Prevalence and determinants of hypertension among people living with HIV on antiretroviral therapy: a cross-sectional study at Mwananyamala Hospital, Tanzania

Hypertension is an increasingly recognized comorbidity among people living with HIV (PLHIV) receiving antiretroviral therapy (ART), contributing substantially to cardiovascular morbidity. As life expectancy among PLHIV improves, understanding both traditional and HIV-related determinants of hypertension is essential. This study assessed the prevalence, associated factors, and hypertension knowledge among PLHIV on ART in Tanzania. A hospital-based cross-sectional study was conducted among 296 PLHIV on ART for more than six months at Mwananyamala Regional Referral Hospital. Data were collected using structured questionnaires and clinical records. Blood pressure was measured according to American Heart Association guidelines. Logistic regression analyses were performed to identify factors independently associated with hypertension at p < 0.05. The prevalence of hypertension was 32.8%. Knowledge of hypertension was moderate (mean = 53.9%), with only 10.8% correctly identifying normal blood pressure levels. Age ≥ 55 years (aOR = 4.786, p < 0.001) and cigarette smoking (aOR = 6.159, p = 0.020) were associated with greater risk of hypertension. Long duration since HIV diagnosis (> 10 years: aOR = 3.090, p = 0.011) was also associated with increased odds of hypertension, whereas shorter ART duration (< 5 years: aOR = 0.106, p = 0.040) was associated with lower risk. Hypertension is prevalent among PLHIV on ART in Tanzania, influenced by both traditional and HIV-related factors. Integrating hypertension screening and education within HIV care services is essential. Strengthening community engagement in chronic disease screening can enhance early detection, improve awareness, and promote preventive behaviours, ultimately reducing the dual burden of HIV and non-communicable diseases.