Increasing prevalence of hypertension among HIV-positive and negative adults in Senegal, West Africa, 1994-2015

Abstract

Background Non-communicable diseases, including hypertension (HTN), are increasingly recognized as important causes of morbidity and mortality among people living with HIV (PLHIV) in resource-limited settings. The goals of this study were to determine the prevalence of HTN among PLHIV in Senegal over time and to identify predictors of HTN among HIV-positive versus HIV-negative adults. Methods We conducted a retrospective study using data from individuals enrolled in previous studies in Senegal from 1994–2015. Blood pressure (BP) measurements taken during study visits were used for analysis. HTN was defined as systolic BP140 or diastolic BP90. We used logistic regression to identify predictors of HTN. Results We analyzed data from 2848 adults (1687 HIV-positive, 1161 HIV-negative). Among PLHIV, the prevalence of HTN increased from 11% during 1994–1999 to 22% during 2010–2015. Among HIV-negative individuals, the prevalence of HTN increased from 16% to 32%. Among both groups, the odds of HTN more than doubled from 1994–1999 to 2010–2015 (HIV-positive OR 24, 95% CI 11–50; HIV-negative OR 26, 95% CI 15–46). One quarter of all individuals with HTN had stage 2 HTN. The strongest risk factor for HTN was obesity (HIV-positive OR 32, 95% CI 17–58; p<001; HIV-negative OR 78, 95% CI 45–136; p<001). Male sex and age 50 were also predictive of HTN among both groups. Among HIV-positive subjects, WHO stage 1 or 2 disease was predictive of HTN and among HIV-negative subjects, having no formal education was predictive. Conclusion Over the past 20 years, the prevalence of HTN has doubled among both HIV-positive and HIV-negative adults in Senegal. Our study indicates that there is an increasing need for the integration of chronic disease management into HIV programs in Senegal. Furthermore, our findings highlight the need for enhanced prevention, recognition, and management of noncommunicable diseases, including hypertension and obesity, among both HIV-positive and HIV-negative individuals in Senegal.