The prevalence of hypertension in people living with HIV at Senkatana ART Clinic, Maseru, Lesotho.

Background Hypertension is a modifiable risk factor for Cardiovascular and Chronic Kidney disease among other complications[1]. Hypertension (HTN) and cardiovascular diseases (CVD) have emerged among people living with HIV (PLHIV) as the most important prevalent contributors of non-AIDS related mortality [2, 3]. Unfortunately, limited data is available regarding the prevalence of hypertension and of risk factors associated with HTN among PLHIV in Lesotho. In this study we aim to determine the prevalence of HTN and identify risk factors associated with HTN in PLHIV in Maseru, Lesotho. Method A cross-sectional study was conducted from February to July 2022 at Senkatana ART clinic, Maseru, Lesotho. Participants randomly selected from among PLHIV who attended the clinic were aged 18 years and above, were on HAART for at least 12 months and provided consent. Structured questionnaires were used to collect data on the socio-demographic, medical, family and behavioral history. Height, Weight and blood pressure (BP) were measured and Body mass index (BMI) calculated. HTN was defined as a systolic BP of ≥ 140 mmHg and/or diastolic BP of ≥ 90 mmHg or a self-reported use of antihypertensive medication(s). Data analysis was done using excel and SAS statistical software (v9.4). Bivariable and multivariable analyses identified risk factors associated with HTN. Results 300 patients participated in the study, of which 64% were females and 36% male. The mean age was 51 years. The prevalence of hypertension was 57% (exact 95% CI: 51.2%, 62.7%). Of those with HTN, 33.3% were newly diagnosed during this study (exact 95% CI: 26.3%, 40.9%). 69% of participants previously diagnosed with HTN had uncontrolled HTN at enrollment (exact 95% CI: 60.0%, 77.6%). Age and BMI were independent risk factors for HTN in this sample. Conclusion According to this study, HTN is prevalent and poorly controlled in PLHIV attending Senkatana ART Clinic and 33 percent of those with HTN were newly diagnosed. Introduction of routine hypertension prevention, diagnostic and treatment measures have the potential to reduce morbidity and mortality within this population. This study provides a model for future investigation of the prevalence and management of other non-communicable diseases (NCDs) to determine optimal clinical practice guidelines for Lesotho. It also shows that siloed single disease oriented care misses critical co-morbidities and therefore brings evidence to support a model of comprehensive healthcare delivery.