A comparative analysis on blood pressure in HIV‐infected individuals versus uninfected controls residing in Sub‐Saharan Africa: a narrative review

Abstract

Purpose: Elevated blood pressure is a well‐documented risk factor for cardiovascular disease and mortality in Sub‐Saharan Africa (SSA). With SSA also affected by high Human Immunodeficiency Virus (HIV) infection rates, it remains controversial whether the HIV‐infected population has a higher cardiovascular risk than the general population. We, therefore reviewed the literature comparing blood pressure estimates in treated HIV‐infected populations against untreated and/or uninfected controls from SSA.

Methods: We conducted a narrative review through PubMed and EBSCO Discovery Service (EDS) to determine the estimates of raised blood pressure and hypertension in the HIV‐infected individuals versus uninfected controls (01 January 2005 to 11 November 2018).

Results: After review, we included 14 eligible studies from six countries including 26,302 participants that compared treated HIV‐infected, versus untreated and uninfected controls. Studies involving 24,696 participants reported lower blood pressure and/or prevalence of hypertension in treated HIV‐infected patients compared to uninfected controls. Studies comprising of 3,536 participants reported higher blood pressure and hypertension prevalence in the treated HIV‐infected group than uninfected counterparts, whereas studies with 6,379 participants showed no difference in blood pressure and/or prevalence of hypertension. When comparing HIV patients with and without antiretroviral treatment, studies with 10,304 patients showed treated patients to have lower blood pressure and/or prevalence of hypertension, one study indicated higher blood pressure and/or prevalence of hypertension and studies with 5,806 patients showed no difference in blood pressure and/or prevalence of hypertension than untreated infected patients.

Conclusion: The majority of the findings in this review indicate lower or similar blood pressure and/or prevalence of hypertension in treated HIV‐infected individuals compared to untreated and uninfected controls from SSA. It is imperative to further clarify these findings to provide reliable tools for screening and monitoring raised blood pressure in HIV‐infected patients