Factors associated with poor blood pressure control in type 2 diabetic hypertensive patients

Introduction Hypertension in type 2 diabetic is an endemic medical problem that leads to a wide range of debilitating and lethal illnesses, such as myocardial dysfunction, cerebrovascular ischemia, renal failure, and peripheral vascular disease. Control of hypertension is difficult in this population. Purpose The aim of this study was to determine the proportion and factors associated with uncontrolled hypertension in patients with type 2 diabetes. Methods Socio-demographic data were collected using a questionnaire. Blood pressure (BP) was measured using an electronic sphygmomanometer after 5 minutes' rest in a seated position. Factors such as socio-economic status, level of education, sedentary lifestyle and obesity were also taken into account. Statistical analysis of the data was performed using SPSS 25 software. Results We recruited 1885 adults aged 18 and over. The mean age was 59.7 ± 10.7 years. The mean systolic BP was 15.8 ±1.9 and the mean diastolic BP was 8.8 ± 1.2. The proportion of uncontrolled hypertension (BP >14/09) was 72%, including 19% of cases of severe hypertension (BP>18/10). Resistant hypertension was found in 20% of cases. Several factors were associated with poor control of hypertension, including age (p=0.001), marital status (p=0.01), socioeconomic status (p=0.02), sedentary lifestyle (p=0.01), obesity (p=0.01) and abdominal obesity (p=0.01), insulin treatment (p=0. 05), insufficient physical activity (p=0.03), duration of treatment greater than 10 years (p= 0.001) and number of tablets greater than 2 (p = 0.04). After logistic regression, the age groups 30 to 45 years (OR = 2.8; 95% CI; p = 0.01) and 45 years and over (OR = 3.9; 95% CI; p = 0.001); men (OR = 4.1; 95% CI; p = 0.001) ; sedentary people with less than 4 hours per day spent sitting in front of the television (OR = 3.15; 95% CI; p = 0.01); obesity (OR = 3.5; 95% CI; p = 0.04) and abdominal obesity (OR = 2.6; 95% CI; p = 0.03) were significantly associated with failure to control hypertension. Conclusion Comprehensive management of cardiovascular risk factors in hypertensive type 2 diabetic subjects is necessary to improve the quality of life of these fragile patients and avoid morbimortal complications.