Determining Occurrence of Hypertension Disease & Associated Risk Factors Among Hiv Patients on Anti-Retroviral Treatment in Nairobi County

Abstract

In Sub Saharan Africa region, age-adjusted prevalence of hypertension has exceeded the global index with an estimated prevalence of 30%, it has the highest figures in the world. Even though a lot of evidence indicate raising numbers of cardiovascular diseases in HIV infected persons, there is no clear information on an association between hypertension disease, HIV infection and ARVs. The purpose of the study was to determine occurrence and risk factors associated with hypertension among HIV patients on antiretroviral treatment in Nairobi City County. The specific objectives were to evaluate occurrence of high blood pressure among HIV patients who are on antiretroviral treatment; determine hypertension associated risk factors among HIV patients who are on antiretroviral treatment; determine the effects of exposure to multiple and changing antiretroviral drugs among patients who are on antiretroviral therapy; and determine association of adherence with ARV medicines intake and possible development of hypertension in HIV infected patients on antiretroviral therapy in Nairobi City County. The study adopted cross-sectional research design among 552 HIV infected patients who are enrolled on ART in Nairobi County. They were sampled using stratified and systematic sampling methods. Qualitative and quantitative data was collected whereby questionnaires, observation checklist, weighing scales, Blood pressure machines, stadiometers, tape measure and BMI wheel were instruments that were used to collect data. SPSS was used to analyze data and generate descriptive and inferential statistics including, cox regression, assessed the different variables. Data was presented in text, tabular and graphical form. The study established that the average age was 39 years which a line with advancing age being a risk factor, females were 65% and males 35%. Majority of the participants were married 56% the rest composed of unmarried, separated and widowed. Education: completed primary 43.6%, secondary 39.3%, college 13.8% and non-formal educated 3.3%. The study population as 98.5% predominantly Christians. Hypertension prevalence revealed 14.5%. The risk factor that stood out were age, gender, family history, Body mass index, and waist circumference among the study population, On association blood pressure and family history (P = 0.021) at 95%CI. Blood pressure and gender (P= 0.040) at 95%CI, blood pressure and BMI (P =0.035) at 95%CL and blood pressure and waist circumference (P=0.04) at 95%CL There was also relationship with earnings, large increase in heart rate (physical activity). No link was found with fruit intake, alcohol consumption and cigarette smoking in this study. It also recorded that 92.2% of these study population are on TDF/3TC/DTG (Tenofovir Disoproxil Fumarate/Lamivudine/ Dolutegravir). The study thus concluded that hypertension is public health concern in HIV patients, and integration of services is recommended. Further, it is critical to incorporate thorough cardiovascular monitoring into standard healthcare programs in addition to HIV treatment, given the high frequency of hypertension among HIV-positive patients.