Hypertension among adults enrolled in HIV care in northern Tanzania: comorbidities, cardiovascular risk, and knowledge, attitudes and practices

Pan Afr Med J. 2022 Apr 7:41:285. doi: 10.11604/pamj.2022.41.285.26952. eCollection 2022.

Abstract

Cite this article: Preeti Manavalan et al. Hypertension among adults enrolled in HIV care in northern Tanzania: comorbidities, cardiovascular risk, and knowledge, attitudes and practices. Pan African Medical Journal. 2022;41(285). 10.11604/pamj.2022.41.285.26952.

Introduction: the epidemiology of non-communicable diseases (NCDs) among people living with HIV (PLHIV) in sub-Saharan Africa is poorly described. In this observational study we examined a cohort of hypertensive PLHIV in northern Tanzania and described comorbidities, cardiovascular risk, and hypertension knowledge, attitudes and practices.

Methods: consecutive patients attending an HIV clinic were screened for hypertension; those who met hypertension study criteria were enrolled. Participants completed a hypertension knowledge, attitudes and practices survey, and underwent height, weight, and waist circumference measurements and urine dipstick, fasting blood sugar, and lipid panel analyses. Kidney disease was defined as 1+ proteinuria, diabetes mellitus was defined as fasting glucose >126mg/dL, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk was defined per the Pooled Cohorts Equations.

Results: of 555 screened patients, 105 met hypertension criteria and 91 (86.7%) were enrolled. The prevalence of diabetes mellitus, kidney disease, and overweight or obesity was 8.8%, 28.6%, and 86.7%, respectively. Almost all participants (n=86, 94.5%) had two or more medical comorbidities. More than half (n=39, 52.7%) had intermediate or high 10-year risk for an ASCVD event. While only 3 (3.3%) participants were able to define hypertension correctly, most would seek care at a medical facility (n=89, 97.8%) and take medication chronically for hypertension (n=79, 87.8%).

Conclusion: we found a high burden of medical comorbidity and ASCVD risk among hypertensive PLHIV in northern Tanzania. Integration of routine NCD screening in the HIV clinical setting, in combination with large-scale educational campaigns, has the potential to impact clinical outcomes in this high-risk population.

Keywords: Tanzania; atherosclerotic cardiovascular disease risk; hypertension; non-communicable diseases; sub-Saharan Africa.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Atherosclerosis* / epidemiology
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Comorbidity
  • Diabetes Mellitus* / epidemiology
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Health Knowledge, Attitudes, Practice
  • Heart Disease Risk Factors
  • Humans
  • Hypertension* / epidemiology
  • Prevalence
  • Risk Factors
  • Tanzania / epidemiology