (haart) compared with haart naïve patients at the limbe regional hospital, Cameroon (25) Cameroon 2016…”