Browsing by Author "Gondwe, Jacqueline"

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    Impact of HIV on risk of Treatment Resistant Hypertension in Malawian Adults (TREAM Study), version 1.0
    (2022-08-17) Gondwe, Jacqueline
    Type of research study Case – control study Problem to be studied Hypertension is a long-term condition with serious effects on the lives and well-being of individuals. Africa, a region that is significantly affected by the HIV pandemic, is experiencing a growing burden of non-communicable diseases such as hypertension. It is now known that HIV increases the risk of hypertension(1), which presents a significant burden on individuals and nations alike. Despite its high burden, most individuals suffering from hypertension do not achieve good blood pressure control. A common emerging cause of inadequate blood pressure control is treatment resistant hypertension(2). Treatment resistant hypertension (RH) is defined as uncontrolled blood pressure (≥140/90 mm Hg) despite treatment with ≥3 medications of different classes (including diuretics) at optimal doses. It is associated with significant risk of end organ damage (such as myocardial infarction, stroke, and impaired renal function). While some studies have quantified the burden of resistant hypertension in Africa, there is paucity of evidence regarding the association of resistant hypertension and HIV. This study seeks to determine the association of HIV and treatment resistant hypertension and investigate other modifiable factors that increase the risk of treatment resistant hypertension in Malawian adults. Objectives This research project seeks to investigate the association of HIV infection and treatment resistant hypertension and determine other modifiable risk factors of treatment resistant hypertension in Malawian adults. Specific objectives 1. To determine the association between HIV infection and RH in Malawian adults (primary objective) 2. To identify other modifiable risk factors associated with RH in Malawian adults (secondary objective) Methodology17-Aug-2022 Version 2 26 July 2022 5 Malawi-Liverpool-Wellcome Trust Clinical Research Programme P.O. Box 30096, Chichiri, Blantyre 3, Malawi Study population: Medical patients over 18years of age presenting to hypertension clinic at Queen Elizabeth Central Hospital Study place: Queen Elizabeth Central Hospital Study duration: 8 months Data management and analysis: Blood pressure will be measured using ambulatory blood pressure cuffs recorded over 6 hours. Weight and height will be measured using standard methods. Body mass index (BMI) will be calculated and categorized by age, sex and percentile. HIV rapid test, creatinine, and total cholesterol will also be measured through chemistry analysis of blood samples. The odds ratio for the association between HIV as well as the various modifiable risk factors and treatment resistant hypertension will be generated using statistical software such as Stata 16. Expected finding and dissemination: The results will provide some evidence of the association between HIV and treatment resistant hypertension, and predictors of the same. This knowledge will add to a larger body of work that is aimed to ascertain the true burden of resistant hypertension in Malawi. Knowing the risk factors will aid in early detection and subsequent control of the risk factors. The results of the study will be disseminated to study participants and through a peer reviewed scientific journal. Additionally, a final report of this study and findings will be submitted to the College of Medicine Research and Ethics Committee (COMREC).