Evaluation of the management of hypertension among diabetic and non-diabetic adult outpatients at a referral hospital in Kenya

Aisha Mongi, David Nyamu, Peter Karimi, Shital Maru

Abstract


Background: Hypertension is a common non-communicable illness that can occur either alone or in combination with diabetes and other diseases. Diabetic hypertensive patients are more vulnerable to cardiovascular and renal complications compared to non-diabetic hypertensive patients. Target blood pressures in these two patient populations are different; nevertheless, optimal blood pressure control is paramount in both groups.

Objective: To evaluate the management of hypertension among diabetic and non-diabetic outpatients at the medical outpatient clinic in Kenyatta National Hospital, Nairobi, Kenya.

Methodology: A tertiary hospital based cross-sectional study was carried out at the medical outpatient clinic in Kenyatta National Hospital. This study comprised of two study groups: 48 diabetic hypertensive patients and 48 non-diabetic hypertensive patients. Face to face interviews were conducted and additional data was extracted from the patient’s file. The main outcomes of interests were the BP readings that formed the dependent variable and the covariates or factors that influenced BP control that formed the independent variables in both the two arms of study. Data was analyzed using SPSS version 19.0 software. The level of significance was determined using Pearson chi square set at 0.05 and p values < 0.05 were considered to be statistically significant.

Results: Of the 96 patients enrolled, the male to female ratio was 1:2, the mean age was 57 years (+11.1) and the mean duration of hypertension was 7.7 years (+6.3). Overall, 70% of the entire study population had inadequate blood pressure control. Among the diabetic patients, 75% had inadequate blood pressure control compared to 65% of the non-diabetic patients. Three quarters of the diabetic patients were on > 2 antihypertensive drugs compared to 98% of the non-diabetic patients.

Conclusion: Control of hypertension in both diabetic and non-diabetic hypertensive patients is poor. We suggest that patient involvement, patient education and continuous counseling on hypertension are essential in the overall management of hypertension.

Key words: Diabetes, Hypertension, Blood Pressure


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