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Competing Interests: Funding Support and Author Disclosures Supported by a grant from the National Heart Lung and Blood Institute (R01HL160332). All authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Background: People living with HIV (PLWH) have a higher prevalence of diastolic dysfunction and left ventricular hypertrophy (LVH) in cross-sectional studies. Longitudinal data are lacking, especially from Africa., Objectives: The aim was to examine: 1) the incidence of diastolic dysfunction in PLWH compared to community controls in Tanzania; 2) the progression of diastolic function and LVH in PLWH after antiretroviral therapy initiation; and 3) traditional, endemic, and HIV-specific risk factors for diastolic function and LVH., Methods: This was a prospective longitudinal cohort of PLWH and HIV-uninfected controls who had an echocardiogram at enrollment and in follow-up. Adjusted Cox proportional HR models were used to determine the incidence of diastolic dysfunction, and multivariable mixed effects regressions were used to determine the progression and risk factors for diastolic function., Results: A total of 781 participants (367 PLWH) were followed for up to 5 years. There was no difference in incidence of diastolic dysfunction by HIV serostatus (aHR: 0.93 [95% CI: 0.61-1.42]). Baseline differences in echo parameters prior to antiretroviral therapy initiation resolved within 3 years of treatment for LVH (baseline difference = 3.57 g/m 2 [95% CI: 0.87-6.26]; no difference after 3 years) and other diastolic dysfunction markers. Hypertension and obesity were important modifiable risk factors for diastolic dysfunction (both P  < 0.001), while subclinical kidney disease, anemia, and manual labor were predictors of LVH and diastolic dysfunction., Conclusions: The incidence of diastolic dysfunction was similar in PLWH and HIV-uninfected controls. Efforts to prevent diastolic heart failure in Africa must focus on addressing hypertension and obesity while also investigating nontraditional risk factors., Competing Interests: This study is funded by grants from the 10.13039/100000050National Heart, Lung, and Blood Institute (R01HL160332 and K24HL170902). The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)

Postpartum care of hypertensive disorders of pregnancy (HDP) often extends only 6 weeks after delivery in low-income countries. This multicenter observational cohort study was conducted to determine 3-month postpartum outcomes of HDP in Tanzania. Of 309 consecutive women admitted to 3 public hospitals, five (1.7 %) died within 3 months. Of the remaining 304, 292 (94.5 %) returned for 3-month follow-up visit and 41.1 % (95 % CI: 35.6 %-46.9 %) had persistent postpartum hypertension. The strongest independent predictor of hypertension persistence was reduced eGFR at delivery (aOR = 2.1[1.01,4.4]). Postpartum follow-up should routinely be extended to 3 months in all women with HDP to diagnose hypertension and prevent cardiovascular disease., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)