Hypertension and Associated Factors among patients on HIV antiretroviral therapy at Korle-Bu Teaching Hospital

Abstract

Background: The chronic nature of HIV infection requires lifelong Antiretroviral Therapy (ART) to continuously suppress HIV viral replication, reducing morbidity and mortality. Management of co-morbidities is one of the major challenges associated with the multi-drug regimens used for HIV therapy. Hypertension as a co-morbidity in Persons Living with HIV (PLHIV) has become an important public health challenge and importantly influence patient management and service delivery at HIV clinics. This study determined the prevalence of hypertension among patients attending HIV clinic at the Korle-bu Teaching Hospital (KBTH) and also explored the nature of the relationship between HIV/ART and hypertension in order to help identify individuals who could benefit from interventions to prevent or delay the onset of complications of hypertension and thereby improve the overall quality of life of PLHIV Methods: A simple random sampling technique was used to recruit study participants based on the routine clinic attendance sample frame. A questionnaire adapted from WHO STEPwise approach to chronic disease risk-factor surveillance was modified and used for the collection of study participants' data. The prevalence of hypertension was estimated among study participants. Socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling using the purposeful selection of covariates method. Results: A total of 311 PLHIV were recruited as study participants. The present study revealed that the prevalence of hypertension in patients attending HIV clinic at KBTH was 36.7% and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2 , total cholesterol level ≥5.17 mmol/L, exposure to ART and increasing duration of ART exposure. Conclusion: This study shows a high prevalence of hypertension among patients attending HIV clinic at KBTH which is associated with exposure to Antiretroviral Therapy and increasing duration of this exposure. Blood pressure monitoring should move from being routine at the HIV clinic to more purposeful screening of patients for hypertension. Patients should be encouraged to have regular blood pressure measurements at home and not only when they visit HIV clinic.