Hypertension among people living with human immunodeficiency virus in sub-Saharan Africa: a systematic review and meta-analysis.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
23 Jul 2024
23 Jul 2024
Historique:
received:
09
12
2023
accepted:
15
07
2024
medline:
23
7
2024
pubmed:
23
7
2024
entrez:
22
7
2024
Statut:
epublish
Résumé
We performed a systematic review and meta-analysis of hypertension in people living with human immunodeficiency virus (HIV) in sub-Saharan Africa (SSA). We searched the PubMed, Google Scholar, African Index Medicus, and Embase databases to identify studies published from January 1, 2010, to December 31, 2021. We used a random-effects model to estimate the pooled prevalence of hypertension and mean SBP/DBP level on a sex-specific basis. We included 48 studies reporting data on a pooled sample of 193,843 people living with HIV (PLW-HIV) in SSA. The pooled mean SBP/DBP level was 120 (95% CI 113-128)/77 (95%CI 72-82) mmHg, while the overall pooled prevalence of hypertension was 21.9% (95% CI 19.9-23.9%). Further meta-regression analyses suggested that the prevalence of hypertension was 1.33 times greater in males, 1.23 times greater in individuals receiving antiretroviral therapy (ART) and 1.45 times greater in those individuals with a CD4-count ≥ 200. This meta-analysis of the contemporary pattern of BP levels among PLW-HIV in SSA, suggests that around one in five of such individuals also have hypertension. Given the further context of greater access to ART and subsequently greater longevity, study findings support calls to integrate cardiovascular management into routine HIV care.
Identifiants
pubmed: 39039244
doi: 10.1038/s41598-024-67703-5
pii: 10.1038/s41598-024-67703-5
doi:
Types de publication
Journal Article
Systematic Review
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
16858Subventions
Organisme : National Health and Medical Research Council of Australia
ID : GNT1135894
Informations de copyright
© 2024. The Author(s).
Références
Nsanzimana, S. & Mills, E. J. Estimating HIV incidence in sub-Saharan Africa. Lancet HIV 10(3), e146–e148 (2023).
pubmed: 36702150
doi: 10.1016/S2352-3018(22)00366-6
Palacios, R. et al. Impact of highly active antiretroviral therapy on blood pressure in HIV-infected patients: A prospective study in a cohort of naive patients. HIV Med. 7(1), 10–15 (2006).
pubmed: 16313287
doi: 10.1111/j.1468-1293.2005.00333.x
Okello, S. et al. Association between HIV and blood pressure in adults and role of body weight as a mediator: Cross-sectional study in Uganda. J. Clin. Hypertens. (Greenwich) 19(11), 1181–1191 (2017).
pubmed: 28895288
doi: 10.1111/jch.13092
Dobe, I. et al. Patterns of cardiovascular risk and disease in HIV-positive adults on anti-retroviral therapy in Mozambique. Cardiovasc. J. Afr. 31(4), 190–195 (2020).
pubmed: 32634198
doi: 10.5830/CVJA-2020-007
Isaac Derick, K. & Khan, Z. Prevalence, awareness, treatment, control of hypertension, and availability of hypertension services for patients living with human immunodeficiency virus (HIV) in Sub-Saharan Africa (SSA): A systematic review and meta-analysis. Cureus 15(4), e37422 (2023).
pubmed: 37182060
pmcid: 10173023
Chen, A. et al. Elevated blood pressure among adolescents in sub-Saharan Africa: A systematic review and meta-analysis. Lancet Glob. Health 11(8), e1238–e1248 (2023).
pubmed: 37474231
doi: 10.1016/S2214-109X(23)00218-8
Guwatudde, D. et al. The burden of hypertension in sub-Saharan Africa: A four-country cross sectional study. BMC Public Health 15, 1211 (2015).
pubmed: 26637309
pmcid: 4670543
doi: 10.1186/s12889-015-2546-z
Keates, A. K. et al. Cardiovascular disease in Africa: Epidemiological profile and challenges. Nat. Rev. Cardiol. 14(5), 273–293 (2017).
pubmed: 28230175
doi: 10.1038/nrcardio.2017.19
da Cunha, J. et al. Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: Old and new drugs. World J. Virol. 4(2), 56–77 (2015).
pubmed: 25964872
pmcid: 4419122
doi: 10.5501/wjv.v4.i2.56
Stewart, S. et al. The clinical consequences and challenges of hypertension in urban-dwelling black Africans: Insights from the Heart of Soweto Study. Int. J. Cardiol. 146(1), 22–27 (2011).
pubmed: 19560221
doi: 10.1016/j.ijcard.2009.05.061
Sliwa, K. et al. Contribution of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic to de novo presentations of heart disease in the Heart of Soweto Study cohort. Eur. Heart J. 33(7), 866–874 (2012).
pubmed: 22048682
doi: 10.1093/eurheartj/ehr398
Thienemann, F. et al. The causes, treatment, and outcome of pulmonary hypertension in Africa: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) Registry. Int. J. Cardiol. 221, 205–211 (2016).
pubmed: 27404676
doi: 10.1016/j.ijcard.2016.06.242
Kanters, S. et al. Evidence synthesis evaluating body weight gain among people treating HIV with antiretroviral therapy—A systematic literature review and network meta-analysis. EClinicalMedicine 48, 101412 (2022).
pubmed: 35706487
pmcid: 9112095
doi: 10.1016/j.eclinm.2022.101412
Hoy, D. et al. Assessing risk of bias in prevalence studies: Modification of an existing tool and evidence of interrater agreement. J. Clin. Epidemiol. 65(9), 934–939 (2012).
pubmed: 22742910
doi: 10.1016/j.jclinepi.2011.11.014
Kharsany, A. B. & Karim, Q. A. HIV infection and AIDS in Sub-Saharan Africa: Current status. Chall. Opportun. Open AIDS J. 10, 34–48 (2016).
doi: 10.2174/1874613601610010034
Page, M. J. et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 372, n71 (2021).
pubmed: 33782057
pmcid: 8005924
doi: 10.1136/bmj.n71
Amare, H. et al. Predictors of glucose metabolism and blood pressure among Ethiopian individuals with HIV/AIDS after one-year of antiretroviral therapy. Trop. Med. Int. Health 26(4), 428–434 (2021).
pubmed: 33405245
doi: 10.1111/tmi.13544
Ataro, Z. et al. Magnitude and associated factors of diabetes mellitus and hypertension among adult HIV-positive individuals receiving highly active antiretroviral therapy at Jugal Hospital, Harar, Ethiopia. HIV AIDS (Auckl) 10, 181–192 (2018).
pubmed: 30349400
pmcid: 6190641
Bengtson, A. M. et al. High blood pressure at entry into antenatal care and birth outcomes among a cohort of HIV-uninfected women and women living with HIV initiating antiretroviral therapy in South Africa. Pregnancy Hypertens. 23, 79–86 (2021).
pubmed: 33285444
doi: 10.1016/j.preghy.2020.11.005
Benzekri, N. A. et al. Increasing prevalence of hypertension among HIV-positive and negative adults in Senegal, West Africa, 1994–2015. PLoS One 13(12), e0208635 (2018).
pubmed: 30596667
pmcid: 6312281
doi: 10.1371/journal.pone.0208635
Bloomfield, G. S. et al. Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya. PLoS One 6(7), e22288 (2011).
pubmed: 21779407
pmcid: 3136516
doi: 10.1371/journal.pone.0022288
Brennan, A. T. et al. Prevalence, incidence, predictors, treatment, and control of hypertension among HIV-positive adults on antiretroviral treatment in public sector treatment programs in South Africa. PLoS One 13(10), e0204020 (2018).
pubmed: 30281618
pmcid: 6169897
doi: 10.1371/journal.pone.0204020
Chepchirchir, A., Jaoko, W. & Nyagol, J. Risk indicators and effects of hypertension on HIV/AIDS disease progression among patients seen at Kenyatta hospital HIV care center. AIDS Care 30(5), 544–550 (2018).
pubmed: 28990417
doi: 10.1080/09540121.2017.1384533
Chiwandire, N. et al. Trends, prevalence and factors associated with hypertension and diabetes among South African adults living with HIV, 2005–2017. BMC Public Health 21(1), 462 (2021).
pubmed: 33676478
pmcid: 7937211
doi: 10.1186/s12889-021-10502-8
Dimala, C. A. et al. Prevalence of Hypertension in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) compared with HAART-naive patients at the Limbe Regional Hospital, Cameroon. PLoS One 11(2), e0148100 (2016).
pubmed: 26862763
pmcid: 4749660
doi: 10.1371/journal.pone.0148100
Diouf, A. et al. Diabetes and hypertension among patients receiving antiretroviral treatment since 1998 in Senegal: Prevalence and associated factors. ISRN AIDS 2012, 621565 (2012).
pubmed: 24052880
pmcid: 3767342
doi: 10.5402/2012/621565
Divala, O. H. et al. The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care: Consequences for integrated services. BMC Public Health 16(1), 1243 (2016).
pubmed: 27955664
pmcid: 5153818
doi: 10.1186/s12889-016-3916-x
Dzudie, A. et al. Hypertension among people living with HIV/AIDS in Cameroon: A cross-sectional analysis from Central Africa International Epidemiology Databases to Evaluate AIDS. PLoS One 16(7), e0253742 (2021).
pubmed: 34292956
pmcid: 8297808
doi: 10.1371/journal.pone.0253742
Fiseha, T. et al. Hypertension in HIV-infected patients receiving antiretroviral therapy in northeast Ethiopia. Int. J. Hypertens. 2019, 4103604 (2019).
pubmed: 31929895
pmcid: 6942833
doi: 10.1155/2019/4103604
Gebrie, A. Hypertension among people living with human immunodeficiency virus receiving care at referral hospitals of Northwest Ethiopia: A cross-sectional study. PLoS One 15(8), e0238114 (2020).
pubmed: 32822432
pmcid: 7446815
doi: 10.1371/journal.pone.0238114
Getahun, Z. et al. Comorbidity of HIV, hypertension, and diabetes and associated factors among people receiving antiretroviral therapy in Bahir Dar city, Ethiopia. J. Comorb. 10, 2235042X19899319 (2020).
Gonah, L., Moodley, I. & Hlongwana, K. Prevalence of diabetes mellitus and hypertension in people living with human immunodeficiency virus on antiretroviral therapy in Gweru district, Zimbabwe. Afr. J. Prim. Health Care Fam. Med. 12(1), e1–e6 (2020).
pubmed: 33181877
doi: 10.4102/phcfm.v12i1.2473
Hoffman, R. M. et al. High rates of uncontrolled blood pressure in Malawian adults living with HIV and hypertension. Glob. Heart 16(1), 81 (2021).
pubmed: 34909372
pmcid: 8663744
doi: 10.5334/gh.1081
Isa, S. E. et al. Hypertension in treated and untreated patients with HIV: a study from 2011 to 2013 at the Jos University Teaching Hospital, Nigeria. Trans. R Soc. Trop. Med. Hyg. 111(4), 172–177 (2017).
pubmed: 28673018
pmcid: 6257023
doi: 10.1093/trstmh/trx030
Kalyesubula, R. et al. Trends and level of control of hypertension among adults attending an ambulatory HIV clinic in Kampala, Uganda: A retrospective study. BMJ Glob. Health 1(3), e000055 (2016).
pubmed: 28588953
pmcid: 5321354
doi: 10.1136/bmjgh-2016-000055
Kasper, P. et al. 24-h-ambulatory blood pressure monitoring in sub-Saharan Africa: Hypertension phenotypes and dipping patterns in Malawian HIV+ patients on antiretroviral therapy. Glob. Heart 16(1), 67 (2021).
pubmed: 34692392
pmcid: 8516010
doi: 10.5334/gh.945
Kwarisiima, D. et al. Population-based assessment of hypertension epidemiology and risk factors among HIV-positive and general populations in rural Uganda. PLoS One 11(5), e0156309 (2016).
pubmed: 27232186
pmcid: 4883789
doi: 10.1371/journal.pone.0156309
Lubega, G. et al. Prevalence and factors associated with hypertension among people living with HIV/AIDS on antiretroviral therapy in Uganda. Pan Afr. Med. J. 38, 216 (2021).
pubmed: 34046122
pmcid: 8140674
doi: 10.11604/pamj.2021.38.216.28034
Malaza, A. et al. Hypertension and obesity in adults living in a high HIV prevalence rural area in South Africa. PLoS One 7(10), e47761 (2012).
pubmed: 23082211
pmcid: 3474786
doi: 10.1371/journal.pone.0047761
Manne-Goehler, J. et al. The ART advantage: Health care utilization for diabetes and hypertension in rural South Africa. J. Acquir. Immune Defic. Syndr. 75(5), 561–567 (2017).
pubmed: 28696346
pmcid: 5516957
doi: 10.1097/QAI.0000000000001445
Manne-Goehler, J. et al. Hypertension and diabetes control along the HIV care cascade in rural South Africa. J. Int. AIDS Soc. 22(3), e25213 (2019).
pubmed: 30916897
pmcid: 6436499
doi: 10.1002/jia2.25213
Mathabire Rucker, S. C. et al. High rates of hypertension, diabetes, elevated low-density lipoprotein cholesterol, and cardiovascular disease risk factors in HIV-infected patients in Malawi. AIDS 32(2), 253–260 (2018).
pubmed: 29135581
doi: 10.1097/QAD.0000000000001700
Memiah, P. et al. Hypertension and associated inflammatory markers among HIV-infected patients in Tanzania. J. Interferon Cytokine Res. 41(8), 291–301 (2021).
pubmed: 34410876
doi: 10.1089/jir.2021.0059
Muddu, M. et al. Integrated hypertension and HIV care cascades in an HIV treatment program in eastern Uganda: A retrospective cohort study. J. Acquir. Immune Defic. Syndr. 81(5), 552–561 (2019).
pubmed: 31045649
pmcid: 6625912
doi: 10.1097/QAI.0000000000002067
Mulugeta, H. et al. Incidence and predictors of hypertension among HIV patients receiving ART at public health facilities, northwest Ethiopia: A one-year multicenter prospective follow-up study. HIV AIDS (Auckl) 13, 889–901 (2021).
pubmed: 34526825
Musekwa, R. et al. Prevalence and correlates of hypertension in HIV-positive adults from the Livingstone Central Hospital, Zambia. Pan Afr. Med. J. 39, 237 (2021).
pubmed: 34659610
pmcid: 8498662
doi: 10.11604/pamj.2021.39.237.29718
Mutemwa, M. et al. Prevalence, detection, treatment, and control of hypertension in human immunodeficiency virus (HIV)-infected patients attending HIV clinics in the Western Cape Province, South Africa. Medicine (Baltimore) 97(35), e12121 (2018).
pubmed: 30170445
doi: 10.1097/MD.0000000000012121
Nduka, C. U. et al. Impact of body fat changes in mediating the effects of antiretroviral therapy on blood pressure in HIV-infected persons in a sub-Saharan African setting. Infect. Dis. Poverty 5(1), 55 (2016).
pubmed: 27245216
pmcid: 4888205
doi: 10.1186/s40249-016-0152-7
Niwaha, A. J. et al. Association between blood pressure and HIV status in rural Uganda: Results of cross-sectional analysis. Glob. Heart 16(1), 12 (2021).
pubmed: 33598392
pmcid: 7880004
doi: 10.5334/gh.858
Njelekela, M. et al. Prevalence of hypertension and its associated risk factors among 34,111 HAART naive HIV-infected adults in Dar es Salaam, Tanzania. Int. J. Hypertens. 2016, 5958382 (2016).
pubmed: 27872756
pmcid: 5107235
doi: 10.1155/2016/5958382
Odukoya, O. et al. Behavioral risk factors for hypertension among adults living with HIV accessing care in secondary health facilities in Lagos State, Nigeria. J. Fam. Med. Prim. Care 9(7), 3450–3457 (2020).
doi: 10.4103/jfmpc.jfmpc_544_20
Ogunmola, O. J., Oladosu, O. Y. & Olamoyegun, A. M. Association of hypertension and obesity with HIV and antiretroviral therapy in a rural tertiary health center in Nigeria: A cross-sectional cohort study. Vasc. Health Risk Manag. 10, 129–137 (2014).
pubmed: 24672244
pmcid: 3964169
doi: 10.2147/VHRM.S58449
Okello, S. et al. D-Dimer levels and traditional risk factors are associated with incident hypertension among HIV-infected individuals initiating antiretroviral therapy in Uganda. J. Acquir. Immune Defic. Syndr. 73(4), 396–402 (2016).
pubmed: 27171743
pmcid: 5085880
doi: 10.1097/QAI.0000000000001074
Okello, S. et al. Incidence and predictors of hypertension in adults with HIV-initiating antiretroviral therapy in south-western Uganda. J. Hypertens. 33(10), 2039–2045 (2015).
pubmed: 26431192
pmcid: 4700387
doi: 10.1097/HJH.0000000000000657
Okello, S. et al. Blood pressure trajectories and the mediated effects of body mass index and HIV-related inflammation in a mixed cohort of people with and without HIV in rural Uganda. J. Clin. Hypertens. (Greenwich) 21(8), 1230–1241 (2019).
pubmed: 31278845
doi: 10.1111/jch.13621
Okpa, H. O. et al. Predictors of hypertension in an urban HIV-infected population at the University of Calabar Teaching Hospital, Calabar, Nigeria. HIV AIDS (Auckl) 9, 19–24 (2017).
pubmed: 28243150
Pangmekeh, P. J. et al. Association between highly active antiretroviral therapy (HAART) and hypertension in persons living with HIV/AIDS at the Bamenda regional hospital, Cameroon. Pan Afr. Med. J. 33, 87 (2019).
pubmed: 31489065
pmcid: 6713512
doi: 10.11604/pamj.2019.33.87.15574
Pfaff, C. et al. Early experiences integrating hypertension and diabetes screening and treatment in a human immunodeficiency virus clinic in Malawi. Int. Health 10(6), 495–501 (2018).
pubmed: 30052987
doi: 10.1093/inthealth/ihy049
Rajagopaul, A. & Naidoo, M. Prevalence of diabetes mellitus and hypertension amongst the HIV-positive population at a district hospital in eThekwini, South Africa. Afr. J. Prim. Health Care Fam. Med. 13(1), e1–e6 (2021).
pubmed: 34636608
doi: 10.4102/phcfm.v13i1.2766
Rodriguez-Arboli, E. et al. Incidence and risk factors for hypertension among HIV patients in rural Tanzania—A prospective cohort study. PLoS One 12(3), e0172089 (2017).
pubmed: 28273105
pmcid: 5342176
doi: 10.1371/journal.pone.0172089
Saito, A., Karama, M. & Kamiya, Y. HIV infection, and overweight and hypertension: A cross-sectional study of HIV-infected adults in Western Kenya. Trop. Med. Health 48, 31 (2020).
pubmed: 32398924
pmcid: 7203910
doi: 10.1186/s41182-020-00215-w
Sander, L. D. et al. Hypertension, cardiovascular risk factors and antihypertensive medication utilisation among HIV-infected individuals in Rakai, Uganda. Trop. Med. Int. Health 20(3), 391–396 (2015).
pubmed: 25430847
doi: 10.1111/tmi.12443
Sarfo, F. S. et al. Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline. J. Clin. Hypertens. (Greenwich) 21(6), 838–850 (2019).
pubmed: 31125188
doi: 10.1111/jch.13561
Hyle, E. P. et al. The association between HIV and atherosclerotic cardiovascular disease in sub-Saharan Africa: A systematic review. BMC Public Health 17(1), 954 (2017).
pubmed: 29246206
pmcid: 5732372
doi: 10.1186/s12889-017-4940-1
Abrahams, Z. et al. Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. AIDS Res. Ther. 12, 24 (2015).
pubmed: 26251665
pmcid: 4526419
doi: 10.1186/s12981-015-0065-8
Nzuobontane, D., Ngu, B. K. & Christopher, K. Cardiovascular autonomic dysfunction in Africans infected with human immunodeficiency virus. J. R. Soc. Med. 95(9), 445–447 (2002).
pubmed: 12205208
pmcid: 1279990
doi: 10.1177/014107680209500905
Robles, N. R. et al. Antiretroviral treatment and antihypertensive therapy. Curr. Pharm. Des. 27(40), 4116–4124 (2021).
pubmed: 34784859
doi: 10.2174/1381612827666210810090805
Nduka, C. U. et al. Evidence of increased blood pressure and hypertension risk among people living with HIV on antiretroviral therapy: A systematic review with meta-analysis. J. Hum. Hypertens. 30(6), 355–362 (2016).
pubmed: 26446389
doi: 10.1038/jhh.2015.97
Dorjee, K. et al. Risk of cardiovascular disease associated with exposure to abacavir among individuals with HIV: A systematic review and meta-analyses of results from 17 epidemiologic studies. Int. J. Antimicrob. Agents 52(5), 541–553 (2018).
pubmed: 30040992
pmcid: 7791605
doi: 10.1016/j.ijantimicag.2018.07.010
Harimenshi, D. et al. Hypertension and associated factors in HIV-infected patients receiving antiretroviral treatment in Burundi: A cross-sectional study. Sci. Rep. 12(1), 20509 (2022).
pubmed: 36443478
pmcid: 9705296
doi: 10.1038/s41598-022-24997-7
Dimala, C. A. et al. Association between CD4 cell count and blood pressure and its variation with body mass index categories in HIV-infected patients. Int. J. Hypertens. 2018, 1691474 (2018).
pubmed: 29610680
pmcid: 5828536
doi: 10.1155/2018/1691474
Dillon, D. G. et al. Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: A systematic review and meta-analysis. Int. J. Epidemiol. 42(6), 1754–1771 (2013).
pubmed: 24415610
doi: 10.1093/ije/dyt198
Nuesch, R. et al. Risk of cardiovascular events and blood pressure control in hypertensive HIV-infected patients: Swiss HIV Cohort Study (SHCS). J. Acquir. Immune Defic. Syndr. 62(4), 396–404 (2013).
pubmed: 23288033
doi: 10.1097/QAI.0b013e3182847cd0
Krsak, M. et al. Myocardial infarction, stroke, and mortality in cART-treated HIV patients on statins. AIDS Patient Care STDS 29(6), 307–313 (2015).
pubmed: 25855882
pmcid: 4516911
doi: 10.1089/apc.2014.0309
Yuyun, M. F. et al. Cardiovascular diseases in sub-Saharan Africa compared to high-income countries: An epidemiological perspective. Glob. Heart 15(1), 15 (2020).
pubmed: 32489788
pmcid: 7218780
doi: 10.5334/gh.403
Deaton, A. S. & Tortora, R. People in sub-Saharan Africa rate their health and health care among the lowest in the world. Health Aff. (Millwood) 34(3), 519–527 (2015).
pubmed: 25715657
doi: 10.1377/hlthaff.2014.0798
Kivuyo, S. et al. Integrated management of HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-AFRICA): A pragmatic cluster-randomised, controlled trial. Lancet 402(10409), 1241–1250 (2023).
pubmed: 37805215
doi: 10.1016/S0140-6736(23)01573-8
Challacombe, S. J. Global inequalities in HIV infection. Oral Dis. 26(Suppl 1), 16–21 (2020).
pubmed: 32862524
doi: 10.1111/odi.13386