Population-Based Assessment of Hypertension Epidemiology and Risk Factors among HIV-Positive and General Populations in Rural Uganda

PLoS One. 2016 May 27;11(5):e0156309. doi: 10.1371/journal.pone.0156309. eCollection 2016.


Background: Antiretroviral therapy scale-up in Sub-Saharan Africa has created a growing, aging HIV-positive population at risk for non-communicable diseases such as hypertension. However, the prevalence and risk factors for hypertension in this population remain incompletely understood.

Methods: We measured blood pressure and collected demographic data on over 65,000 adults attending multi-disease community health campaigns in 20 rural Ugandan communities (SEARCH Study: NCT01864603). Our objectives were to determine (i) whether HIV is an independent risk factor for hypertension, and (ii) awareness and control of hypertension in HIV-positive adults and the overall population.

Results: Hypertension prevalence was 14% overall, and 11% among HIV-positive individuals. 79% of patients were previously undiagnosed, 85% were not taking medication, and 50% of patients on medication had uncontrolled blood pressure. Multivariate predictors of hypertension included older age, male gender, higher BMI, lack of education, alcohol use, and residence in Eastern Uganda. HIV-negative status was independently associated with higher odds of hypertension (OR 1.2, 95% CI: 1.1-1.4). Viral suppression of HIV did not significantly predict hypertension among HIV-positives.

Significance: The burden of hypertension is substantial and inadequately controlled, both in HIV-positive persons and overall. Universal HIV screening programs could provide counseling, testing, and treatment for hypertension in Sub-Saharan Africa.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • HIV Infections / complications*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypertension / complications*
  • Hypertension / epidemiology*
  • Hypertension / therapy
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Rural Population / statistics & numerical data*
  • Uganda / epidemiology
  • Young Adult