title: Predictors of hypertension in an urban HIV-infected population at the University of Calabar Teaching Hospital, Calabar, Nigeria.
abstract: BACKGROUND
  The introduction of highly active antiretroviral therapy (HAART) has remarkably improved the prognosis of human immunodeficiency virus (HIV)-infected patients, at the expense of the development of long-term complications such as cardiovascular and renal diseases. Hypertension (HTN) is a major risk factor for cardiovascular diseases and its associated mortality. In this study, we aimed to determine the prevalence of HTN and to identify possible predictors among HIV-infected patients attending the HIV Special Treatment Clinic at the University of Calabar Teaching Hospital, Calabar.
  
  
  METHODS
  A cross-sectional study was carried out over a 5-month period from February to July 2016. A total of 112 HIV-infected persons were consecutively recruited and their blood pressures were measured in two consecutive clinic visits. They were compared with the HIV-negative control group (n=309). Data collected were analyzed with SPSS 18, and statistical significance was set atP<0.05.
  
  
  RESULTS
  There was a female preponderance in both the HIV-infected individuals and HIV-negative control group (57.5% vs. 57.4%). The mean ages were 39.3 and 33.9 years in HIV-infected and HIV-negative subjects, respectively. The risk factors that were associated with HTN in both groups were older age (>40 years), increased weight and body mass index (BMI), and presence of obesity. Male sex and duration of exposure to HAART and CD4count levels >200 cells/mm3were associated with HTN in HIV-infected patients, whereas the absence of family history of HTN was significantly associated with HTN in both groups. However, in a multivariate logistic regression, the predictors of HTN in both groups are absence of family history of HTN and older age in HIV-infected patients and HIV-negative subjects, respectively.
  
  
  CONCLUSIONS
  Traditional risk factors such as older age, increased BMI, and obesity were linked to HTN in both HIV-infected and HIV-negative subjects, but higher CD4count level and cumulative HAART exposure were associated with HTN in HIV-positive individuals. In a multivariate logistic regression, the predictors of HTN in both groups are absence of family history of HTN and older age in HIV-infected patients and HIV-negative subjects, respectively.
authors.affiliation: Department of Internal Medicine.
authors.forename: Henry Ohem
authors.initials: HO
authors.lastname: Okpa
authors.affiliation: Department of Family Medicine, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria.
authors.forename: Elvis Mbu
authors.initials: EM
authors.lastname: Bisong
authors.affiliation: Department of Internal Medicine.
authors.forename: Ofem Egbe
authors.initials: OE
authors.lastname: Enang
authors.affiliation: Department of Family Medicine, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria; Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USA.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Monjok
authors.affiliation: Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USA.
authors.forename: Ekere James
authors.initials: EJ
authors.lastname: Essien
keywords: Calabar; HIV; Nigeria; hypertension; population; urban