Prevalence of Hypertension and Its Associated Factors Among Adult People Living with HIV/AIDS at Anti-Retroviral Treatment (ART) Centers in Mumbai, India.

Abstract

Background: Globally, non-communicable diseases (NCDs), including hypertension, are the leading cause of mortality. People Living with HIV (PLHIV) on antiretroviral therapy (ART) have a higher prevalence of hypertension, risk of cardiovascular events, and all-cause mortality than HIV-uninfected individuals. We describe the implementation of an integrated hypertension screening initiative in a routine program setting and assessed the prevalence of hypertension and its associated factors among PLHIV accessing services at ART centers in Mumbai, India.

Methods: From November 2021 to October 2022, we implemented hypertension screening across 21 ART centers in Mumbai, India. An expert committee developed a clinical protocol for hypertension management among PLHIVs aged ≥18 years, and ART center staff were trained on hypertension screening and management. We measured the prevalence of hypertension and determined the relationship between hypertension and various factors using univariable and multivariable modified poisson regression.

Results: We screened 92% (36,098/39,402) of eligible adult PLHIV for hypertension; 23.8% (8,604/36,098) had hypertension (56.7% were newly identified, and 43.3% known cases), factors such as age ≥60 years, male gender, being overweight or obese were significantly associated with hypertension (p<0.05). The HIV-related factors such as CD4 cell count of 200 cells/mm³ or higher, suppressed viral load (<1000 copies/mL), and longer duration of ART were also significantly associated with hypertension.

Conclusion: About one in every four PLHIV enrolled in the Mumbai ART program was hypertensive, reflecting hypertension prevalence in the general population. The findings highlight the increasing concern of NCDs among PLHIV, driven by longer life expectancies due to effective ART. This underscores the need for healthcare systems to evolve and adopt comprehensive and integrated care models that address HIV and non-communicable diseases. Integration of hypertension screening into routine HIV care can accelerate the early identification and management of hypertension.