Factors associated with blood pressure control in patients with hypertension and HIV at a large urban HIV clinic in Uganda

Douglas Joseph Musimbaggo*, Isaac Derick Kimera, Christabellah Namugenyi, Jeremy I. Schwartz, Rebecca Ssenyonjo, Fortunate Ambangira, Lubega Kizza, Mary Mbuliro, Rodgers Katwesigye, Isaac Ssinabulya, Martin Muddu, Dinesh Neupane, Michael Hecht Olsen, Manan Pareek, Fred C. Semitala


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Globally, people living with HIV on antiretroviral therapy have an increased risk of cardiovascular disease. Hypertension is the most important preventable risk factor for cardiovascular disease and is associated with increased morbidity. We conducted an exploratory survey with hypertensive persons living with HIV who received integrated HIV and hypertension care in a large clinic in Uganda between August 2019 and March 2020 to determine factors associated with blood pressure control at six months. Controlled blood pressure was defined as <140/90 mmHg. Multivariable logistic regression was used to determine baseline factors associated with blood pressure control after 6 months of antihypertensive treatment. Of the 1061 participants, 644 (62.6%) were female. The mean age (SD) was 51.1 (9.4) years. Most participants were overweight (n = 411, 38.7%) or obese (n = 276, 25.9%), and 98 (8.9%) had diabetes mellitus. Blood pressure control improved from 14.4% at baseline to 66.1% at 6 months. Comorbid diabetes mellitus (odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.26–0.64, p < 0.001) and HIV status disclosure (OR = 0.73, 95% CI = 0.55–0.98, p = 0.037) were associated with the absence of controlled blood pressure at 6 months. In conclusion, comorbid diabetes mellitus and the disclosure of an individual’s HIV status to a close person were associated with poor blood pressure control among persons living with HIV who had hypertension. Therefore, subpopulations of persons living with HIV with hypertension and comorbid diabetes mellitus may require more thorough assessments and intensive antihypertensive management approaches to achieve blood pressure targets.

TidsskriftJournal of Human Hypertension
Antal sider7
StatusE-pub ahead of print - 2022

Bibliografisk note

Funding Information:
The study was funded by Resolve to Save Lives [Grant number: MJAP/VITAL 2019/001].

Funding Information:
The authors acknowledge the support of the staff of the Mulago ISS clinic for the implementation of the study. We would like to acknowledge the support of the Emerging Authors Program for Global Cardiovascular Disease Research, a mentorship collaboration consisting of the Lancet Commission on Hypertension Group, the U.S. Centers for Disease Control and Prevention, Resolve to Save Lives, an initiative of Vital Strategies, and the World Hypertension League. This initiative received support from Bloomberg Philanthropies and Resolve to Save Lives through a grant to the National Foundation for the Centers for Disease Control and Prevention Inc. (CDC Foundation). Resolve to Save Lives is funded by grants from Bloomberg Philanthropies; the Bill and Melinda Gates Foundation; and the Chan Zuckerberg Initiative DAF, an advised fund of Silicon Valley Community Foundation.

Publisher Copyright:
© 2022, The Author(s).


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