Background: Expanded ART access has shifted morbidity among PLHIV toward non-communicable diseases. In Cameroon, hypertension (HTN) integration within routine HIV care remains inconsistent. We aimed to identify factors associated with HTN among PLHIV in Yaoundé to inform standardized integrated care.
Methods: A case-control study was conducted at the Central Hospital of Yaoundé (n=460; 199 cases, 261 controls). Cases were defined as BP ≥140/90 mmHg or current antihypertensive therapy. We collected sociodemographic, clinical, ART-related, and lifestyle data. Multivariable logistic regression, adjusted for age, sex, BMI, ART duration, and viral load, estimated adjusted odds ratios (aOR). Reporting followed STROBE guidelines.
Results: Hypertensive cases were significantly older (≥40 years: 92.5% vs 78.5%; p<0.001) and more likely to be obese (27.6% vs 19.5%; p=0.024) than controls. Family history of HTN was more frequent in cases (p<0.001). No significant associations were found for sex, marital status, HIV stage at initiation, or viral load class (p>0.05). In adjusted models, age <40 years was inversely associated with HTN (aOR: 0.37; 95% CI: 0.19–0.69; p=0.002), while obesity nearly doubled the odds (aOR: 1.96; 95% CI: 1.18–3.28; p=0.010). Long-term ART exposure (≥15 years) showed borderline significance (aOR: 1.50; 95% CI: 0.99–2.30; p=0.059). The model demonstrated moderate discrimination (AUC: 0.689) with no significant multicollinearity (GVIF <5).
Conclusion: HTN among PLHIV in Yaoundé is primarily driven by aging and adiposity, while the impact of prolonged ART requires further longitudinal investigation. These findings support the urgent integration of standardized HTN screening, weight management, and lifestyle counseling (WHO HEARTS) into routine HIV services to address the dual burden of disease in Cameroon.