Incidence of high blood pressure among Kenyan adults living with HIV: a longitudinal cohort analysis from 2004-2023.

Objective: People with HIV (PWH) face a heightened risk of cardiovascular diseases, partly due to increased high blood pressure risk. This study assessed high blood pressure burden (i.e., incidence, prevalence) among PWH in Kenya over time.

Design: Longitudinal, open cohort study.

Methods: We estimated the incidence and prevalence of high blood pressure in a large sample of Kenyans with HIV from the Coptic Hope Center using electronic medical records from 2004-2023. We defined incident high blood pressure as first visit after baseline at which each patient had a systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg.

Results: Our sample included 38,709 PWH seeking care at Coptic Hope Center clinics in Kenya (2004-2023). Nearly 40% of patients had high blood pressure at first visit. Among the 60% of patients initially normotensive, almost 40% developed high blood pressure within 20 years. The yearly prevalence of high blood pressure ranged from 8-58%. Average SBP was higher among patients who had their first visit from 2019-2023 compared to those visiting in the early 2000 s and 2010 s.

Conclusions: Our findings reveal a high and rising burden of high blood pressure among PWH in a large, faith-based health system in Kenya. This underscores the need for stronger integration of care for individuals with concurrent HIV, high blood pressure, and other non-communicable diseases. Current systems are insufficient for achieving blood pressure control among PWH. Further research and funding for efforts to address HIV and NCD care in Kenya are warranted.