{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:40:36Z","timestamp":1787226036072,"version":"build-2736575974"},"reference-count":45,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T00:00:00Z","timestamp":1757203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"South African Medical Research Council (SAMRC)","award":["MRC-RFA-CC-01-2024"],"award-info":[{"award-number":["MRC-RFA-CC-01-2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Antiretroviral therapy (ART) has significantly improved outcomes in individuals with human immunodeficiency virus (HIV), yet its long-term cardiovascular effects, especially on hypertension risk, remain debated. This pilot study investigated hypertension risk factors in HIV-positive patients undergoing ART and aimed at hypothesis generation rather than drawing definitive causal conclusions. Seventy HIV-infected adults without baseline hypertension were enrolled and followed. Hypertension was defined using the 2017 ACC\/AHA guidelines by the South African Hypertension Society. Data on demographic, anthropometric, metabolic, inflammatory, coagulation, and HIV-related variables were collected. Cox regression analysis identified independent predictors of hypertension. Participants had a median age of 37 years (IOR = 10.96), with 84.3% being female. After a median ART exposure of 61.01 months (range: 2\u2013164), 27 individuals (38.6%) developed high blood pressure. In multivariable Cox models adjusting for metabolic syndrome and BMI, age \u2265 35 years was associated with a 2.2-fold higher hypertension risk (Hazard Ratio [HR]: 2.2; 95% Confidence Interval [CI]: 1.04\u20134.55; p = 0.04). Elevated triglycerides significantly increased risk, with a 7.9-fold higher likelihood of hypertension (HR: 7.9; 95% CI: 1.04\u201359.5; p = 0.046). ART regimen type, whether initial or current, did not independently predict hypertension. In conclusion, hypertension is prevalent during ART. We hypothesized that traditional cardiovascular risk factors, notably age \u226535 years and hypertriglyceridemia, were key independent predictors, emphasizing the need for routine cardiovascular risk assessment in HIV management.<\/jats:p>","DOI":"10.3390\/ijerph22091397","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T08:06:32Z","timestamp":1757318792000},"page":"1397","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prolonged Exposure to Antiretroviral Therapy and Risk of Developing Hypertension Among HIV-Infected Clinic Attendees: A Pilot Study in Rural Eastern Cape Province, South Africa"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1329-3864","authenticated-orcid":false,"given":"Teke","family":"Apalata","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha B-5110, South Africa"},{"name":"National Health Laboratory Service, Nelson Mandela Academic Hospital, Mthatha B-5110, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7991-0610","authenticated-orcid":false,"given":"Urgent","family":"Tsuro","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Community Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha B-5110, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olufunmilayo Olukemi","family":"Akapo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha B-5110, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,7]]},"reference":[{"key":"ref_1","unstructured":"UNAIDS (2025, May 28). 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