Prevalence, risk factors, and management of uncontrolled hypertension among patients with diabetes: A hospital-based cross-sectional study

Abstract

Aims: This research examines the prevalence of uncontrolled hypertension and associated risk factors among patients with diabetes in Saudi Arabia.

Methods: A hospital-based, cross-sectional study was used in patients with diabetes and hypertension attending outpatient diabetes clinics in King Khaled Hospital and Prince Sultan Center for Health Care in Al-Kharj, Riyadh. Patients' information, data on hypertension, type of treatment, and comorbidities were captured through electronic medical records. Uncontrolled hypertension was defined as blood pressure (BP) measurements greater than or equal to 140/90 mmHg. Antihypertensive medication use among these patients was analyzed. Multivariate analysis was performed to detect the associated factors of uncontrolled hypertension.

Results: Of 1178 outpatients‬ with diabetes who were included in the study sample, uncontrolled hypertension presented in 846 (71.8%). Most patients were on two antihypertensive medications, and the most frequently used was calcium channel blockers, followed by angiotensin-converting enzyme inhibitors. Individuals most likely to have uncontrolled hypertension were those older than 65 years (OR 1.99, 95%CI: 1.059, 3.77), male (OR = 1.51, 95%CI: 1.031, 2.22), and obese (OR = 2.39, 95%CI: 1.63, 3.504), with two (OR = 3.894, 95% CI: 2.481, 6.114) or three or more comorbidities (OR = 4.020, 95% CI: 2.510, 6.439), and with polypharmacy (OR = 1.814, 95% CI: 1.238, 2.656).

Conclusion: The extent of uncontrolled hypertension among patients with diabetes in the study sample was found to be high. Age, sex, obesity, number of comorbidities, and polypharmacy are the most important correlates with increased risk of uncontrolled hypertension.

Keywords: Diabetes mellitus; Prevalence; Risk factors; Uncontrolled hypertension.