Prevalence, Awareness, and Factors Associated with Hypertension Among People Living with HIV in Eastern Uganda. A Multicentre Cross-Sectional Study

Andrew Marvin Kanyike,1,2,&ast; Ashley Winfred Nakawuki,3 Gabriel Madut Akech,1 Raymond Bernard Kihumuro,4 Timothy Mwanje Kintu,5 Racheal Nalunkuma,2 Rachael Mukisa Nakandi,2 Joshua Mugabi,1 Nicholas Twijukye,1 Denis Bwayo,1 Richard Katuramu1,&ast; 1Department of Internal Medicine, Faculty of Health Sciences, Busitema University, Mbale, Uganda; 2Department of Internal Medicine, Mengo Hospital, Kampala, Uganda; 3Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, Uganda; 4Way Forward Youth Africa Limited, Kampala, Uganda; 5Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda&ast;These authors contributed equally to this workCorrespondence: Andrew Marvin Kanyike, Department of Internal Medicine, Mengo Hospital, Kampala, Uganda, Email [email protected]: Despite advancements in Antiretroviral Therapy (ART), people living with HIV (PLHIV) face increasing risks of HTN, leading to significant morbidity and premature mortality, undermining the hard-earned gains of fighting HIV. The prevalence of hypertension among HIV patients and associated risk factors has not been extensively studied in the rural parts of Uganda.Objective: We assessed the prevalence, awareness, and factors associated with hypertension among PLHIV at two health facilities in Eastern Uganda.Methods: A cross-sectional study was conducted at Mbale Regional Referral Hospital and Bugobero Health Center IV HIV clinics from May to July 2023. We recruited patients with HIV above the age of 18 years and willing to consent. Participants were interviewed using a structured questionnaire adapted from the WHO STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) and the AIDS Clinical Trials Group. Anthropometric measurements and blood pressure were taken. Bivariate and multivariable logistic regression were performed. A P value < 0.2 in the bivariate analysis was transferred to the multivariable logistic regression model. A P value < 0.05 was statistically significant.Results: The study surveyed 400 PLHIV with a mean age of 46.5 (SD: 12.4) years; most were female (n=261, 65.3%). Hypertension prevalence was at 37.5%, with 20.5% in stage 2 and 68% ((n=102) of hypertensive participants were unaware. Hypertension was associated with age ≥ 50 years (aOR: 2.11, 95% CI: 1.33– 3.37, p = 0.002), a suppressed viral load (aOR: 3.71, 95% CI: 1.02– 5.13, p = 0.046) and BMI ≥ 25 Kg/m2 (aOR: 1.64, 95% CI: 1.01– 2.66, p = 0.044).Conclusion: Hypertension is a significant burden among PLHIV in Eastern Uganda, influenced by HIV and lifestyle-related risk factors. Improved screening and diagnosis are needed with close monitoring for patients with viral load suppression due to the possible negative effects of ART on blood pressure.Plain Language Summary: This study explored the prevalence, awareness, and risk factors linked to high blood pressure among people living with HIV (PLHIV) at two health facilities in Eastern Uganda. We found that 37.5% of the participants had high blood pressure, yet the majority (68%) were unaware of their condition. We identified older age ≥ 50 years, a higher body mass index (BMI) ≥ 25 kg/m2, and having a suppressed viral load as significant risk factors for high blood pressure among PLHIV. These results reveal the urgent need for improved health strategies that integrate the management of HIV and hypertension and preventive care to enhance the overall health outcomes for PLHIV in rural areas.Keywords: human immunodeficiency syndrome, antiretroviral therapy, hypertension, body mass index