Prevalence of hypetension, its control and other cardiovascular risk factors among diabetic patients at Muhimbili national hospital, Dar es salaam

Abstract

Background: Hypertension is a common eo morbidity of diabetes that has twice the risk of cardiovascular disease as compared to non-diabetic. This risk is reduced by hypertension treatment to a target blood pressure (BP) level of <130/80 mmHg. However, reaching target BP in hypertensive patients is often difficult and it has only been reached in 9 to 58% of diabetics studied. Generally, hypertension in type 2 diabetic patients clusters with other cardiovascular risk factors such as obesity, hyperglycemia, and dyslipidemia. Little information is available about the magnitude of hypertension, its control and other associated cardiovascular risk factors among diabetics in our setting. Objectives: To determine the prevalence of hypertension, its control and the prevalence of other cardiovascular risk factors among diabetic patients at Muhimbili Diabetic clinic, Dar es Salaam Methods: This was 6 months prospective cross-sectional and descriptive study that consecutively enrolled 150 diabetics patients attending MNH clinic aging 18 years and above. Data on weight and height, blood pressure, random capillary blood glucose, lipid profile and serum creatinine were ascertained. Hypertension and diabetes therapy were also documented. Results: Fifty four percent of all patients were hypertensive. Of these, 67 (81.7%) patients were on anti- hypertensive medications with only 34% of them achieving a controlled target of BP < 130/80 mmHg. Hypertensive patients were older, more overweight/obese, had a longer duration of diabetes and elevated serum creatinine. Majority of the patients were on glucose-lowering agents but only 23.3% achieved glycemic control (pre-prandia1 glucose < 7.2 mmol/1). Dyslipidemia was highly frequent (88%) with elevated LDL cholesterol being the commonest fOlID. Hypertrig1yceridemia was significantly associated with poor glycemic control. Overweight and obesity were found in 48.7% and 18.7% respectively. Active cigarette smoking was uncommon (1.3%). Conclusion: Hypertension, hyperglycaemia, dyslipidaemia and obesity are prevalent among our diabetic patients. Of all patients who were on antihypertensive drugs only a third reached a control target level of 130/80 mmHg. Similarly most patients had poor glycemic control. It is recommended that a more aggressive and multifactorial approach to address cardiovascular risk factors be used in this high-risk group to prevent cardiovascular events.