Prevalence, detection, treatment, and control of hypertension in human immunode?ciency virus (HIV)-infected patients attending HIV clinics in the Western Cape Province, South Africa

13 Aug 2020

Representative data on the prevalence of hypertension, a major non-infectious comorbidity in human immunode?ciency virus (HIV)- infected people, is lacking. We assessed the prevalence, awareness, treatment, and control, as well as determinants of hypertension in HIV-infected adults in South Africa. A cross-sectional survey was conducted between March 2014 and February 2015 in a random sample of 827 adults (77.7% women), receiving care for HIV infection at 17 randomly selected public health facilities across the Western Cape Province, South Africa. Participants? mean age was 38.4 years overall, 41.1 years in men and 37.7 years in women (P < .001). The median diagnosed duration of HIV infection, similar in men and women, was 5 years, while the median CD4 count was 381 cell/mm3. Age-standardized prevalence, awareness, treatment, and control of hypertension was 38.6% (95% CI: 34.3?42.9), 46.3% (37.7?54.9), 76.4% (61.1?91.7), and 81.1% (62.9?99.3) in the overall sample; 40.0% (30.0?50.0), 36.3% (17.6?55.0), 84.8% (38.3?131.3), and 87.0% (38.2? 135.8) in men; and 37.7% (32.9?42.5), 48.9% (38.9?58.9), 75.8% (59.1?92.5), and 81.3% (61.1?101.5) in women. Age and education were weakly associated with prevalent hypertension, while CD4 count and diagnosed duration of HIV infection were unrelated to prevalent hypertension. Similar to reports in the general population in this and other countries in the region, hypertension is frequent in young South Africans receiving care for HIV infection, with similar diagnostic and treatment gaps. Integrating HIV and non-communicable disease (NCD) prevention and care will, at least in part, reduce missed opportunities for implementing NCD prevention in HIV-infected people in care. Abbreviations: ANOVA = analysis of the variance, ART = antiretroviral therapy, BP = blood pressure, CD4 = cluster of differentiation 4, CI = con?dence interval, CVD = cardiovascular disease, HIV = human immunode?ciency virus, NCD = non- communicable disease, NNRTIs = non-nucleoside reverse transcriptase inhibitors, OR = odds ratio, PDA = personal digital assistant, SBP = systolic blood pressure, SD = standard deviation, STEPs = stepwise approach to surveillance, WC = waist circumference, WHO = World Health Organization.