Prevalence of hypertension and determinants of poor blood pressure control in patients with Type 2 diabetes mellitus attending a Tertiary Clinic in Lagos, Nigeria

Abstract

Objective: The objective is to determine the prevalence of comorbid hypertension and blood pressure (BP) control among patients with Type-2-diabetes-mellitus attending a tertiary-hospital in Lagos, and identify the determinants of poor BP control. Materials and Methods: A cross-sectional study of 238 consecutive patients with Type-2-diabetes Mellitus (DM) at the adult diabetes-clinic of a tertiary health-facility in Lagos, Nigeria over a 5-month period. Data were retrieved with the aid of structured-investigator-administered-questionnaire, physical examination, and review of hospital record. Hypertension was defined as BP ≥140/90 mmHg and target BP control was defined as <130/80 mmHg. Logistic regression analysis was used to identify the independent determinants of poor BP control. Results: Comorbid hypertension was present in 187 (78.6%) of study participants with males (68/87 [78.8%]) and females (119/151 [78.2%]) similarly affected, P = 0.907. Older age (62.9 ± 10.1 vs. 54.9 ± 9.6 years) and obesity (35.3% vs. 17.6%) were associated with comorbid hypertension, P < 0.05. Awareness, treatment, and medication adherence rates were 96.3%, 100%, and 46%, respectively. Only 17.1% ( n = 32/187) had BP controlled to target. Waist circumference (WC) (adjusted odd ratio: 1.04, 95% confidence interval [CI]: 1.01–1.06) and poor glycemic control (adjusted odd ratio: 5.39, 95% CI: 2.07–13.99) were the predictors of poor BP control. Conclusion: The prevalence of co-morbid hypertension in Type 2 DM patients in our setting is high and the BP control rate is low. Increasing WC and poor glycemic control are the independent determinants of poor BP control. Individualized weight reduction and glycemic control strategies may help achieve target BP control.