Incidence of high blood pressure among Kenyan adults with HIV.

OBJECTIVE

People with HIV (PWH) face a heightened risk of cardiovascular diseases, partly because of increased high blood pressure risk. This study assessed high blood pressure burden (i.e. incidence and prevalence) among PWH in Kenya over time.

DESIGN

Longitudinal, open cohort study.

METHODS

We estimated the incidence and prevalence of high blood pressure in a large sample of Kenyans with HIV from the Coptic Hope Center using electronic medical records from 2004 to 2023. We defined incident high blood pressure as first visit after baseline at which each patient had a SBP at least 140 mmHg and/or a DBP at least 90 mmHg.

RESULTS

Our sample included 38 709 PWH seeking care at Coptic Hope Center clinics in Kenya (2004-2023). Nearly 40% of patients had high blood pressure at first visit. Among the 60% of patients initially normotensive, almost 40% developed high blood pressure within 20 years. The yearly prevalence of high blood pressure ranged from 8 to 58%. Average SBP was higher among patients who had their first visit from 2019 to 2023 compared with those visiting in the early 2000s and 2010s.

CONCLUSION

Our findings reveal a high and rising burden of high blood pressure among PWH in a large, faith-based health system in Kenya. This underscores the need for stronger integration of care for individuals with concurrent HIV, high blood pressure, and other noncommunicable diseases (NCDs). Current systems are insufficient for achieving blood pressure control among PWH. Further research and funding for efforts to address HIV and NCD care in Kenya are warranted.