HIV care in Cameroon: a missed opportunity to screen for high blood pressure among adults living with HIV/AIDS?

Abstract

Background: Two third of the thirty-seven million people living with HIV/AIDS (PLWHA) globally live in Africa. With the advent of antiretroviral drugs, African PLWHA are living longer and are at increased risk of cardiovascular diseases including high blood pressure (HBP). In this preliminary study, we assessed how often blood pressure (BP) was measured and recorded and the prevalence of HBP in PLWHA followed at three hospitals in Cameroon.

Methods: We retrospectively analysed the blood pressure measurement frequency and data of patients enrolled in the HIV care at the Limbe Regional hospital, Bamenda Regional hospital and the Jamot hospital in Yaounde from 2014 to 2017. Files of all PLWHA aged ≥21years were reviewed. Sociodemographic, laboratory and clinical data were captured. HBP was defined as systolic (and/or diastolic) blood pressure (BP)≥ 140 (90) mm Hg, or ongoing BP- lowering medications. Analysis were done using Epi info version 2.0. Statistical significance was set at p-value<0.05 at 95% confidence interval.

Results: Of 991 medical files examined, 875 files (88.3%) had BP recorded at least once during the study period among which only 418 (47.8%) participants at enrolment in care. 281 (67.2%) were women, mean age was 42.6±10.6 years. The prevalence of HBP was 24.2% in 2014, dropped to 20.2% in 2015, rose to 26.3% in 2016, then dropped again to 18.9% in 2017. Compared with females, this prevalence was consistently higher among males each year.

Conclusion: Less than half of PLWHA had their BP recorded at enrolment in HIV care but almost 1 of every 5 of these patients had HBP. The trend of HBP prevalence over the study period was inconsistent due to poor recording. These results warrant awareness raising for HBP screening in HIV treatment centres and further studies in larger sample with a longer follow-up period to better understand the occurrence of HBP in PLWH.

Keywords: HIV/AIDS, High Blood Pressure, opportunity, trend, prevalence, Cameroon