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RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
62
VOLUME 15 NUMBER 2 • NOVEMBER 2018
to lack of capacity. A non-diabetic control group would have
provided better comparison, however in this study we assessed the
prevalence and associated factors of hypertension but not its risk
factors among diabetics. The recruitment time between June 2014
and January 2015 was relatively short due to limitations in logistics.
This could have obscured seasonal differences.
Conclusion
The prevalence of hypertension was high in this population of newly
diagnosed diabetics, who had little knowledge of hypertension, and
very few patients were on appropriate treatment. Both modifiable
and non-modifiable risk factors were associated with hypertension
in this group. Therefore, routine assessment, treatment and control
of hypertension among diabetics is necessary to prevent CVD
complications and death. Pharmacotherapy should be combined
with lifestyle changes to address the modifiable risk factors.
Research reported in this manuscript was supported by the
Fogarty International Center of the National Institutes of Health
under award number R24TW008861. Dr Mudda was also
supported by the Fogarty International Center and the National
Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of
Health under the Global Health Equity Scholars Consortium at Yale
University (D43TW010540). The content is solely the responsibility
of the authors and does not necessarily represent the official views
of the National Institutes of Health. The authors are grateful to the
following persons for their invaluable support: Professors Nelson
Sewankambo and Moses R Kamya, the staff of Ward 4B Endocrine,
Diabetic Clinic, and the echocardiography and clinical laboratory of
Mulago Hospital.
References
1. Kavishe B, Biraro S, Baisley K, Vanobberghen F, Kapiga S,
et al
. High prevalence
of hypertension and of risk factors for non-communicable diseases (NCDs):
a population based cross-sectional survey of NCDS and HIV infection in
Northwestern Tanzania and Southern Uganda.
BMC Med
2015;
13
(126): 126.
2. Twagirumukiza M, de Bacquer D, Kips JG, de Backer G, Stichele RV, van Bortel
LM. Current and projected prevalence of arterial hypertension in sub-Saharan
Africa by sex, age and habitat: an estimate from population studies.
J Hypertens
2011;
29
: 1243–1252.
3. Bloomfield GS, Barasa FA, Doll JA, Velazquez EJ. Heart failure in sub-Saharan
Africa.
Curr Cardiol Rev
2013;
9
: 157–173.
4. Moran AE, Tzong KY, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M,
et al
.
Variations in ischemic heart disease burden by age, country, and income: the
Global Burden of Diseases, Injuries, and Risk Factors 2010 study.
Glob Heart
2014;
9
: 91–99.
5. Kotwani P, Kwarisiima D, Clark TD, Kabami J,
et al
. Epidemiology and awareness
of hypertension in a rural Ugandan community: a crosssectional study.
BMC
Public Health
2013;
13
: 1151.
6. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden
of hypertension: analysis of worldwide data.
Lancet
2005;
365
: 217–223.
7. Musinguzi G, Nuwaha F. Prevalence, awareness and control of hypertension in
Uganda.
PloS One
2013;
8
(4): 62236.
8. Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N. Epidemiology of
hypertension in low-income countries: a cross-sectional populationbased survey
in rural Uganda.
J Hypertens
2011;
29
: 1061–1068.
9. Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N,
et al
. Distribution of
hyperglycaemia and related cardiovascular disease risk factors in low-income
countries: a cross-sectional population-based survey in rural Uganda.
Int J
Epidemiol
2011;
40
: 160–171.
10. Mondo CK, Otim MA, Akol G, Musoke R, Orem J. The prevalence and distribution
of non-communicable diseases and their risk factors in Kasese district, Uganda.
Cardiovasc J Afr
2013;
24
(3): 31–36
11. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates
for 2000 and projections for 2030.
Diabetes Care
2004;
27
: 1047–1053.
12. Adler AI, Stratton IM, HAW Neil, Yudkin JS. Association of systolic blood pressure
with macrovascular and microvascular complications of type 2 diabetes (UKPDS
36): prospective observational study.
Br Med J
2000;
321
: 412–419.
13. Cutler JA. High blood pressure and endorgan damage.
J Hypertens
1996;
14
(Suppl): 36.
14. Tuomilehto J, Rastenyte D, Birkenhäger WH, Thijs L, Antikainen R, Bulpitt CJ,
et
al
. Effect of calcium channel blockade in older patients with diabetes and systolic
hypertension.
N Engl J Med
1999;
320
: 67784.
15. Sowers J. Recommendations for special populations: diabetes mellitus and the
metabolic syndrome.
Am J Hypertens
2003;
16
(11 pt 2): 41S–45S.
16. Makowsky M, Ally PH, Prebtani A, Gelfer M, Manohar A, Jones C. Management
of hypertension in people with diabetes mellitus: translating the 2012 Canadian
Hypertension Education Program recommendations into practice.
Can J Diabetes
2012;
36
: 345–353.
17. Dinh W, Lankisch M, Nickl W, Scheyer D, Scheffold T,
et al
. Insulin resistance
and glycemic abnormalities are associated with deterioration of left ventricular
diastolic function: a cross-sectional study.
Cardiovasc Diabetol
2010;
9
: 63.
18. Cooper R, Rotimi C, Ataman S, McGee D,
et al
. The prevalence of hypertension in
seven populations of west African origin.
Am J Public Health
1997;
87
: 160–168.
19. Kengne AP, Amoah AG, Mbanya J-C. Cardiovascular complications of diabetes
mellitus in sub-Saharan Africa.
Circulation
2005;
112
: 3592–3601.
20. Baba MM, Balogun MO, Akintomide AO, Adebayo RA, Talle MA,
et al
. Left
ventricular geometry in Nigerians with type II diabetes mellitus.
Nig Q J Hosp Med
2012;
22
(3): 152–157.
21. Somaratne JB, Whalley GA, Poppe KK, ter Bals MM, Wadams G,
et al
. Screening
for left ventricular hypertrophy in patients with type 2 diabetes mellitus in the
community.
Cardiovasc Diabetol
2011;
10
: 29.
22. Havranek E, Esler A, Estacio RO, Mehler PS, Schrier RW. Differential effects
of antihypertensive agents on electrocardiographic voltage: results from the
Appropriate Blood Pressure Control in Diabetes (ABCD) trial.
Am Heart J
2003;
145
(6): 993–998.
23. Keil JE, Sutherland SE, Knapp RG, Lackland DT, Gazes PG, Tyroler HA. Mortality
rates and risk factors for coronary disease in black as compared with white men
and women.
N Engl J Med
1993;
329
: 738.
24. Collins R, Peto R, MacMahon S, Herbert P, Fiebach N, Eberlein K,
et al
. Blood
pressure, stroke, and coronary heart disease.
Lancet
1990;
335
: 827–838.
25. Lawes CM, van der Hoorn S, Rodgers A. Global burden of bloodpressure related
disease, 2001.
Lancet
2008;
371
: 1513–1518.
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by SAHPRA, 17 February 2017.
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