Associations between HIV status and self-reported hypertension in a high HIV prevalence sub-Saharan African population: a cross-sectional study

Abstract

Objectives: This study examined whether HIV status and antiretroviral therapy (ART)-exposure were associated with self-reported hypertension in Zimbabwe. Design: Study data were taken from a cross-sectional, general population survey, which included HIV testing (July 2018 – December 2019). Setting: The data were collected in Manicaland Province, Zimbabwe. Participants: 9,780 people aged 15 years and above were included. Outcome measure: Self-reported hypertension was the outcome measure. This was defined as reporting a previous diagnosis of hypertension by a doctor or nurse. After weighting of survey responses by age and sex using household census data, chi-squared tests and logistic regression were used to explore whether HIV status and ART-exposure were associated with self-reported hypertension. Results: The weighted prevalence of self-reported hypertension was 13.6% (95% Confidence Interval: 12.9%-14.2%) and the weighted prevalence of HIV was 11.1% (10.4%-11.7%). In univariable analyses, there was no evidence of a difference in the weighted prevalence of self-reported hypertension between people living with HIV (PLHIV) and HIV-negative people (14.1%, 11.9%-16.3% vs 13.3%, 12.6%-14.0%; p=0.503) or between ART-exposed and ART-naive PLHIV (14.8%, 12.0%-17.7% vs 12.8%, 9.1%-16.4%, p=0.388). Adjusting for socio-demographic variables in logistic regression did not alter this finding (odds ratios: HIV status: 0.88, 0.70-1.10, p=0.261; ART-exposure: 0.83, 0.53-1.30, p=0.411). Conclusions: Approximately one in seven PLHIV self-reported having hypertension, highlighting an important burden of disease. However, no associations were found between HIV status or ART-exposure and self-reported hypertension, suggesting that it will be valuable to focus on managing other risk factors for hypertension in this population. These findings should be fully accounted for as Zimbabwe re-orients its health system towards non-communicable disease control and management.