Prevalence, treatment and control of hypertension among type 2 diabetic patients at Moi teaching and referral hospital, Eldoret, Kenya

Abstract

Objectives: To describe the prevalence, treatment and control of hypertension among type 2 diabetic patients at Moi Teaching and Referral Hospital (MTRH) and to determine predictors of blood pressure (BP) control. Design: A cross-sectional study. Setting: Diabetic Outpatient Clinic at MTRH, Eldoret, Kenya Subjects: Type 2 diabetic patients Interventions: The study collected socio-demographic (age, gender, employment status, monthly income, education level, marital status, cigarette smoking and alcohol use), clinical (BP, weight, height and waist circumference) and laboratory (serum fasting lipids and creatinine, urine proteins) data from type 2 diabetic patients. Good BP control was defined as <130mmHg systolic and <80mmHg diastolic. Association between BP control and social demographic, clinical and laboratory variables of study subjects was determined using the chi-square, T-test, fisher’s exact test and logistic regression. Results: We studied 218 type 2 diabetics: mean age 57±9 years; 122 (56%) were females. Average duration of diabetes was 11±7 years. Prevalence of hypertension was 185/218 (85%) out of who 40 (21%) had good BP control. Average duration of hypertension was 7±5 years. Of the 185 hypertensive diabetics: 92 (50%) had total cholesterol at goal; 102 (55%) had low density lipoproteins (LDL) at goal; 74 (40%) had triglycerides at goal; 65(35%) had high density lipoprotein (HDL) at goal and 85(45%) had Proteinuria. All hypertensive patients had >1 anti-hypertensive agent prescribed. Good BP control was associated with compliance to anti-hypertensives (OR= 0.342, 95% CI: 0.105- 1.432) and having HDL at goal (OR = 0.247, 95% CI: 0.126-0.845). Poor BP control was associated with a higher number of prescribed anti-hypertensive agents (OR=1.377, 95% CI: 1.112- 2.302). Conclusion: Prevalence of hypertension among type 2 diabetic patients in MTRH is high and BP control is poor despite anti-hypertensive treatment. Significant predictors of BP control include compliance to anti-hypertensives and control of HDL.