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Hypertension prevalence and Framingham risk score stratification in a large HIV-positive cohort in Uganda

Farrah J Mateen1, Steve Kanters, Robert Kalyesubula

  • 1Department of International Health, the Bloomberg School of Public Health, the Johns Hopkins University, Baltimore, Maryland 21205, USA.

Journal of Hypertension
|April 26, 2013
PubMed

Insights

Hypertension affects nearly 28% of HIV-positive individuals starting antiretroviral therapy in sub-Saharan Africa. Men are at higher risk for cardiovascular disease, necessitating integrated HIV and cardiovascular care.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Assessing hypertension prevalence and cardiovascular disease (CVD) risk in HIV-positive individuals in sub-Saharan Africa.
  • Evaluating outcomes in a large cohort initiating antiretroviral therapy (ART).

Purpose of the Study:

  • To determine the prevalence of hypertension.
  • To project the 10-year absolute risk of CVD.
  • To analyze risk factors in HIV-positive youth and adults in sub-Saharan Africa.

Main Methods:

  • Prospective cohort study of HIV-positive individuals (≥13 years) starting ART.
  • Repeated blood pressure measurements and laboratory tests (cholesterol, CD4 count) over the first year.
  • Hypertension defined by Joint National Committee 7th edition; CVD risk estimated using Framingham Risk Score.

Main Results:

  • Hypertension diagnosed in 27.9% of 5,563 patients; 14.1% had stage 2 hypertension.
  • Age-standardized prevalence in Ugandans (≥13 years) was 24.8%.
  • Among men, 20% had a ≥10% 10-year CVD risk, compared to nearly all women with ≤10% risk.

Conclusions:

  • Integrated HIV treatment and vascular disease prevention are crucial.
  • Noncommunicable disease multimorbidity is a significant concern for HIV-positive individuals.
  • Targeted interventions for men are particularly needed.
Abstract

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