Charles Muiruri1,2,3, Bahati Wajanga4,5, Christine Kim6, Brandon A Knettel7,8, Carl J Mhina9,10, John A Bartlett7,10, Jamal J Msangi4, Msabah A Msabah4, Helene Vilme9, Samuel Kalluvya4,5. 1. Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St., Suite 210, Durham, NC, 27701, USA. charles.muiruri@duke.edu. 2. Duke Global Health Institute, Duke University, Durham, NC, USA. charles.muiruri@duke.edu. 3. Kilimanjaro Christian Medical University College, Moshi, Tanzania. charles.muiruri@duke.edu. 4. Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania. 5. Department of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania. 6. Department of Health Policy and Management, University of North Carolina Chapel Hill, Chapel Hill, NC, USA. 7. Duke Global Health Institute, Duke University, Durham, NC, USA. 8. Duke University School of Nursing, Durham, NC, USA. 9. Department of Population Health Sciences, Duke University School of Medicine, 215 Morris St., Suite 210, Durham, NC, 27701, USA. 10. Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Abstract
PURPOSE OF REVIEW: The objective of this study was to describe the increasing incidence and risk of cardiovascular disease among persons living with HIV (PLWH) in Sub-Saharan Africa. We also used data to compare hypertension (a common NCD among PLWH) outcomes between PLWH and HIV-uninfected individuals among older adults in Northwestern Tanzania. RECENT FINDINGS: Hypertension is increasingly common in Sub-Saharan Africa and a leading cause of cardiovascular disease for PLWH. Among those with hypertension, PLWH have a 50% higher risk of incident myocardial infarction compared to the general population. In response to the rising incidence of these non-communicable diseases (NCDs) among PLWH, recently, the Joint United Nations Program on HIV/AIDS supported the integration of NCD care into routine clinical care for HIV. However, data are lacking on levels of awareness of hypertension status, diagnosis, and antihypertensive medication adherence. Given the higher likelihood of elevated blood pressure among PLWH, there is an urgent need to implement interventions to improve blood pressure control in this population. Researchers should evaluate treatment barriers at multiple levels including health system, healthcare providers, and patients' level and tailor evidence-based interventions to increase achievement of blood pressure control for PLWH.
PURPOSE OF REVIEW: The objective of this study was to describe the increasing incidence and risk of cardiovascular disease among persons living with HIV (PLWH) in Sub-Saharan Africa. We also used data to compare hypertension (a common NCD among PLWH) outcomes between PLWH and HIV-uninfected individuals among older adults in Northwestern Tanzania. RECENT FINDINGS: Hypertension is increasingly common in Sub-Saharan Africa and a leading cause of cardiovascular disease for PLWH. Among those with hypertension, PLWH have a 50% higher risk of incident myocardial infarction compared to the general population. In response to the rising incidence of these non-communicable diseases (NCDs) among PLWH, recently, the Joint United Nations Program on HIV/AIDS supported the integration of NCD care into routine clinical care for HIV. However, data are lacking on levels of awareness of hypertension status, diagnosis, and antihypertensive medication adherence. Given the higher likelihood of elevated blood pressure among PLWH, there is an urgent need to implement interventions to improve blood pressure control in this population. Researchers should evaluate treatment barriers at multiple levels including health system, healthcare providers, and patients' level and tailor evidence-based interventions to increase achievement of blood pressure control for PLWH.
Authors: Charles Muiruri; Preeti Manavalan; Shelley A Jazowski; Brandon A Knettel; Helene Vilme; Leah L Zullig Journal: Curr Hypertens Rep Date: 2019-08-26 Impact factor: 5.369
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