RT Journal Article SR Electronic T1 High rate of left ventricular hypertrophy on screening echocardiography among adults living with HIV in Malawi JF Open Heart JO Open Heart FD British Cardiovascular Society SP e002026 DO 10.1136/openhrt-2022-002026 VO 9 IS 1 A1 Risa M Hoffman A1 Florence Chibwana A1 Ben Allan Banda A1 Daniel Kahn A1 Khumbo Gama A1 Zachary P Boas A1 Mayamiko Chimombo A1 Chiulemu Kussen A1 Judith S Currier A1 Dan Namarika A1 Joep van Oosterhout A1 Sam Phiri A1 Agnes Moses A1 Jesse W Currier A1 Hitler Sigauke A1 Corrina Moucheraud A1 Tim Canan YR 2022 UL http://openheart.bmj.com/content/9/1/e002026.abstract AB Background There are limited data on structural heart disease among people living with HIV in southern Africa, where the success of antiretroviral therapy (ART) has drastically improved life expectancy and where risk factors for cardiovascular disease are prevalent.Methods We performed a cross-sectional study of screening echocardiography among adults (≥18 years) with HIV in Malawi presenting for routine ART care. We used univariable and multivariable logistic regression to evaluate correlates of abnormal echocardiogram.Results A total of 202 individuals were enrolled with a median age of 45 years (IQR 39–52); 52% were female, and 27.7% were on antihypertensive medication. The most common clinically significant abnormality was left ventricular hypertrophy (LVH) (12.9%, n=26), and other serious structural heart lesions were rare (<2% with ejection fraction less than 40%, moderate-severe valve lesions or moderate-severe pericardial effusion). Characteristics associated with abnormal echocardiogram included older age (OR 1.04, 95% CI 1.01 to 1.08), higher body mass index (OR 1.09, 95% CI 1.02 to 1.17), higher mean systolic blood pressure (OR 1.03, 95% CI 1.02 to 1.05) and higher mean diastolic blood pressure (OR 1.03, 95% CI 1.01 to 1.05). In a multivariable model including age, duration on ART, body mass index, and systolic and diastolic blood pressure, only mean body mass index (adjusted OR 1.10, 95% CI 1.02 to 1.19), systolic blood pressure (aOR 1.05, 95% CI 1.03 to 1.08) and diastolic blood pressure (aOR 0.96, 95% CI 0.92 to 1.00) remained associated with abnormal echocardiogram.Conclusions LVH was common in this population of adults on ART presenting for routine care and was associated with elevated blood pressure. Further research is needed to characterise the relationship between chronic hypertension, LVH and downstream consequences, such as diastolic dysfunction and heart failure in people living with HIV.Data are available on reasonable request. Deidentified participant data are available from the corresponding author on request.