Factors associated with prevalent hypertension among adults living with HIV receiving antiretroviral therapy in Yaounde, Cameroon: a cross-sectional study
摘要
Hypertension is a frequent comorbidity among people living with HIV (PLHIV) in sub-Saharan Africa, but analytical data from routine HIV clinics in Cameroon remain limited. This study assessed factors associated with prevalent hypertension among adults receiving antiretroviral therapy (ART) at an urban HIV clinic in Yaounde, Cameroon.
MethodsWe conducted a cross-sectional study at the Day Hospital of Yaounde Central Hospital between January and March 2024. The analytical dataset included 460 adults living with HIV receiving ART. Prevalent hypertension was coded as a binary outcome. Robust Poisson regression was used to estimate prevalence ratios (PRs) and adjusted prevalence ratios (aPRs) because hypertension was common. Sensitivity models were fitted to clarify the interpretation of cumulative ART duration in relation to current age.
ResultsAmong 460 participants, 199 (43.3%) had prevalent hypertension. The mean age was 50.5 ± 10.9 years, and 338 (73.5%) participants were women. In bivariable analysis, older age (PR per 1-year increase 1.02, 95% CI 1.01–1.03; p < 0.001), longer ART duration (PR per 1-year increase 1.03, 95% CI 1.01–1.05; p < 0.001), family history of hypertension (PR 2.98, 95% CI 2.40–3.71; p < 0.001), HIV stage II at ART initiation (PR 1.29, 95% CI 1.03–1.60; p = 0.024), and obesity (PR 1.43, 95% CI 1.10–1.87; p = 0.007) were associated with hypertension. In the final multivariable model, older age (aPR 1.02, 95% CI 1.01–1.03; p = 0.002), family history of hypertension (aPR 2.83, 95% CI 2.25–3.57; p < 0.001), and obesity (aPR 1.29, 95% CI 1.01–1.65; p = 0.045) remained independently associated with prevalent hypertension, whereas cumulative ART duration was not independently associated after adjustment (aPR 1.00, 95% CI 0.99–1.02; p = 0.619). Restricted cubic spline analysis did not show evidence of an overall association or non-linearity for ART duration.
ConclusionsIn this urban HIV clinic, hypertension was frequent and was associated mainly with age, family history of hypertension, and obesity in the adjusted model. Cumulative ART duration was associated with hypertension in crude or minimally adjusted models but not after adjustment for age and cardiometabolic factors. These findings support integrating routine blood-pressure screening, weight management, lifestyle counselling, and standardized hypertension care into HIV services.