Determinants of hypertension among diabetes patients attending selected comprehensive specialized hospitals of the Amhara Region, Ethiopia: An unmatched case-control study.

Abstract

The coexistence of diabetes mellitus and hypertension is a worldwide public health problem causing significant morbidity, mortality, and decreased quality of life. Despite the increasing burden of hypertension among patients with DM, data on determinants of hypertension among patients with DM in the Amhara region of Ethiopia is scarce. Hence, this study identified determinants of hypertension among people with diabetes attending chronic disease follow-up clinics in the Amhara region of comprehensive specialized hospitals in Ethiopia. An institutional-based unmatched case-control study was conducted among 470 individuals with diabetes in the Amhara region's comprehensive specialized hospitals (Debre Berhan, Felege Hiwot, and Dessie Comprehensive specialized hospital). A multistage sampling technique was used to select participants for this study. We collected the data using standard questionnaires (short form of international physical activity questionnaire, Morisky medication adherence scale, patient health questionnaire, perceived dietary adherence scale, Oslo social support questionnaire, and alcohol use disorder identification test), physical measurements, and data extraction checklists. A multivariable binary logistic regression was fitted to identify determinants of hypertension, and we presented the findings using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). 235 cases and 235 controls participated in this study. The median (IQR) age for the cases was 60 (52-66 = 14), and the mean age (± SD) for the controls was 51.72 (± 12.51). The significant determinants of hypertension with AOR [95% CI] were a lower level of physical activity: 1.82 [1.00, 3.31], depression: 2.00 [1.24, 3.21], family history of hypertension: 2.13 [1.34, 3.37], not having diabetic health education: 1.87 [1.18, 2.96], a longer duration of diabetes: 1.99 [1.05, 3.79], and poor glycemic control: 1.57 [1.01, 2.45]. In this study, determinants that increase the risk of hypertension among people with diabetes mellitus were older age, physical inactivity, depression, family history of hypertension, not having diabetic health education, a longer duration of diabetes, and poor glycemic control.