Awareness and management of elevated blood pressure among human immunodeficiency virus–infected adults receiving antiretroviral therapy in urban Zambia: a call to action. Issue 1 (1st January 2017)

• Record Type: Journal Article
• Authors: Bauer, Sophie; Wa Mwanza, Mwanza; Chilengi, Roma; Holmes, Charles B.; Zyambo, Zude; Furrer, Hansjakob; Egger, Matthias; Wandeler, Gilles; Vinikoor, Michael J.
• Is Part Of: Global health action. Volume 10:Issue 1(2017)
• Publication Date: 2017-01-01
• Subjects: Africa -- HIV/AIDS -- high blood pressure -- antiretroviral therapy -- non-communicable diseases; World health -- Periodicals; Global Health; World health; Periodicals; 362.1
• DOI: 10.1080/16549716.2017.1359923
• Languages: English
• ISSNs: 1654-9716

Abstract

ABSTRACT: The prevalence of high blood pressure (HBP) and hypertension (HTN), awareness of the diagnoses, and use of anti-hypertensive drugs were examined among human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy (ART) in Zambia's capital Lusaka. Within a prospective cohort based at two public sector ART clinics, BP was measured at ART initiation and every 6 months thereafter as a routine clinic procedure. Predictors of HBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) during one year on ART were analyzed using logistic regression, and the proportion with HTN (2+ episodes of HBP >3 months apart) described. A phone survey was used to understand patient awareness of HBP, use of anti-hypertensive drugs, and history of cardiovascular events (CVE; myocardial infarction or stroke). Among 896 cohort participants, 887 (99.0%) had at least one BP measurement, 98 (10.9%) had HBP, and 57 (6.4%) had HTN. Increasing age (10-year increase in age: adjusted odds ratio [AOR] = 1.50; 95% confidence interval [CI] 1.20–1.93), male sex (AOR = 2.33, 95% CI 1.43–3.80), and overweight/obesity (AOR = 4.07; 95% CI 1.94–8.53) were associated with HBP. Among 66 patients with HBP, 35 (53.0%) reported awareness of the condition, and nine (25.7%) of these reported having had a CVE. Only 14 (21.2%) of those reached reported ever taking an anti-hypertensive drug, and one (1.5%) was currently on treatment. These data suggest that major improvements are needed in the management of HBP among HIV-infected individuals in settings such as Zambia.