Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda

Samson Okello, Michael Kanyesigye, Winnie R. Muyindike, Brian Herb Annex, Peter W. Hunt, Sebastien Haneuse, Mark Jacob Siedner

Research output: Contribution to journalArticle

Abstract

Objective: The successful scale-up of antiretroviral therapy (ART) in sub-Saharan Africa has led to increasing life expectancy, and thus increased risk of hypertension. We aimed to describe the incidence and predictors of hypertension in HIV patients receiving ART at a publicly funded clinic in rural Uganda. Methods: We abstracted data from medical records of adult patients who initiated ART at an HIV clinic in south-western Uganda during 2010-2012. We defined hypertension as at least two consecutive clinical visits, with a SBP at least 140 mmHg and/or SBP of at least 90 mmHg, or prescription for an antihypertensive medication. We calculated the incidence of hypertension and fit multivariable Cox proportional-hazards models to identify predictors of hypertension. Results: A total of 3389 patients initiated ART without a prior diagnosis of hypertension during the observation period. Over 3990 person-years of follow-up, 445 patients developed hypertension, for a crude incidence of 111.5/1000 (95% confidence interval 101.9-121.7) person-years. Rates were highest among men aged at least 40 years (158.8per/1000 person-years) and lowest in women aged 30-39 years (80/1000 person-years). Lower CD4 + cell count at ART initiation, as well as traditional risk factors including male sex, increasing age, and obesity, were independently associated with hypertension. Conclusion: We observed a high incidence of hypertension in HIV-infected persons on ART in rural Uganda, and increased risk with lower nadir CD4 + cell counts. Our findings call for increased attention to screening of and treatment for hypertension, along with continued prioritization of early ART initiation.

Original languageEnglish (US)
Pages (from-to)2039-2045
Number of pages7
JournalJournal of hypertension
Volume33
Issue number10
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Uganda
HIV
Hypertension
Incidence
Therapeutics
CD4 Lymphocyte Count
Africa South of the Sahara
Secondary Prevention
Life Expectancy
Proportional Hazards Models
Antihypertensive Agents
Medical Records
Prescriptions
Obesity
Observation
Confidence Intervals

Keywords

  • aging
  • antiretroviral therapy
  • HIV/AIDS
  • hypertension
  • noncommunicable disease
  • sub-Saharan Africa

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Okello, S., Kanyesigye, M., Muyindike, W. R., Annex, B. H., Hunt, P. W., Haneuse, S., & Siedner, M. J. (2015). Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda. Journal of hypertension, 33(10), 2039-2045. https://doi.org/10.1097/HJH.0000000000000657

Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda. / Okello, Samson; Kanyesigye, Michael; Muyindike, Winnie R.; Annex, Brian Herb; Hunt, Peter W.; Haneuse, Sebastien; Siedner, Mark Jacob.

In: Journal of hypertension, Vol. 33, No. 10, 01.01.2015, p. 2039-2045.

Research output: Contribution to journalArticle

Okello, S, Kanyesigye, M, Muyindike, WR, Annex, BH, Hunt, PW, Haneuse, S & Siedner, MJ 2015, 'Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda', Journal of hypertension, vol. 33, no. 10, pp. 2039-2045. https://doi.org/10.1097/HJH.0000000000000657
Okello, Samson ; Kanyesigye, Michael ; Muyindike, Winnie R. ; Annex, Brian Herb ; Hunt, Peter W. ; Haneuse, Sebastien ; Siedner, Mark Jacob. / Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda. In: Journal of hypertension. 2015 ; Vol. 33, No. 10. pp. 2039-2045.
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