Background: Dolutegravir (DTG), a novel antiretroviral therapy (ART) for HIV, is increasingly adopted across sub-Saharan Africa. However, its impact on blood pressure in Ethiopia remains unclear, highlighting a need for further studies.
Objective: This study aimed to investigate the association between DTG-based first-line regimens and other covariates of high blood pressure (HBP) among adults living with HIV receiving care at health facilities in Hawassa City, southern Ethiopia.
Design: A cross-sectional study.
Methods: Data were collected between January 2023 and May 2024 among 444 systematically selected adults, complemented with a review of their medical records. HBP was defined according to the seventh report of the Joint National Committee (JNC7) guidelines, with a threshold of systolic or diastolic blood pressure of ⩾120/80 mmHg. Multivariable logistic regression analysis was performed to identify predictors of HBP. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed to determine statistically significant associations.
Results: Of the study participants, 58.3% were women and 41.7% were men, resulting in a response rate of 95.5%. The mean (standard deviation (SD]) age of the participants was 38.4(±8.9) years. The prevalence of HBP was 57.9% (95% CI: 52.5-62.4), with 40.5% classified as prehypertension and 17.3% as hypertension. Among participants with hypertension, 84.4% were newly diagnosed. Initiating ART with DTG-based regimens was associated with higher odds of HBP (AOR 5.9; 95% CI: 1.5-22.7) and switching to DTG-based regimens also increased the odds of HBP (AOR 3.8; 95% CI: 1.1-13.9). Other significant covariates associated with HBP included being male (AOR 2.6; 95% CI: 1.4-4.9), age >45 years (AOR 2.0; 95% CI: 1.2-3.4), high waist-to-height ratio (AOR 2.4; 95% CI: 1.1-4.9), inadequate vegetable intake (AOR 1.7; 95% CI: 1.0-2.7), low physical activity (AOR 2.4; 95% CI: 1.1-5.4), and LDL-cholesterol (AOR 1.1; 95% CI: 1.0-1.2).
Conclusion: Proactive blood pressure screening and management are important for individuals on DTG-based regimens. In addition, early identification and intervention of modifiable risk factors through comprehensive strategies and regular screenings are pivotal for improving cardiovascular health among individuals on ART.
Keywords: Ethiopia; HIV; antiretroviral therapy; blood pressure; dolutegravir; hypertension.
The association between dolutegravir based antiretroviral therapy and high blood pressure among adults with HIV in southern Ethiopia This study in southern Ethiopia evaluated blood pressure in adults with HIV on first-line antiretroviral treatment (ART). The rate of high blood pressure (HBP) was 57.9%, with 40.5% classified as prehypertension and 17.3% as hypertension. Among participants with hypertension, 84.4% were newly diagnosed in this study. ART initiating or switching to DTG-based first-line regimens was significantly associated with HBP compared to efavirenz-based regimens. Additionally, factors such as male sex, advanced age, waist-height ratio, low vegetable intake, inadequate physical activity, and low density lipoprotein cholesterol levels were significantly associated with the prevalence of HBP. Therefore, addressing post-treatment HBP in individuals on DTG based regimens is essential for enhancing cardiovascular health. In addition timely identification and management of modifiable risk factors, supported by comprehensive strategies and routine screenings are vital for this population.
© The Author(s), 2024.