Systemic Hypertension in Type 2 Diabetes Mellitus: Frequency, Interrelation and Risk Factors

K. Lafta, Riyadh; J. Hadi, Berq; Shawky, Nizar

	Systemic Hypertension in Type 2 Diabetes Mellitus: Frequency, Interrelation and Risk Factors
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 23, Issue 4, 2010, Pages 236-242
Authors
Riyadh K. Lafta; Berq J. Hadi; Nizar Shawky
Abstract
Abstract: Background: The public health burden of type 2 diabetes mellitus and of hypertension is significant and rapidly growing. Hypertension accompanying diabetes mellitus is a major factor contributing to the excessive risk of myocardial infraction, stroke, and heart failure. Patients with hypertension are already at high risk for cardiovascular mortality and this risk increases two-fold in those with concomitant type 2 diabetes. Objective: to uncover the occurrence of hypertension in type 2 diabetics attending the National Diabetes Center, and to determine whether it is comparable to the non-diabetics in Iraq and to diabetics of other countries. Method: A cross-sectional study with an analytic element was conducted on type 2 diabetic individuals attending the National Diabetes Center during the period from January through September 2009. The sampling method was a convenient non-random one, carried out through consecutive pooling of all newly registered type 2 diabetics attending the center during the study period. Thorough information concerning the patients' condition was obtained, via a questionnaire-form paper, specifically constructed for this purpose. For each patient; the following variables were assessed: age, sex, education, marital status, duration of diabetes, self-reported history of hypertension and its duration, blood pressure (systole and diastole), fasting plasma glucose level, and glycosylated hemoglobin percentage. Results: A total of 495 patients with type 2 diabetes had been enrolled in this study. The mean systolic blood pressure of them was (136.71±20.95) mmHg and the mean diastole was (85.78±10.14) mmHg. Hypertension was reported in 64.6%, and borderline blood pressure in 27.1% of the participants. In respect to the temporal relationship; 29.7% of respondents had hypertension before or at time of diagnosis of diabetes mellitus, 20% became hypertensive after the onset of diabetes, and 14.9% were discovered to be hypertensive for the first time during the study course. A higher rate of hypertension was seen in females than males, 68% vs. 61% respectively (P=0.038). The percentage of hypertension in those with elementary education was 69.1%, secondary education (58.8%), and 67.3% in patients with higher education. Although the prevalence of hypertension in the participants rose when the duration of diabetes increased, from 60.7% in patients affected from period equal or less than 5 years to 69.2% in those with more than 10 years of disease, this raising did not reveal significant difference (P=0.165). Diabetics with hypertension reported a mean level of fasting plasma glucose of (180.54±68.29) mg/dl, while those with borderline blood pressure and normotensive individuals showed mean levels of (201.48±83.05) and (218.54±91.28) mg/dl respectively (P=0.001). The mean percentage of glycosylated hemoglobin was (8.58±1.90) % in hypertensive patients, (9.08±2.38) % in those with borderline blood pressure, and (9.37 ± 2.51) % in normotensive individuals (P=0.013). Conclusion: hypertension is a common problem in patients with type 2 diabetes mellitus. Its prevalence is higher than that found in the general Iraqi population, and is nearly equal to that reported in diabetics of other countries. Key Words

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