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A comparative analysis of blood pressure in HIV-infected patients versus uninfected controls residing in Sub-Saharan Africa: a narrative review

Journal of Human Hypertension volume 34, pages 692–708 (2020)Cite this article

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Abstract

Elevated blood pressure (BP) is an important risk factor for cardiovascular disease and mortality in Sub-Saharan Africa (SSA). We reviewed the literature comparing BP in treated HIV-infected populations against untreated and/or uninfected controls from SSA. We conducted a narrative review through PubMed and EBSCO Discovery Service to determine estimates of raised BP and hypertension in HIV-infected patients versus untreated/uninfected controls (1 January 2005 to 31 July 2019 and 9 May 2020). We included 19 eligible studies that compared treated HIV-infected with untreated and/or uninfected controls. In studies comparing treated HIV-infected patients to uninfected controls, studies including 6882 (56.30%) and 21,819 (79.2%) participants reported lower BP and hypertension prevalence, respectively in HIV-infected patients; whereas studies including 753 (6.16%) and 3553 (12.9%) participants showed a higher BP and hypertension prevalence. Lastly, 4588 (37.54%) and 2180 (7.91%) participants showed no difference in BP and the prevalence of hypertension. When comparing BP of treated versus untreated HIV-infected patients, studies including 5757 (44.2%) patients reported lower BP in treated patients; while studies with 200 (1.53%) patients showed higher BP and 7073 (54.28%) showed no difference in BP. For hypertension status, studies with 4547 (74.5%) patients reported a lower prevalence of hypertension in treated patients; whereas studies with 598 (9.80%) patients showed higher prevalence; and 959 (15.7%) no difference in prevalence between treated versus untreated HIV-infected patients. In studies conducted in Sub-Saharan Africa, the majority of the findings indicate lower blood pressure and/or prevalence of hypertension in treated HIV-infected individuals compared to untreated and uninfected controls.

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Fig. 1: Flow chart of the literature selection process.
Fig. 2: Do HIV-infected patients using ART have higher blood pressure (or prevalence of hypertension) than uninfected controls and untreated HIV-infected patients?

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All data generated or analyzed during this study are included in this published article (and its Supplementary Information Files).

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Acknowledgements

AES received financial support from the South African National Research Foundation (SARChI GUN86895) and the South African Medical Research Council. Edith Phalane received financial support from Department of Science and Technology/ National Research Foundation and TATA Africa Holdings.

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Authors and Affiliations

  1. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa

    Edith Phalane, Carla M. T. Fourie, Catharina M. C. Mels & Aletta E. Schutte

  2. Medical Research Council Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa

    Carla M. T. Fourie, Catharina M. C. Mels & Aletta E. Schutte

  3. School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia

    Aletta E. Schutte

  4. The George Institute for Global Health, Sydney, Australia

    Aletta E. Schutte

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  1. Edith Phalane
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Phalane, E., Fourie, C.M.T., Mels, C.M.C. et al. A comparative analysis of blood pressure in HIV-infected patients versus uninfected controls residing in Sub-Saharan Africa: a narrative review. J Hum Hypertens 34, 692–708 (2020). https://doi.org/10.1038/s41371-020-0385-6

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