title: Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya.
abstract: BACKGROUND
  There is increased risk of cardiovascular disease among HIV seropositive individuals. The prevalence of HIV is highest in sub-Saharan Africa; however, HIV-related cardiovascular risk research is largely derived from developed country settings. Herein, we describe the prevalence of hypertension and obesity in a large HIV treatment program in Kenya.
  
  
  METHODS
  We performed a retrospective analysis of the electronic medical records of a large HIV treatment program in Western Kenya between 2006 and 2009. We calculated the prevalence of hypertension and obesity among HIV+ adults as well as utilized multiple logistic regression analyses to examine the relationship between clinical characteristics, HIV-related characteristics, and hypertension.
  
  
  RESULTS
  Our final sample size was 12,194. The median systolic/diastolic blood pressures were similar for both sexes (male: 110/70 mmHg, female: 110/70 mmHg). The prevalence of hypertension among men and women were 11.2% and 7.4%, respectively. Eleven percent of men and 22.6% of women were overweight/obese (body mass index ≥25 kg/m(2)). Ordinal logistic regression analyses showed that overweight/obesity was more strongly associated with hypertension among HIV+ men (OR 2.41, 95% CI 1.88-3.09) than a higher successive age category (OR 1.62, 95% CI 1.40-1.87 comparing 16-35, 36-45 and >45 years categories). Among women, higher age category and overweight/obesity were most strongly associated with hypertension (age category: OR 2.21, 95% CI 1.95-2.50, overweight/obesity: OR 1.80, 95% CI 1.50-2.16). Length of time on protease inhibitors was not found to be related to hypertension for men (OR 1.62, 95% CI 0.42-6.20) or women (OR 1.17, 95% CI 0.37-2.65) after adjustment for CD4 count, age and BMI.
  
  
  CONCLUSIONS
  In Western Kenya, there is a high prevalence of hypertension and overweight/obesity among HIV+ patients with differences observed between men and women. The care of HIV+ patients in sub-Saharan Africa should also include both identification and management of associated cardiovascular risk factors.
authors.affiliation: Division of Cardiology and Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America. gerald.bloomfield@duke.edu
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Bloomfield
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Hogan
authors.forename: Alfred
authors.initials: A
authors.lastname: Keter
authors.forename: Edwin
authors.initials: E
authors.lastname: Sang
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Carter
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Velazquez
authors.forename: Sylvester
authors.initials: S
authors.lastname: Kimaiyo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult