Anastase Dzudie1,2,3,4, Donald Hoover5, Hae-Young Kim6, Rogers Ajeh1, Adebola Adedimeji7, Qiuhu Shi6, Walter Pefura Yone2,8, Denis Nsame Nforniwe9, Kinge Thompson Njie10, Andre Pascal Kengne1,11, Peter Vanes Ebasone1, Blaise Barche1, Zoung-Kany Bissek Anne Cecile2,12, Denis Nash13,14, Marcel Yotebieng15, Kathryn Anastos6,15. 1. Clinical Research Education, Networking and Consultancy, Yaounde, Cameroon. 2. Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon. 3. Service of Internal Medicine, Douala General Hospital, Douala, Cameroon. 4. Department of Global Health and Population, Lown Scholars Program, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America. 5. Department of Statistics and Institute for Health, Health Care Policy and Aging Research, Rutgers the State University of New Jersey, New Brunswick, New Jersey, United States of America. 6. Department of Public Health, New York Medical College, Valhalla, New York, United States of America. 7. Department of Epidemiology and Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States of America. 8. Jamot Hospital, Yaounde, Cameroon. 9. Limbe Regional Hospital, Limbe, Cameroon. 10. Bamenda Regional Hospital, Bamenda, Cameroon. 11. South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, South Africa. 12. Division of Operational Health Research (DROS), Ministry of Public Health (MSP), Yaounde, Cameroon. 13. Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, New York, United States of America. 14. Department of Epidemiology and Biostatistics, Graduate School of Public Health, City University of New York, New York, New York, United States of America. 15. Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, United States of America.
Abstract
BACKGROUND: Antiretroviral therapy (ART) success has led people to live longer with HIV/AIDS (PLWH) and thus be exposed to increasing risk of cardiovascular diseases (CVD). Hypertension (HTN), the biggest contributor to CVD burden, is a growing concern among PLWH. The current report describes the prevalence and predictors of HTN among PLWH in care in Cameroon. METHODS: This cross-sectional study included all PLWH aged 20 years and above who received care between 2016 and 2019 at one of the three Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA) sites in Cameroon (Bamenda, Limbe, and Yaoundé). HTN was defined as blood pressure (BP) ≥140/90 mm Hg or self-reported use of antihypertensive medication. Logistic regressions models examined the relationship between HTN and clinical characteristics, and HIV-related factors. RESULTS: Among 9,839 eligible PLWH, 66.2% were women and 25.0% had prevalent HTN [age-standardized prevalence 23.9% (95% CI: 22.2-25.6)], among whom 28 (1.1%) were on BP lowering treatment, and 6 of those (21.4%) were at target BP levels. Median age (47.4 vs. 40.5 years), self-reported duration of HIV infection (5.1 vs 2.8 years years), duration of ART exposure (4.7 vs 2.3 years), and CD4 count (408 vs 359 cell/mm3) were higher in hypertensives than non-hypertensives (all p<0.001). Age and body mass index (BMI) were independently associated with higher prevalent HTN risk. PLWH starting ART had a 30% lower risk of prevalent HTN, but this advantage disappeared after a cumulative 2-year exposure to ART. There was no significant association between other HIV predictive characteristics and HTN. CONCLUSION: About a quarter of these Cameroonian PLWH had HTN, driven among others by age and adiposity. Appropriate integration of HIV and NCDs services is needed to improve early detection, treatment and control of common comorbid NCD risk factors like hypertension and safeguard cardiovascular health in PLWH.
BACKGROUND: Antiretroviral therapy (ART) success has led people to live longer with HIV/AIDS (PLWH) and thus be exposed to increasing risk of cardiovascular diseases (CVD). Hypertension (HTN), the biggest contributor to CVD burden, is a growing concern among PLWH. The current report describes the prevalence and predictors of HTN among PLWH in care in Cameroon. METHODS: This cross-sectional study included all PLWH aged 20 years and above who received care between 2016 and 2019 at one of the three Central Africa International Epidemiology Databases to Evaluate AIDS (CA-IeDEA) sites in Cameroon (Bamenda, Limbe, and Yaoundé). HTN was defined as blood pressure (BP) ≥140/90 mm Hg or self-reported use of antihypertensive medication. Logistic regressions models examined the relationship between HTN and clinical characteristics, and HIV-related factors. RESULTS: Among 9,839 eligible PLWH, 66.2% were women and 25.0% had prevalent HTN [age-standardized prevalence 23.9% (95% CI: 22.2-25.6)], among whom 28 (1.1%) were on BP lowering treatment, and 6 of those (21.4%) were at target BP levels. Median age (47.4 vs. 40.5 years), self-reported duration of HIV infection (5.1 vs 2.8 years years), duration of ART exposure (4.7 vs 2.3 years), and CD4 count (408 vs 359 cell/mm3) were higher in hypertensives than non-hypertensives (all p<0.001). Age and body mass index (BMI) were independently associated with higher prevalent HTN risk. PLWH starting ART had a 30% lower risk of prevalent HTN, but this advantage disappeared after a cumulative 2-year exposure to ART. There was no significant association between other HIV predictive characteristics and HTN. CONCLUSION: About a quarter of these Cameroonian PLWH had HTN, driven among others by age and adiposity. Appropriate integration of HIV and NCDs services is needed to improve early detection, treatment and control of common comorbid NCD risk factors like hypertension and safeguard cardiovascular health in PLWH.
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