Predictors of hypertension among diabetics patients in Hawassa, Sidama, Ethiopia: Unmatched case control study

Background The comorbidity of hypertension and diabetes mellitus (DM) is a public health problem in resource-limited settings. The majority of the existing studies were conducted on burden. However, there is little evidence on predictors of hypertension among diabetic patients. Objective The aim of this study was to explore predictors associated with hypertension among DM patients. Design Observational design, unmatched case control study. Methods This hospital-based case-control study assessed hypertension comorbidity among persons with DM in the Sidama region. A random sampling procedure was applied to select 395 respondents. The data were collected with a pretested and structured tool through the Kobo tool. The collected data were exported to SPSS (v27) for statistical analysis. Descriptive statistics were employed to summarize continuous variables, frequencies and proportions. Bivariable and multivariable logistic regression were employed to identify predictors. Results Approximately 390 respondents were included in this study. The median serum low-density lipoprotein level was 105 mg/dl among the patients and 52 mg/dl among the controls. In the regression model, patients were aged over 60 years (AOR) = 3.1; 95% CI: 1.7-5.6, p< 0.004), had a family history of hypertension (AOR = 6.4; 95% CI: 3.4- 12.3, p<0.001), did not attend diabetes education sessions (AOR = 2.30; 95% CI: 1.28-4.13, p<0.023), did not engage in moderate-intensity exercise (AOR = 4.09; 95% CI: 1.64-10.20, p< 0.001), and engaged in sedentary behavior for four or more hours per day (AOR = 4.27; 95% CI: 2.1-8.6, p< 0.001). Additionally, sleeping more than seven hours per night (AOR = 2.53; 95% CI: 1.2-4.9, p< 0.002) and having a BMI between 25–29.9 kg/m 2 (AOR = 2.75; 95% CI: 1.2-6.2, p< 0.01) were associated with an increased risk of hypertension. Conclusion This study highlights multiple risk factors that increase hypertension burden in DM patients. These findings underscore the urgent need for targeted interventions.