title: Population-Based Assessment of Hypertension Epidemiology and Risk Factors among HIV-Positive and General Populations in Rural Uganda.
abstract: BACKGROUND
  Antiretroviral therapy scale-up in Sub-Saharan Africa has created a growing, aging HIV-positive population at risk for non-communicable diseases such as hypertension. However, the prevalence and risk factors for hypertension in this population remain incompletely understood.
  
  
  METHODS
  We measured blood pressure and collected demographic data on over 65,000 adults attending multi-disease community health campaigns in 20 rural Ugandan communities (SEARCH Study: NCT01864603). Our objectives were to determine (i) whether HIV is an independent risk factor for hypertension, and (ii) awareness and control of hypertension in HIV-positive adults and the overall population.
  
  
  RESULTS
  Hypertension prevalence was 14% overall, and 11% among HIV-positive individuals. 79% of patients were previously undiagnosed, 85% were not taking medication, and 50% of patients on medication had uncontrolled blood pressure. Multivariate predictors of hypertension included older age, male gender, higher BMI, lack of education, alcohol use, and residence in Eastern Uganda. HIV-negative status was independently associated with higher odds of hypertension (OR 1.2, 95% CI: 1.1-1.4). Viral suppression of HIV did not significantly predict hypertension among HIV-positives.
  
  
  CONCLUSIONS
  The burden of hypertension is substantial and inadequately controlled, both in HIV-positive persons and overall. Universal HIV screening programs could provide counseling, testing, and treatment for hypertension in Sub-Saharan Africa.
authors.affiliation: Infectious Diseases Research Collaboration, Kampala, Uganda.
authors.forename: Dalsone
authors.initials: D
authors.lastname: Kwarisiima
authors.affiliation: Harvard University, Boston, Massachusetts, United States of America.|University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Laura
authors.initials: L
authors.lastname: Balzer
authors.affiliation: University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Heller
authors.affiliation: University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Prashant
authors.initials: P
authors.lastname: Kotwani
authors.affiliation: University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chamie
authors.affiliation: University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Tamara
authors.initials: T
authors.lastname: Clark
authors.affiliation: Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
authors.forename: James
authors.initials: J
authors.lastname: Ayieko
authors.affiliation: Infectious Diseases Research Collaboration, Kampala, Uganda.
authors.forename: Florence
authors.initials: F
authors.lastname: Mwangwa
authors.affiliation: University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Vivek
authors.initials: V
authors.lastname: Jain
authors.affiliation: Infectious Diseases Research Collaboration, Kampala, Uganda.
authors.forename: Dathan
authors.initials: D
authors.lastname: Byonanebye
authors.affiliation: University of California, Berkeley, California, United States of America.
authors.forename: Maya
authors.initials: M
authors.lastname: Petersen
authors.affiliation: University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Diane
authors.initials: D
authors.lastname: Havlir
authors.affiliation: Infectious Diseases Research Collaboration, Kampala, Uganda.|Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Moses R
authors.initials: MR
authors.lastname: Kamya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000150:complications*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult