Magnitude and determinants of Hypertension among people living with HIV attending care and treatment centres in Tabora region, western Tanzania

Abstract

ABSTRACT Background: HIV is associated with an increased risk of hypertension among people living with HIV (PLWHIV). While long-term survival due to ART use has increased the burden of hypertension among PLWHIV, but the burden is not well known especially in remote and less urbanized regions of Tanzania. Objective: This study determined the magnitude and determinants of hypertension among people living with HIV attending care and treatment clinic in the Tabora region. Methodology: A cross-sectional study of 712 PLWHIV aged 18 years and older attending CTC was conducted in twelve randomly selected facilities in Tabora Region in 2024. Data were collected using an interview-administered standardized questionnaire. Hypertension was defined by blood pressure ≥140 or ≥ 90 mmHg. Data were analysed using STATA 15. modified poison regression was used to assess associations between hypertension and independent variables with p value of < 0.05 significant. Ethical approval was obtained from the MUHAS ethical research review board. Results: A total of 712 participants were recruited in the study, of whom 398 (55.9%) female and the mean age (SD) was 45.3 (13.2) years. The overall prevalence of was estimated at 25.8%. Majority 114 (47.05) were aged between 40–59 years. The participants who were aged 60 years older had 17% Increased prevalence of having hypertension with (aPR (95%, CI): 1.17: (1.08 - 1.28) p<0.001)) compared with those with less than 40 years, while those 40 -59 years had 13% increased prevalence of hypertension with (aPR 95%, CI: 1.13(1.10 - 1.19) p<0.01. compared to those with less than 40 years. Those with the history of hypertension had 13% Increased prevalence of hypertension with aPR (95%, CI) 1.13(1.07 - 1.19) p<0.01), compared to those with no family history of hypertension. Those who were obese and overweight had 26% and 12% Increased prevalence of hypertension with aPR (95%, CI): 1.26: (1.11 - 1.42) p<0.001and aPR (95%, CI): 1.12 (1.02 - 1.23) p value of 0.016 compared to those with underweight. Conclusion and Recommendation: Hypertension is higher and the proportional of untreated hypertension among PLWHIV not known. Key factors include, age above 40years, family history of hypertension, obese and overweight which were found to be significantly associated with increased hypertension, while physical activity and viral load count less th20 copies were found to be protective. Recommend lifestyle modification particularly physical activity and weight loss program among PLHIV patients on ART, also integration of HIV care with Hypertension within the routine in the CTCs.