Persistent hypertension among postpartum women with comorbid HIV and preeclampsia in Zambia

• Published in: PloS one 2024-09, Vol.19 (9), p.e0309915
• Main Authors: Mukosha, Moses, Hatcher, Abigail, Lubeya, Mwansa Ketty, Maposa, Innocent, Chi, Benjamin H, Mutale, Wilbroad
• Format: Article
• Language: English
• Subjects: Adult; Antiretroviral agents; Antiretroviral therapy; Anxiety; Biology and Life Sciences; Blood pressure; Body mass index; Body size; Care and treatment; Comorbidity; Complications and side effects; Diagnosis; Enrollments; Female; Gestational age; Health risks; Health services; Health surveys; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV patients; Hospitals; Human immunodeficiency virus; Humans; Hypertension; Hypertension - complications; Hypertension - epidemiology; Medicine and Health Sciences; Midwifery; Postnatal care; Postpartum; Postpartum Period; Pre-eclampsia; Pre-Eclampsia - epidemiology; Preeclampsia; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Premature birth; Prenatal care; Prospective Studies; Questionnaires; Risk Factors; Urinalysis; Womens health; Zambia - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0309915

Persistent hypertension is common after preeclampsia and is causally tied to later cardiovascular risks. This study examined whether being HIV-infected and on antiretroviral therapy (ART) is associated with persistent postpartum hypertension among women diagnosed with preeclampsia. We conducted a six-month prospective cohort study at Kanyama and Women and Newborn hospitals from January 01, 2022, to June 30, 2023, among 190 women diagnosed with preeclampsia (59 HIV-positive, 131 HIV-negative). Sociodemographic and clinical characteristics were collected at delivery, six weeks, three months and six months after giving birth. Persistent hypertension was diagnosed if a participant presented with elevated blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg and/or taking medication for hypertension at the study visit. We used a generalized estimating equation to describe the relationship between treated HIV and persistent hypertension six months following delivery. We retained 136 participants (71.6%) to six months postpartum, at a median age of 30 years. Overall, persistent hypertension at six weeks, three months, and six months postpartum was common (37.4%, 17.1% and 16.9%, respectively). Six-week postpartum prevalence was higher in the HIV group than HIV-negative group (54.6% vs 28.8%, p