In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.
References
[1]
Federal Ministry of Health (2018) Nigeria AIDs Indicator and Impacts Survey 2018. https://www.ciheb.org/media/som/microsites/ciheb/documents/naiis-report-2018.pdf
[2]
Joint United Nations Programme on HIV and AIDS (2014) The Gap Report: Children and Pregnant Women Living with HIV. Geneva. https://files.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf
[3]
Obeagu, E.I. (2022) An Update on the Survival of People Living with HIV in Nigeria. Journal of Public Health and Nutrition, 5, Article No. 129.
[4]
Moyo-Chilufya, M., Maluleke, K., Kgarosi, K., Muyoyeta, M., Hongoro, C. and Musekiwa, A. (2023) The Burden of Non-Communicable Diseases among People Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. EClinical Medicine, 65, Article ID: 102255. https://doi.org/10.1016/j.eclinm.2023.102255
[5]
Jean J.B. and Jean J.N. (2021) Global Burden of Hypertension in People Living with HIV. BMC Medicine, 19, Article No. 112. https://doi.org/10.1186/s12916-021-01981-y
[6]
Shah, A.S.V., Stelzle, D., Lee, K.K., Beck, E.J., Alam, S., Clifford, S., et al. (2018) Global Burden of Atherosclerotic Cardiovascular Disease in People Living with HIV. Circulation, 138, 1100-1112. https://doi.org/10.1161/CIRCULATIONAHA.117.033369
[7]
Smit, M., Brinkman, K., Geerlings, S., Smit, C., Thyagarajan, K., Sighem, A., et al. (2015) Future Challenges for Clinical Care of an Aging Population Infected with HIV: A Modeling Study. The Lancet Infectious Diseases, 15, 810-818. https://doi.org/10.1016/S1473-3099(15)00056-0
[8]
Edward, A., Oladayo, A., Omolola, A., Adetiloye, A. and Adedayo, P. (2013) Prevalence of Traditional Cardiovascular Risk Factors and Evaluation of Cardiovascular Risk Using Three Risk Equations in Nigerians Living with Human Immunodeficiency Virus. North American Journal of Medicine and Science, 5, 680-688. https://doi.org/10.4103/1947-2714.123251
[9]
Ekrikpo, U., Akpan, E., Ekott, J., Bello, A., Okpechi, I. and Kengne, A. (2018) Prevalence and Correlates of Traditional Risk Factors for Cardiovascular Disease in a Nigerian ART-Naive HIV Population: A Cross-Sectional Study. BMJ Open, 8, e019664. https://doi.org/10.1136/bmjopen-2017-019664
[10]
Xu, Y.N., Chen, X.G. and Wang, K. (2017) Global Prevalence of Hypertension among People Living with HIV: A Systematic Review and Meta-Analysis. Journal of the American Society of Hypertension, 11, 530-540. https://doi.org/10.1016/j.jash.2017.06.004
[11]
Isaac Derick, K. and Khan, Z. (2023) Prevalence, Awareness, Treatment, Control of Hypertension, and Availability of Hypertension Services for Patients Living with Human Immunodeficiency Virus (HIV) in Sub-Saharan Africa (SSA): A Systematic Review and Meta-Analysis. Cureus, 15, e37422. https://doi.org/10.7759/cureus.37422
[12]
Msoka, T., Rogath, J., Van Guilder, G., Kapanda, G., Smulders, Y., Van Furth, M.T., et al. (2021) Comparison of Predicted Cardiovascular Risk Profiles by Different Cvd Risk-Scoring Algorithms between Hiv-1-Infected and Uninfected Adults: A Cross-Sectional Study in Tanzania. HIV/AIDS—Research and Palliative Care, 13, 605-615. https://doi.org/10.2147/HIV.S304982
[13]
Peck, R.N., Shedafa, R., Kalluvya, S., Downs, J.A., Todd, J., Suthanthiran, M., et al. (2014) Hypertension, Kidney Disease, HIV and Antiretroviral Therapy among Tanzanian Adults: A Cross-Sectional Study. BMC Medicine, 12, Article No. 125. https://doi.org/10.1186/s12916-014-0125-2
[14]
Gazzaruso, C., Bruno, R., Garzaniti, A., Giordanetti, S., Fratino, P., Sacchi, P., et al. (2003) Hypertension among HIV Patients: Prevalence and Relationships to Insulin Resistance and Metabolic Syndrome. Journal of Hypertension, 21, 1377-1382. https://doi.org/10.1097/00004872-200307000-00028
[15]
Odubela, O., Odunukwe, N., Peer, N., et al. (2023) Prevalence of Hypertension among Antiretroviral Therapy Naïve Patients in Lagos, Nigeria. Clinical Hypertension, 29, Article No. 29. https://doi.org/10.1186/s40885-023-00253-6
[16]
Isa, S.E., Kang’ombe, A.R., Simji, G.S., Shehu, N.Y., Oche, A.O., Idoko, J.A., Cuevas, L.E. and Gill, G.V. (2017) Hypertension in Treated and Untreated Patients with HIV: A Study from 2011 to 2013 at the Jos University Teaching Hospital, Nigeria. Transactions of the Royal Society of Tropical Medicine and Hygiene, 111, 172-177. https://doi.org/10.1093/trstmh/trx030
[17]
Ilesanmi, O.S. and Akpa, O.M. (2020) Prevalence and Risk Factors of Hypertension in HIV-Positive Adults on Antiretroviral Therapy in Ondo State, Nigeria. HIV & AIDS Review, 19, 199-205. https://doi.org/10.5114/hivar.2020.99681
[18]
Jackson, I.L., Lawrence, S.M., Igwe, C.N., Ukwe, C.V. and Okonta, M.J. (2022) Prevalence and Control of Hypertension among People Living with HIV Receiving Care at a Nigerian Hospital. The Pan African Medical Journal, 41, Article No. 153.
[19]
De Socio, G.V., Ricci, E., Maggi, P., Parruti, G., Celesia, B.M., Orofino, G., et al. (2017) Time Trend in Hypertension Prevalence, Awareness, Treatment, and Control in a Contemporary Cohort of HIV-Infected Patients: The HIV and Hypertension Study. Journal of Hypertension, 35, 409-416. https://doi.org/10.1097/HJH.0000000000001150
[20]
Krauskopf, K., Natta, M.L.V., Danis, R.P., Gangaputra, S., Ackatz, L., Addessi, A., et al. (2013) Correlates of Hypertension in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy. Journal of the International Association of Providers of AIDS Care, 12, 325-333. https://doi.org/10.1177/2325957413491432
[21]
Okeke, N.L., Davy, T., Eron, J.J. and Napravnik, S. (2016) Hypertension among HIV-Infected Patients in Clinical Care, 1996-2013. Clinical Infectious Diseases, 63, 242-248. https://doi.org/10.1093/cid/ciw223
[22]
Okello, S., Kanyesigye, M., Muyindike, W.R., Annex, B.H., Hunt, P.W., Haneuse, S., et al. (2015) Incidence and Predictors of Hypertension in Adults with HIV Initiating Antiretroviral Therapy in Southwestern Uganda. Journal of Hypertension, 33, 2039-2045. https://doi.org/10.1097/HJH.0000000000000657
[23]
RodríGuez-Arbolí, E., Mwamelo, K., Kalinjuma, A.V., Furrer, H., Hatz, C., Tanner, M., et al. (2017) Incidence and Risk Factors for Hypertension among HIV Patients in Rural Tanzania—A Prospective Cohort Study. PLOS ONE, 12, e0172089. https://doi.org/10.1371/journal.pone.0172089
[24]
Mutemwa, M., Peer, N., De Villiers, A., Mukasa, B., Matsha, T.E., Mills, E.J. and Kengne, A.P. (2018) Prevalence, Detection, Treatment, and Control of Hypertension in Human Immunodeficiency Virus (HIV)-Infected Patients Attending HIV Clinics in the Western Cape Province, South Africa. Medicine (Baltimore), 97, e12121. https://doi.org/10.1097/MD.0000000000012121
[25]
Bauer, S., Wa Mwanza, M., Chilengi, R., et al. (2017) Awareness and Management of Elevated Blood Pressure among Human Immunodeficiency Virus-Infected Adults Receiving Antiretroviral Therapy in Urban Zambia: A Call to Action. Global Health Action, 10, Article ID: 1359923. https://doi.org/10.1080/16549716.2017.1359923
[26]
Bloomfield, G.S., Hogan, J.W., Keter, A., Sang, E., Carter, E.J., Velazquez, E.J. and Kimaiyo, S. (2011) Hypertension and Obesity as Cardiovascular Risk Factors among HIV Seropositive Patients in Western Kenya. PLOS ONE, 6, e0022288. https://doi.org/10.1371/journal.pone.0022288
[27]
Venkatesh, U., Grover, A., Vignitha, B., Ghai, G., Malhotra, S., Kishore, J., Jaswal, N., Yashwanth, R.D., Durga, R., Goel, S. and Kishore, S. (2022) Urban-Rural Disparities in Blood Pressure and Lifestyle Risk Factors of Hypertension among Indian Individuals. Journal of Family Medicine and Primary Care, 11, 5746-5756. https://doi.org/10.4103/jfmpc.jfmpc_573_22
[28]
Ruamtawee, W., Tipayamongkholgul, M., Aimyong, N., et al. (2023) Prevalence and Risk Factors of Cardiovascular Disease among People Living with HIV in the Asia-Pacific Region: A Systematic Review. BMC Public Health, 23, Article No. 477. https://doi.org/10.1186/s12889-023-15321-7
[29]
Wikipedia. Demograpy of Nasarawa State. https://en.wikipedia.org/wiki/nasarawa_state
[30]
FMOH. Nigeria HIV/AIDS Indicator and Impact Survey Report. https://www.naiis.ng/
[31]
Wikipedia. Demography of Karu LGA. https://en.wikipedia.org/wiki/karu_lga
[32]
Wikipedia. Demography of Lafia LGA. https://en.wikipedia.org/wiki/lafia
[33]
Wikipedia. Demography of Toto LGA. https://en.wikipedia.org/wiki/toto,_nigeria
[34]
Oyawa, I., Adhiambo, M., Wesonga, B., Wanzala, M., Adungo, F., Makwaga, O. and Mwau, M. (2022) Burden of Hypertension and Associated Factors among HIV-Positive Adults in Busia County, Kenya. The Pan African Medical Journal, 43, Article No. 143. https://doi.org/10.11604/pamj.2022.43.143.36394
[35]
Sarfo, F.S., Nichols, M., Singh, A., et al. (2019) Characteristics of Hypertension among People Living with HIV in Ghana: Impact of New Hypertension Guideline. The Journal of Clinical Hypertension, 21, 838-850. https://doi.org/10.1111/jch.13561
[36]
Adeke, A.S., Chori, B.S., Neupane, D., et al. (2022) Socio-Demographic and Lifestyle Factors Associated with Hypertension in Nigeria: Results from a Country-Wide Survey. Journal of Human Hypertension. https://doi.org/10.1038/s41371-022-00673-1
[37]
Singh, S., Shankar, R. and Singh, G.P. (2017) Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. International Journal of Hypertension, 2017, Article ID: 5491834. https://doi.org/10.1155/2017/5491838
[38]
Mbuthia, G.W., Magutah, K. and McGarvey, S.T. (2021) The Prevalence and Associated Factors of Hypertension among HIV Patients. International Journal of Hypertension, 2021, Article ID: 5544916. https://doi.org/10.1155/2021/5544916
[39]
Tegegne, K.D., Adela, G.A., Kassie, G.A., et al. (2023) Prevalence and Factors Associated with Hypertension among Peoples Living with HIV in East Africa, A Systematic Review and Meta-Analysis. BMC Infectious Diseases, 23, Article No. 724. https://doi.org/10.1186/s12879-023-08679-x
[40]
Ya’u, S. and Martin, O. (2023) HIV-Hypertension Comorbidity, Associated Factors and Treatment Option among HIV Patients Attending Katsina General Hospital, Katsina State Nigeria. International Journal of Science for Global Sustainability, 9, 199-205. https://doi.org/10.57233/ijsgs.v9i2.480
[41]
Nimi, B.M., Mbenza, B.L., Nzuzi, C.N., et al. (2021) Hypertension in HIV-Infected Patients at Boma Hospital in Democratic Republic of the Congo. International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 7, 1-7. https://doi.org/10.11648/j.ijhpebs.20210701.11
