Clinical and Echocardiographic Characteristics Associated with Hypertension in a Cohort of People Living with and without HIV

Background: Hypertension is a major cardiovascular risk factor in sub-Saharan Africa, particularly among people living with HIV (PLWH). The contributions of cardiac structural remodeling, metabolic factors, and the renin-angiotensin-aldosterone system (RAAS) to hypertension in this population remain incompletely understood. This study aimed to provide a detailed characterization of the clinical and echocardiographic determinants of hypertension in a cohort predominantly composed of people living with HIV. Methods: In this cross-sectional study, 366 adults (70.2% female, 73.5% PLWH) attending a tertiary hospital in Zambia were enrolled. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mmHg or current antihypertensive use. We collected sociodemographic, clinical, biochemical (lipid profile, RAAS markers, inflammatory cytokines), and echocardiographic data. Multivariable logistic regression models were used to identify independent predictors of hypertension, with statistical significance at p