Key result
Among patients with type 2 diabetes, isolated systolic hypertension was significantly associated with uncontrolled hypertension (aOR 7.58; 95% CI 2.18-26.36; P=0.001).
Why the study?
Most patients with diabetes are prone to uncontrolled blood pressure despite effective therapies, which increases cardiovascular morbidity and mortality, but data on its prevalence and associated factors were needed in southwestern Uganda.
Cross-Sectional (n=206)
No
Odds Ratio: 7.58 (95% CI 2.18–26.36)
p-value: p=0.001
A high prevalence of uncontrolled hypertension (82.5%) was found among patients with T2DM in Southwestern Uganda, highlighting a need for optimized therapy.
May flag high-risk subgroup for uncontrolled BP in type 2 diabetes; leaves open prospective validation before practice change.
INTRODUCTION: most patients with diabetes mellitus are prone to uncontrolled blood pressures despite effective medical therapies; only about 30% of hypertensive patients have their blood pressures controlled. Poor control of hypertension is associated with increased risk for cardiovascular mortality and morbidity. We aimed to determine the prevalence and associated factors of uncontrolled hypertension among patients with type 2 diabetes mellitus (T2DM) attending ambulatory care at Mbarara Regional Referral Hospital, Southwestern Uganda. METHODS: we conducted a cross-sectional study from January to April 2019, among hypertensive T2DM patients. We used a structured questionnaire to obtain data on socio-demographic and clinical characteristics. We defined uncontrolled hypertension in participants with blood pressure ≥140/90mmHg and performed binary logistic regression to determine factors associated with uncontrolled hypertension. RESULTS: we analyzed data of 206 hypertensive participants with concomitant T2DM, with a median age of 54 (IQR, 49-60) years, and median duration of diabetes of 4 (IQR, 3-8) years; 71% were female. The prevalence of uncontrolled hypertension was 82.5% (170/206). Isolated systolic hypertension (aOR=7.58; 95%CI: 2.18-26.36, P=0.001) and left ventricular hypertrophy (LVH) (aOR=5.38; 95%CI: 1.11-26.10, P=0.037) were significantly associated with uncontrolled hypertension. CONCLUSION: this study revealed a high prevalence of uncontrolled hypertension among T2DM patients in Southwestern Uganda. Isolated systolic hypertension and LVH were the key factors associated with uncontrolled hypertension. We recommend optimization therapy to reduce the burden of uncontrolled hypertension among patients with T2DM especially in those with isolated systolic hypertension, and left ventricular hypertrophy, who are at higher cardiovascular risk.
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Saasita et al. (2021) conducted a cross-sectional in Type 2 diabetes mellitus and hypertension (n=206). Isolated systolic hypertension vs. Absence of isolated systolic hypertension was evaluated on Uncontrolled hypertension (blood pressure ≥140/90mmHg) (aOR 7.58, 95% CI 2.18-26.36, p=0.001). Among patients with type 2 diabetes, isolated systolic hypertension was significantly associated with uncontrolled hypertension (aOR 7.58; 95% CI 2.18-26.36; P=0.001).
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