Hypertension Occurrence and Associated Risk Factors in HIV Patients on Antiretroviral Therapy in Nairobi County, Kenya
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Abstract
Due to advances in antiretroviral treatment, the incidence of HIV infection has declined in recent years. However, cardiovascular illnesses continue to be the primary cause of death and morbidity among HIV-positive individuals, accounting for 10% of all deaths that are not related to AIDS. The paper aimed to determine occurrence and risk factors associated with hypertension among HIV patients on antiretroviral treatment in Nairobi County. The study adopted a cross-sectional design, and a sample size of 552 respondents. Purposive sampling technique was used to select the area, and systemic random sampling was used to select participants. Structured questionnaires were used to collect data, which was analyzed using excel and SPSS. Results indicated (64.86%) female and 35.69% male participants. About 55.43% participants were married, 61.41% had informal jobs, 43.48% had attained elementary school level, and 99.64% identified as Christians. Accordingly, 14.52% of people had elevated blood pressure, and 85.48% recorded normal blood pressure. About 44.21% of people were overweight/obese as indicated by their waist circumference and BMI findings, and 24.64% were at risk because of their elevated waist circumference. The risk of hypertension is substantially higher among respondents 46 years and older than in respondents under 25 years (p = 0.008) at 95%CL. A higher waist circumference is linked to a higher risk of hypertension (p = 0.012), family history (p=0.021) Cl, whereas a person's chance of developing hypertension is higher when their heart rate remains constant than when it changes slightly (p = 0.036). In conclusion, advancing age, female gender, increase in waist circumference, overweight/obesity and family history were predictors for hypertension in this study. The study recommended Nairobi health service to integrate hypertension and HIV services; to give health education to patients and care givers and promote lifestyle modification; and the Ministry of Health (MoH) to formulate integration policies.
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References
Bell, J. A., Carslake. D., O'Keeffe, L. M., Frysz, M., Howe, L. D., Hamer, M., Wadec, K. H., Timpson, N. J., Davey. S. G. (2018). Associations of Body Mass and Fat Indexes With Cardiometabolic Traits. The Journal of the American College of Cardiology, 72(24), 3142-3154. https://doi.10.1016/j.jacc.2018.09.066 DOI: https://doi.org/10.1016/j.jacc.2018.09.066
Cerrato, E., D’Ascenzo, F., Biondi-Zoccai, G., Calcagno, A., Frea, S., Grosso Marra, W., Castagno, D., Omedè, P., Quadri, G., Sciuto, F., Presutti, D., Frati, G., Bonora, S., Moretti, C., & Gaita, F. (2013). Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: A meta-analysis in the highly active antiretroviral therapy era. European Heart Journal, 34(19), 1432–1436. https://doi.org/10.1093/eurheartj/ehs471 DOI: https://doi.org/10.1093/eurheartj/ehs471
Chiwandire, N., Zungu, N., Mabaso, M., & Chasela, C. (2021). Trends, prevalence and factors associated with hypertension and diabetes among South African adults living with HIV, 2005–2017. BMC Public Health, 21(1), 462-3, https://doi.org/10.1186/s12889-021-10502-8 DOI: https://doi.org/10.1186/s12889-021-10502-8
Dai, B., Addai-Dansoh, S., Nutakor, J. A., Osei-Kwakye, J., Larnyo, E., Oppong, S., Boahemaa, P. Y., & Arboh, F. (2022). The prevalence of hypertension and its associated risk factors among older adults in Ghana. Frontiers in Cardiovascular Medicine, 9. https://doi.org/10.3389/fcvm.2022.990616 DOI: https://doi.org/10.3389/fcvm.2022.990616
Denu, M. K. I., Revoori, R., Buadu, M. A. E., Oladele, O., & Berko, K. P. (2024). Hypertension among persons living with HIV/AIDS and its association with HIV-related health factors. AIDS Research and Therapy, 21(5), 1-6. https://doi.org/10.1186/s12981-023-00576-2 DOI: https://doi.org/10.1186/s12981-023-00576-2
Dhindsa, D. S., Khambhati, J., Schultz, W. M., Tahhan, A. S., & Quyumi, A. A. (2020). Marital status and outcomes in patients with cardiovascular disease. Trends in cardiovascular medicine, 30(4), 215–220. https://doi.org/10.1016/j.tcm.2019.05.012 DOI: https://doi.org/10.1016/j.tcm.2019.05.012
Expert Panel on Detection, E., and Treatment of High Blood Cholesterol in Adults. (2001). Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19), 2486–2497. https://doi.org/10.1001/jama.285.19.2486 DOI: https://doi.org/10.1001/jama.285.19.2486
Fahme, S. A., Bloomfield, G. S., & Peck, R. (2018). Hypertension in HIV-Infected Adults. Hypertension, 72(1), 44–55. https://doi.org/10.1161/HYPERTENSIONAHA.118.10893 DOI: https://doi.org/10.1161/HYPERTENSIONAHA.118.10893
Gill, D., Zuber, V., Dawson, J., Pearson-Stuttard, J., Carter, A. R., Sanderson, E., Karhunen, V., Levin, M. G., Wootton, R. E., Klarin, D., Tsao, P. S., Tsilidis, K. K., Damrauer, S. M., Burgess, S., & Elliott, P. (2021). Risk factors mediating the effect of body mass index and waist-to-hip ratio on cardiovascular outcomes: Mendelian randomization analysis. International Journal of Obesity, 45(7), 1428–1438.https://doi.org/10.1038/s41366-021-00807-4 DOI: https://doi.org/10.1038/s41366-021-00807-4
Hatleberg, C. I., Ryom, D. L., Monforte, A. d’Arminio, Fontas, E., Reiss, P., Kirk, O., Sadr, W. E., Phillips, A., de Wit, S., Dabis, F., Weber, R., Law, M., Lundgren, J. D., & Sabin, C. (2018). Association between exposure to antiretroviral drugs and the incidence of hypertension in HIV-positive persons: The DAD Study. HIV Medicine, 19(9), 605–618. https://doi.org/10.1111/hiv.12639 DOI: https://doi.org/10.1111/hiv.12639
Harimenshi, D., Niyongabo, T., Preux, P. M., Aboyans, V., & Desormais, I. (2022). Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: Across-sectional study. Scientific Reports, 12(1), 1–8. https://doi.org/10.1038/s41598-022-24997-7 DOI: https://doi.org/10.1038/s41598-022-24997-7
Lubega, G., Mayanja, B., Lutaakome, J., Abaasa, A., Thomson, R., & Lindan, C. (2021). Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda. Pan African Medical Journal 38(216), 1-10. https://doi.org/10.11604/pamj.2021.38.216.28034 DOI: https://doi.org/10.11604/pamj.2021.38.216.28034
Ma, H., Wang, X., Li, X., Heianza, Y., & Qi, L. (2022). Adding Salt to Foods and Risk of Cardiovascular Disease. College Journal of the American of Cardiology, 80(23), 2157-2167. https://doi.org/10.1016/j.jacc.2022.09.039 DOI: https://doi.org/10.1016/j.jacc.2022.09.039
Maffoni, M., Traversoni, S., Costa, E., Midão, L., Kardas, P., Kurczewska-Michalak, M., & Giardini, A. (2020). Medication adherence in the older adults with chronic multimorbidity: A systematic review of qualitative studies on patient’s experience. European Geriatric Medicine, 11(3), 369–381. https://doi.org/10.1007/s41999-020-00313-2 DOI: https://doi.org/10.1007/s41999-020-00313-2
McCombe, G., Murtagh, S., Lazarus, J. V., Van Hout, M. C., Bachmann, M., Jaffar, S., Garrib, A., Ramaiya, K., Sewankambo, N. K., Mfinanga, S., & Cullen, W. (2021). Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: A Delphi consensus study on international best practice. BMC Health Services Research, 21(1), 1235-6. https://doi.org/10.1186/s12913-021-07073-0 DOI: https://doi.org/10.1186/s12913-021-07073-0
Mogaka, J. N., Sharma, M., Temu, T., Masyuko, S., Kinuthia, J., Osoti, A., Zifodya, J., Nakanjako, D., Njoroge, A., Otedo, A., Page, S., & Farquhar, C. (2022). Prevalence and factors associated with hypertension among adults with and without HIV in Western Kenya. PLOS ONE, 17(1), e0262400. https://doi.org/10.1371/journal.pone.0262400 DOI: https://doi.org/10.1371/journal.pone.0262400
Okyere, J., Ayebeng, C., Owusu, B. A., & Dickson, K. S. (2022). Prevalence and factors associated with hypertension among older people living with HIV in South Africa. BMC Public Health, 22(1), 1684-5. https://doi.org/10.1186/s12889-022-14091-y DOI: https://doi.org/10.1186/s12889-022-14091-y
Parati, G., Lombardi, C., Pengo, M., Bilo, G., & Ochoa, J. E. (2021). Current challenges for hypertension management: From better hypertension diagnosis to improved patients' adherence and blood pressure control. International Journal of Cardiology, 331(3), 262-269. https://doi.org/10.1016/j.ijcard.2021.01.070 DOI: https://doi.org/10.1016/j.ijcard.2021.01.070
Passi, S. J. (2017). Prevention of Non-communicable Diseases by Balanced Nutrition: Population- specific Effective Public Health Approaches in Developing Countries. Current Diabetes Reviews, 13(5), 461–476. https://doi.org/10.2174/1573399812666160905105951 DOI: https://doi.org/10.2174/1573399812666160905105951
Patel, P., Rose, C. E., Collins, P. Y., Nuche-Berenguer, B., Sahasrabuddhe, V. V., Peprah, E., Vorkoper, S., Pastakia, S. D., Rausch, D., Levitt, N. S., & Group, for the N. H. P. D. C. T. O. (2018). Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: A systematic review and meta-analysis. AIDS, 32(), S5-S20 https://doi.org/10.1097/QAD.0000000000001888 DOI: https://doi.org/10.1097/QAD.0000000000001888
Peck, R., Mghamba, J., Vanobberghen, F., Kavishe, B., Rugarabamu, V., Smeeth, L., Hayes, R., Grosskurth, H., & Kapiga, S. (2014). Preparedness of Tanzanian health facilities for outpatient primary care of hypertension and diabetes: A cross-sectional survey. The Lancet Global Health, 2(5), 285–292. https://doi.org/10.1016/S2214-109X(14)70033-6 DOI: https://doi.org/10.1016/S2214-109X(14)70033-6
Probst, C., Kilian, C., Sanchez, S., Lange, S., & Rehm, J. (2020). The role of alcohol use and drinking patterns in socioeconomic inequalities in mortality: A systematic review. The Lancet Public Health, 5(6), 324–332. https://doi.org/10.1016/S2468-2667(20)30052-9 DOI: https://doi.org/10.1016/S2468-2667(20)30052-9
Ranasinghe, P., Cooray, D. N., Jayawardena, R., & Katulanda, P. (2015). The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults. BMC Public Health, 15, 576. https://doi.org/10.1186/s12889-015-1927-7 DOI: https://doi.org/10.1186/s12889-015-1927-7
Remais, J. V., Zeng, G., Li, G., Tian, L., & Engelgau, M. M. (2012). Convergence of non-communicable and infectious diseases in low- and middle-income countries, International Journal of Epidemiology, 42(1), 221–227, https://doi.org/10.1093/ije/dys135 DOI: https://doi.org/10.1093/ije/dys135
Saito, A., Karama, M., & Kamiya, Y. (2020). HIV infection, and overweight and hypertension: A cross-sectional study of HIV-infected adults in Western Kenya. Tropical Medicine and Health, 48, 31. https://doi.org/10.1186/s41182-020-00215-w DOI: https://doi.org/10.1186/s41182-020-00215-w
Tian, Y., & Zhang, Y. (2022). The relationship between hypertension and physical activity in middle-aged and older adults controlling for demographic, chronic disease, and mental health variables. Medicine (Baltimore).101(47), e32092-4. https://doi: 10.1097/MD.0000000000032092 DOI: https://doi.org/10.1097/MD.0000000000032092
Todowede, O. O., Sartorius, B., Magula, N., & Schutte, A. E. (2019a). Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa. Diabetology & Metabolic Syndrome, 11(1), 105 https://doi.org/10.1186/s13098-019-0502-2
Todowede, O. O., Sartorius, B., Magula, N., & Schutte, A. E. (2019b). Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa. Diabetology & Metabolic Syndrome, 11, 105 https://doi.org/10.1186/s13098-019-0502-2 DOI: https://doi.org/10.1186/s13098-019-0502-2
Wang, Q., Song, X., Du, S., Du, W., Su, C., Zhang, J., Zhang, X., Zhang, B., & Wang, H. (2022). Waist Circumference Trajectories in Relation to Blood Pressure and the Risk of Hypertension in Chinese Adults. Nutrients, 14(24), 5260, https://doi.org/10.3390/nu14245260 DOI: https://doi.org/10.3390/nu14245260
World Health Organization. (2024). HIV/AIDS: Overview. https://www.afro.who.int/health-topics/hivaids