# Prevalence and determinants of hypertension among people living with HIV in Ghana: A cross-sectional study

## TL;DR

This study finds that 33% of people living with HIV in Ghana have hypertension, with factors like ART type and muscle mass affecting risk.

## Contribution

The study identifies second-line ART and higher muscle mass as protective factors against hypertension in people living with HIV in Ghana.

## Key findings

- Second-line ART is associated with a significantly lower risk of hypertension compared to first-line ART.
- Higher muscle mass is linked to a reduced risk of hypertension among people living with HIV.
- Obesity and higher dietary diversity scores are associated with increased odds of hypertension.

## Abstract

Hypertension is a major health concern in Sub-Saharan Africa (SSA). People living with human immunodeficiency virus (PLHIV) face unique risks for cardiometabolic disorders. However, the factors associated with hypertension among PLHIV have been understudied in SSA. This study examines the prevalence and determinants of hypertension among PLHIV in Ghana.

A total of 440 PLHIV aged 18 years and older receiving antiretroviral therapy (ART) for a minimum of six months were recruited in this hospital-based cross-sectional study. Variables assessed included blood pressure, alcohol consumption, type of antiretroviral therapy (ART) medication, duration of exposure to ART, smoking history, age, sex, level of education, and exercise. Binary logistic regression was used to determine the factors associated with hypertension.

The overall prevalence of hypertension was 33%. People living with HIV who were on second-line ART had a lower risk of hypertension compared to those on first-line ART (OR = 0.379; 95% CI: 0.169–0.846; p = 0.018). Similarly, participants with high muscle mass (OR = 0.177; 95% CI: 0.064–0.487; p < 0.01) and those with very high muscle mass (OR = 0.220; 95% CI: 0.051–0.943; p = 0.041) had a lower risk of hypertension compared to those with low muscle mass. In contrast, participants who were obese had approximately four times greater odds of hypertension compared to those with underweight (OR = 4.046; 95% CI: 1.018–16.083; p = 0.047). Additionally, participants with medium IDDS (OR = 1.968; 95% CI: 1.150–3.369; p = 0.014) and high IDDS (OR = 2.348; 95% CI: 1.078–5.115; p = 0.032) had about twice the risk of hypertension compared to those with low IDDS.

This study found a high prevalence of hypertension among PLHIV. Second-line ART may reduce the risk of hypertension, while higher muscle mass may have a protective effect. Further research is needed to better understand the impact of dietary diversity and specific dietary components on hypertension in this population.