The longitudinal care cascade for hypertension in people with and without HIV in South Africa: A clinic-based observational study
by Siphamandla Bonga Gumede, Jennifer Manne-Goehler, Elizabeth Kelechi Oladimeji, Nicola Bulled, Alana T. Brennan, Samanta Tresha Lalla-Edward Background Hypertension (HTN) constitutes a major and growing public health challenge in South Africa, a setting where HIV prevalence also remains high. Despite this dual burden, longitudinal evidence describing how individuals move through the HTN care…
In South Africa, hypertension (HTN) is a significant public health issue coexisting with a high prevalence of HIV. However, there is limited longitudinal data on the progression and regression of HTN among people living with HIV (PLHIV) compared to those not living with HIV (PNLHIV). A recent study aimed to fill this gap by analyzing data from the iHEART-SA trial conducted in Johannesburg.
The study included adults aged 18 years and above, receiving chronic care, with known HIV status and a completed medical file review. Of the 23,855 participants, 78.5% were PLHIV, with a median age of 42 years (IQR 36–49) and 69% being female. The median systolic blood pressure (SBP) was 132 mmHg (IQR: 120–145 mmHg).
The results showed that PLHIV were three times more likely to remain undiagnosed for HTN compared to PNLHIV (aRR 3.40; 95% CI 2.45, 4.73). During follow-up, PLHIV experienced a higher rate of regression along the HTN care cascade, including treatment discontinuation (22% versus 11%; aRR 1.51; 95% CI 1.03, 2.23) and loss of blood pressure control (aRR 1.10; 95% CI 1.02, 1.18).
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