A Control of Hypertension among Diabetic Patients in a Referral Hospital in Tanzania Cross-Sectional Study

Abstract

BACKGROUND: Hypertension is common among diabeticpatients. The co-existence of two conditions carries an excessiverisk of severe complications and mortalities. Limited informationexists on the determinants of poor hypertension control amongthese patients. We aimed at determining the prevalence and factorsassociated with poor hypertension control in these patients.METHODS: Data of diabetic patients who were also hypertensiveattending an outpatient clinic from 1 August 2015 to 31 December2015 at Bugando Medical Centre were retrospectively analyzed.Uncontrolled hypertension was defined as a blood pressure of≥130mmHg and/or ≥80mmHg systolic and diastolic respectively. Adesigned questionnaire was used to collect data of patients.Continuous variables were summarized by median andinterquartile ranges (IQR) and categorical variables weresummarized by frequency and percentage. Logistic regression wasused to find the predictors of uncontrolled hypertension.RESULTS: The majority of our study population were females,161/295 (54.6%), and the median age was 57 years (IQR 50-64).The prevalence of hypertension was 206/295 (69.8%). A total of174/206 (84.5%) patients had uncontrolled hypertension. This poorcontrol was significantly associated with poor adherence to anti-hypertensives (OR 1.73[1.26-2.38] p=0.002), presence of any long-term complication (OR 3.19 [1.65-6.18] p=0.03) and overweight(BMI>24.9 Vs <24.9) (OR 1.68 [0.98-2.88], p=0.04). Under-prescription and ambiguous drugs combination was also observed.CONCLUSION: The prevalence of poor hypertension controlamong diabetic patients in Tanzania is alarming. Most of thefactors associated with this situation can be modified. Theclinicians should advocate individualized management, continuoushealth education and adherence to the available guidelines.