{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:25:08Z","timestamp":1791228308978,"version":"4.1.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"crossref","award":["R21 TW010459"],"award-info":[{"award-number":["R21 TW010459"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"crossref","award":["D43 TW009580"],"award-info":[{"award-number":["D43 TW009580"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000025","name":"NIMH","doi-asserted-by":"crossref","award":["K01MH115789"],"award-info":[{"award-number":["K01MH115789"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>The burden of cardiovascular disease (CVD) is increasing in sub-Saharan Africa with untreated hypertension being a major contributing factor. Understanding the magnitude of the problem and risk factors associated with HIV and long-term antiretroviral therapy (ART) is critically important for designing effective programs for diagnosing and treating hypertension in Kenya.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this cross-sectional study, we enrolled 300 persons with HIV (PWH) on long term ART (\u22656 months) and 298 HIV-negative adults seeking care at the Kisumu County Hospital between September 2017 and May 2018. Hypertension was defined as blood pressure of \u2265140\/90mmHg or a previous hypertension diagnosis. Multivariate regression was used to assess the association between hypertension and HIV adjusting for age, sex, and known CVD risk factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall prevalence of hypertension was 22%. PWH had a lower prevalence of hypertension than HIV-negative persons (16% vs 27% respectively; p&lt;0.002). In multivariate analyses, persons with HIV were 37% less likely to have hypertension compared to HIV-negative individuals (adjusted prevalence ratio 0.63; 95% confidence interval: 0.46\u20130.86). Other factors that were associated with hypertension in all participants included older age &gt;40 years, body mass index (BMI) &gt;25 kg\/m<jats:sup>2<\/jats:sup> and low-density lipoproteins \u2265130mg\/dL. Among PWH, being older than 40 years and higher BMI &gt;30 kg\/m<jats:sup>2<\/jats:sup> were associated with hypertension.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Prevalence of hypertension was high, affecting nearly one in every 4 adults, and associated with older age, higher BMI and high low-density lipoproteins. PWH on long-term ART had significantly lower prevalence of hypertension compared to HIV-negative individuals, potentially due to increased access to healthcare services and interaction with prevention messaging. Interventions to increase screening for and prevention of hypertension in the community for all adults are warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0262400","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T18:22:17Z","timestamp":1641838937000},"page":"e0262400","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":35,"title":["Prevalence and factors associated with hypertension among adults with and without HIV in Western Kenya"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9913-9034","authenticated-orcid":true,"given":"Jerusha Nyabiage","family":"Mogaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-1561","authenticated-orcid":true,"given":"Monisha","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tecla","family":"Temu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Masyuko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kinuthia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Osoti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Zifodya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0935-2112","authenticated-orcid":true,"given":"Damalie","family":"Nakanjako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Njoroge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Otedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Page","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey","family":"Farquhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"pone.0262400.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-015-2546-z","article-title":"The burden of hypertension in sub-Saharan Africa: A four-country cross sectional study","volume":"15","author":"D Guwatudde","year":"2015","journal-title":"BMC Public Health"},{"key":"pone.0262400.ref002","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1093\/ajh\/hpx196","article-title":"The State of Hypertension in Sub-Saharan Africa: Review and Commentary","author":"A Yoruk","year":"2018","journal-title":"American Journal of Hypertension"},{"key":"pone.0262400.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0032638","article-title":"Hypertension in Sub-Saharan Africa: Cross-sectional surveys in four rural and urban communities","volume":"7","author":"ME Hendriks","year":"2012","journal-title":"PLoS One"},{"key":"pone.0262400.ref004","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1038\/jhh.2015.97","article-title":"Evidence of increased blood pressure and hypertension risk among people living with HIV on antiretroviral therapy: A systematic review with meta-analysis","author":"CU Nduka","year":"2016","journal-title":"Journal of Human Hypertension"},{"key":"pone.0262400.ref005","doi-asserted-by":"crossref","first-page":"e736","DOI":"10.1016\/S2214-109X(18)30259-6","article-title":"May measurement month 2017: an analysis of blood pressure screenings worldwide","volume":"6","author":"Thomas Beaney","year":"2017","journal-title":"Lancet Glob Heal"},{"key":"pone.0262400.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-015-2610-8","article-title":"Risk factors of hypertension among adults aged 35\u201364 years living in an urban slum Nairobi, Kenya","volume":"15","author":"B Olack","year":"2015","journal-title":"BMC Public Health"},{"key":"pone.0262400.ref007","first-page":"6","article-title":"Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya","author":"GS Bloomfield","year":"2011","journal-title":"PLoS One"},{"key":"pone.0262400.ref008","article-title":"Prevalence and Associated Factors of Hypertension: A Community-Based Cross-Sectional Study in Municipalities of Kathmandu","volume":"2016","author":"RR Dhungana","year":"2016","journal-title":"Nepal. Int J Hypertens"},{"key":"pone.0262400.ref009","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/2141-9248.149793","article-title":"Modifiable risk factors of hypertension and socio-demographic profile in Oghara, Delta State; prevalence and correlates","volume":"5","author":"R. Ibekwe","year":"2015","journal-title":"Ann Med Health Sci Res"},{"key":"pone.0262400.ref010","unstructured":"Institute for Health Metrics and Evaluation. GBD Compare | IHME Viz Hub. In: Global Burden of Disease [Internet]. 2015 [cited 26 Mar 2020]. http:\/\/ihmeuw.org\/3pgz."},{"key":"pone.0262400.ref011","first-page":"39","volume-title":"WHO | Raised blood pressure","author":"World Health Organization","year":"2011"},{"key":"pone.0262400.ref012","unstructured":"Institute for Health Metrics and Evaluation. GBD Compare | IHME Viz Hub. In: Global Burden of Disease [Internet]. 2015 [cited 16 May 2020]. http:\/\/ihmeuw.org\/3pgz."},{"key":"pone.0262400.ref013","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.trstmh.2005.07.021","article-title":"The double burden of communicable and non-communicable diseases in developing countries","author":"A. Boutayeb","year":"2006","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"key":"pone.0262400.ref014","doi-asserted-by":"crossref","first-page":"e349","DOI":"10.1016\/S2352-3018(17)30066-8","article-title":"Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies","volume":"4","author":"ATC Collaboration","year":"2017","journal-title":"lancet HIV"},{"key":"pone.0262400.ref015","first-page":"3","article-title":"Prevalence of CKD, Diabetes, and Hypertension in Rural Tanzania","author":"DW Ploth","year":"2018","journal-title":"Kidney Int Reports"},{"key":"pone.0262400.ref016","doi-asserted-by":"crossref","unstructured":"The Joint United Nations Programme on HIV\/AIDS U. Global AIDS. In: Aids [Internet]. 2016 pp. S3-11. doi: 10.1073\/pnas.86.15.5781","DOI":"10.1073\/pnas.86.15.5781"},{"key":"pone.0262400.ref017","author":"A. Chepchirchir","year":"2018","journal-title":"International Journal of Cytokine Expression and Hypertension Comorbidity in HIV \/ AIDS Patients at Kenyatta National Hospital HIV Care"},{"key":"pone.0262400.ref018","doi-asserted-by":"crossref","DOI":"10.11604\/pamj.2021.38.216.28034","article-title":"Prevalence and factors associated with hypertension among people living with HIV\/AIDS on antiretroviral therapy in Uganda","volume":"38","author":"G Lubega","year":"2021","journal-title":"PAMJ"},{"key":"pone.0262400.ref019","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1086\/605890","article-title":"Serum Immune Activation Markers Are Persistently Increased in Patients with HIV Infection after 6 Years of Antiretroviral Therapy despite Suppression of Viral Replication and Reconstitution of CD4 + T Cells","volume":"200","author":"MA French","year":"2009","journal-title":"J Infect Dis"},{"key":"pone.0262400.ref020","first-page":"11","article-title":"Population-based assessment of hypertension epidemiology and risk factors among HIV-positive and general populations in rural Uganda","author":"D Kwarisiima","year":"2016","journal-title":"PLoS One"},{"key":"pone.0262400.ref021","doi-asserted-by":"crossref","first-page":"1321279","DOI":"10.1080\/16549716.2017.1321279","article-title":"Prevalence,awareness and factors associated with hypertension in North West Tanzania","volume":"10","author":"J Todd","year":"2017","journal-title":"Glob Health Action"},{"key":"pone.0262400.ref022","unstructured":"World Health Organization. WHO STEPwise approach to NCD surveillance. 2003; 43. Available: http:\/\/www.who.int\/ncd_surveillance\/en\/steps_framework_dec03.pdf."},{"key":"pone.0262400.ref023","first-page":"8","article-title":"Kenya STEPwise Survey for Non Communicable Diseases Risk Factors 2015 Report","volume":"5","author":"Ministry of Health, Kenyan National Bureau of Statistics WHO, MoH-Kenya, Ministry of Health, Kenyan National Bureau of Statistics WHO, MoH-Kenya","year":"2015","journal-title":"Public Health"},{"key":"pone.0262400.ref024","doi-asserted-by":"crossref","first-page":"e20845","DOI":"10.1097\/MD.0000000000020845","article-title":"Metabolic syndrome and 10-year cardiovascular risk among HIV-positive and HIV-negative adults: A cross-sectional study","volume":"99","author":"SJ Masyuko","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"pone.0262400.ref025","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jama.2018.16755","article-title":"The 2018 European Society of Cardiology\/European Society of Hypertension and 2017 American College of Cardiology\/American Heart Association Blood Pressure Guidelines: More Similar Than Different","volume":"320","author":"PK Whelton","year":"2018","journal-title":"JAMA\u2014J Am Med Assoc"},{"key":"pone.0262400.ref026","unstructured":"MoH-Kenya. Kenya national guidelines for cardiovascular diseases management division of non-communicable diseases ministry of health ministry of health. 2018 [cited 23 Jul 2021]. Available: www.health.go.ke."},{"key":"pone.0262400.ref027","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"FC Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"pone.0262400.ref028","first-page":"8","article-title":"Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation","author":"World Health O","year":"2008","journal-title":"World Heal Organ"},{"key":"pone.0262400.ref029","unstructured":"NASCOP K. Kenya-ARV-Guidelines-2018-Final_20thAug2018."},{"key":"pone.0262400.ref030","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/MBP.0b013e328363ee43","article-title":"Effects of antiretroviral therapy on arterial stiffness in Cameroonian HIV-infected patients","volume":"18","author":"W Ngatchou","year":"2013","journal-title":"Blood Press Monit"},{"key":"pone.0262400.ref031","first-page":"18","article-title":"A population-based national estimate of the prevalence and risk factors associated with hypertension in Rwanda: Implications for prevention and control","author":"MR Nahimana","year":"2017","journal-title":"BMC Public Health"},{"key":"pone.0262400.ref032","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12916-014-0125-2","article-title":"Hypertension, kidney disease, HIV and antiretroviral therapy among Tanzanian adults: A cross-sectional study","volume":"12","author":"Rehema Shedafa Robert N Peck","year":"2014","journal-title":"BMC Med"},{"key":"pone.0262400.ref033","first-page":"56","volume-title":"Current Hypertension Reports","author":"SK Masenga","year":"2019"},{"key":"pone.0262400.ref034","first-page":"1","article-title":"Prevalence of hypertension and associated cardiovascular risk factors in an urban slum in Nairobi, Kenya: A population-based survey","volume":"14","author":"GS Bloomfield","year":"2014","journal-title":"BMC Public Health"},{"key":"pone.0262400.ref035","doi-asserted-by":"crossref","DOI":"10.1177\/2050312118756663","article-title":"Evaluation of lipid profiles and hematological parameters in hypertensive patients: Laboratory-based cross-sectional study","volume":"6","author":"A Gebrie","year":"2018","journal-title":"SAGE Open Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T18:23:10Z","timestamp":1641838990000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262400"}},"subtitle":[],"editor":[{"given":"Weijing","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,10]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0262400","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,10]]}}}