Prevalence and Determinants of Hypertension Among People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study at Mwananyamala Hospital, Tanzania

Introduction

Hypertension is an emerging concern among people living with HIV (PLHIV) on antiretroviral therapy (ART), with limited data from Tanzania. This study aimed to determine the prevalence and determinants of hypertension among PLHIV on ART.

Methods

A cross-sectional study was conducted at Mwananyamala Regional Referral Hospital, Tanzania, in July 2024. We enrolled 296 PLHIV on ART for >6 months using simple random sampling. Data on sociodemographic characteristics, HIV-related factors, and hypertension knowledge were collected through structured questionnaires. Blood pressure and body mass index (BMI) were measured. Bivariate and multivariate logistic regression analyses assessed associations between HIV-related factors and hypertension (defined as ≥140/90 mmHg or use of antihypertensive medication).

Results

The prevalence of hypertension was 32.8% (97/296). Longer duration of HIV diagnosis (1–5 years: adjusted odds ratio [aOR] 5.119, 95% CI 1.772–14.787, p=0.003; 6–10 years: aOR 3.738, 95% CI 1.568–8.910, p=0.003) and higher CD4 counts (≥500 cells/mm ³ : aOR 11.505, 95% CI 1.287–102.853, p=0.029; 350–499 cells/mm ³ : aOR 12.173, 95% CI 1.389–106.670, p=0.024) were associated with increased hypertension risk. Shorter ART duration (<1 year: aOR 0.122, 95% CI 0.016–0.935, p=0.043) reduced risk. Traditional risk factors (age >35 years, overweight/obesity, family history of hypertension, physical inactivity) also increased hypertension risk. Knowledge of hypertension was moderate (53.85%), with 21.6% demonstrating good knowledge.

Conclusions

Hypertension is prevalent among PLHIV on ART in Tanzania, driven by HIV-related and traditional risk factors. Integrated screening and education within HIV care are critical.

KEY MESSAGES

• What is already known on this topic: Hypertension prevalence among PLHIV on ART in sub-Saharan Africa varies widely (6%-53%), with conflicting evidence on HIV-related risk factors and limited data on knowledge levels.

• What this study adds: This study reports a 32.8% hypertension prevalence among PLHIV on ART in Tanzania, identifying longer HIV duration, higher CD4 counts, and traditional risk factors as key determinants, while highlighting moderate hypertension knowledge.

• How this study might affect research, practice, or policy: These findings underscore the need for routine hypertension screening in HIV care, targeted health education, and longitudinal studies to establish causality between HIV/ART and hypertension.