The SA Journal Diabetes & Vascular Disease Vol 15 No 2 (November 2018)

21 / 52

SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE
VOLUME 15 NUMBER 2 • NOVEMBER 2018 59
odds ratio (OR) and their 95% confidence interval (CI). Only factors
with a p-value < 0.2 at bivariate analysis were considered for
multivariate analysis. Multivariate logistic regression was performed
and interaction was assessed for with the Chunk test. Confounding
was assessed for using a 10% difference between the crude and
adjusted models. Significance was at p ≤ 0.05.
Results
This study recruited 201 newly diagnosed diabetic patients between
June 2014 and January 2015. Of these, 102 (50.8%) were males.
The mean age of the participants was 46 ± 15 years (Table 1).
Patients with type 1 and type 2 DM had mean ages of 25.6 (18–42)
and 51.9 (26–90) years, respectively. The majority of patients had
type 2 DM (n = 159, 79.1%) and the rest had type 1 DM (n = 42,
20.9%) (Table 2). The mean HbA1c was 13.9 ± 5.3%. Mean duration
of diabetes was two months. The majority of patients (124, 62.0%)
were unemployed.
Blood pressure assessment was performed on all 201participants
and the results are shown in Table 3. Prevalence of hypertension was
61.9% (95% CI: 54.8–68.6%). Systolic hypertension was present
in 104 (51.5%) participants (95% CI: 45.3–59.2%) while diastolic
hypertension was present in 92 (45.5%) (95% CI: 39.3–53.2%).
Among those who were hypertensive, only 56 (27.7%) knew that
they were hypertensive, and among these, only 24 (44.4%) were
on treatment for hypertension. The use of either ACE inhibitors or
angiotensin receptor blockers (ARBs) among those who knew their
hypertension status was only 19 (33.9%) subjects.
For participants who knew their hypertension status, the
majority 44 (77.2) had been hypertensive for less than five years.
The number who had been hypertensive for durations between five
and 10 years and more than 10 years were eight (4.3%) and five
(8.8%), respectively.
In bivariate analysis, the factors associated with hypertension
included: female gender, age above 40 years, participants who were
Table 1. Social demographics of 201 newly diagnosed diabetic patients
at Mulago National Referral Hospital who participated in the study
Total Total Hypertensive Normotensive
Characteristics (n) (%) n (%) n (%)
Age
< 40 years 58 28.9 21 (36.2) 37 (63.8)
> 40 years 143 71.1 105 (73.4) 38 (26.6)
Gender
Male 102 50.8 54 (52.9) 48 (47.1)
Female 99 49.3 72 (72.7) 27 (27.3)
Employment
Employed 76 38.0 41 (53.9) 35 (46.1)
Unemployed 124 62.0 85 (68.6) 39 (31.4)
Pregnancy
Yes 6 5.4 3 (50.0) 3 (50.0)
No 105 94.6 74 (70.5) 31 (29.5)
Education
None 17 8.5 10 (58.8) 7 (41.2)
Primary 78 38.8 50 (64.1) 28 (35.9)
Secondary 75 37.3 45 (60.0) 30 (40.0)
Tertiary 31 15.4 21 (67.7) 10 (32.3)
Marital status
Never married 29 14.4 7 (24.1) 22 (75.9)
Currently married 119 59.2 83 (69.8) 36 (30.3)
No longer married 53 26.4 36 (67.9) 17 (32.1)
Table 2. Characteristics of 201 newly diagnosed diabetic patients at
Mulago National Referral Hospital who participated in the study
Total Total Hypertensive Normotensive
Characteristics (n ) (%) n (%) n (%)
Physical activity at work
Sedentary 25 12.4 16 (69.6) 7 (30.4)
Mild 51 25.3 33 (64.7) 18 (35.3)
Moderate 82 40.6 54 (66.7) 27 (33.3)
Strenuous 22 (50.0) 22 (50.0)
Does not work 44 21.8 1 (50.0) 1 (50.0)
Physical activity at leisure
Sedentary 142 71.0 96 (67.6) 46 (32.4)
Moderate 58 29.0 29 (50.0) 29 (50.0)
DM type
Type 1 42 20.9 11 (26.2) 31 (73.8)
Type 2 159 79.1 115 (72.3) 44 (27.7)
Microalbumin in urine
Absent 79 44.9 50 (62.5) 30 (37.5)
Present 97 55.1 58 (61.1) 37 (38.3)
BMI
Underweight 39 19.4 10 (25.6) 29 (74.4)
Normal weight 75 37.3 40 (53.3) 35 (46.7)
Over weight 3 1.5 1 (33.3) 2 (66.7)
Obesity 84 41.8 75 (89.3) 9 (10.7)
Waist:hip ratio
Normal 141 69.8 81 (57.9) 59 (42.1)
Abnormal 61 30.2 45 (73.8) 16 (26.2)
HbA1c (%)
< 7% 15 8.4 11 (73.3) 4 (26.7)
> 7% 164 91.6 101 (61.9) 62 (38.0)
Ejection fraction (%)
> 50% 158 78.2 102 (64.6) 56 (35.4)
< 50% 44 21.8 24 (55.8) 19 (44.2)
LVH
Present 39 19.3 89 (77.4) 26 (26.5)
Absent 163 80.7 37 (43.0) 49 (56.9)
Diastolic function
Normal 91 45.1 44 (48.9) 46 (51.1)
Impaired 111 54.9 82 (73.9) 29 (26.1)
Wall motion
Normal 193 96.5 120 (62.2) 73 (37.8)
Abnormal 7 3.5 5 (71.4) 2 (28.6)
Table 3. Prevalence, knowledge and treatment of hypertension among
201 newly diagnosed diabetic patients at Mulago Hospital
Parameters Number Prevalence (%) 95% CI
Hypertension 125 61.9 54.8–68.6
Systolic BP > 140 mmHg 104 51.5 45.3–59.2
Diastolic BP > 90 mmHg 92 45.5 39.3–53.2
Knowledge of hypertension 56 27.7 22.1–34.6
HTN newly diagnosed 69 34.2 27.6–39.8
ACEI/ARB use in known HTN 19 33.9 26.7–39.2
Known HTN on drugs 24 44.4 38.9–52.4
Known HTN not on drugs 30 55.6 47.2–62.1
HTN: hypertension, ACEI: ace inhibitor, ARB: angiotensin receptor blocker.
employed, participants who were never married and those who
were currently married, overweight and obesity, increase in waist:hip
ratio, LVH and diastolic dysfunction (Table 4). After adjusting for the
patients’ gender, age, employment, marital status, BMI, waist:hip
ratio, LVH and diastolic dysfunction, the only significant factors
associated with hypertension were being employed (OR 0.37, 95%
CI: 0.16–0.90, p = 0.029), and overweight and obesity (OR 11.6,
95% CI: 4.29–31.2, p < 0.0001).