Hypertensive Diabetic Patients Research Articles

P5731Optimal blood pressure in diabetic hypertensive patients with overt proteinuria

Abstract Background Evidence for the benefit of intensive blood pressure lowering in diabetic nephropathy is not clear at this time. The objective of this study was to demonstrate whether lower mean blood pressure (BP) in treated hypertensive patients with diabetic nephropathy is associated with better prognosis. Methods From the National Health Insurance Service (NHIS) Health Examination Database, diabetic hypertensive subjects with proteinuria between 2009 and 2010 were selected and followed-up until 2015 (N=8,663). Mean of the recorded systolic and diastolic BP during follow-up health examinations were stratified into five categories (SBP: <120, 120 to <130, 130 to <140, 140 to <150, and ≥150 mmHg; DBP: <70, 70 to <80, 80 to <90, 90 to <100, and ≥100 mmHg). All-cause death, myocardial infarction (MI), stroke, and renal outcome (progression to end stage renal disease or doubling of serum creatinine) were examined by Cox proportional hazard models with the propensity scores adjusted method. Results Compared to SBP of 130 to <140 mmHg, SBP of 120 to <130 mmHg was associated with lower risk of all-cause death (HR=0.78; 95% CI, 0.64–0.95), stroke (HR: 0.65; 95% CI, 0.45–0.94), and renal outcome (HR: 0.81; 95% CI, 0.68–0.97). SBP of <120 mmHg was associated with benefit for renal outcomes (HR: 0.69; 95% CI 0.55–0.88) but not with elevated risk of other outcomes. Compared to DBP of 80 to <90 mmHg, DBP of 70 to <80 mmHg were associated with lower risk of all-cause death (HR: 0.75; 95% CI, 0.64–0.88) but with higher risk of MI (HR: 1.52; 95% CI, 1.05–2.21). DBP of <70 mmHg was associated with reduced risk of all-cause death (HR: 0.79; 95% CI, 0.64–0.98). Conclusion In diabetic hypertensive subjects with overt proteinuria, deterioration of renal function decreased with decreasing SBP and the lowest risk of all-cause death and stroke were observed in SBP <130 mmHg. Low DBP was associated with low risk of all-cause death but there was a J curve phenomenon for MI in DBP of 70 to <80 mmHg.

Nevoia de multidisciplinaritate în managementul pacientului diabetic hipertensiv

Nevoia de multidisciplinaritate în managementul pacientului diabetic hipertensiv

Stresul și tulburările depresive la pacientul diabetic hipertensiv

Stresul și tulburările depresive la pacientul diabetic hipertensiv

A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic patients

Background: Hypertension management is of paramount importance in diabetic patients for reduction of cardiovascular and other complications. The objective of the present study was to assess prescribing pattern of antihypertensive drugs in hypertensive type 2 diabetic patients and evaluate them by comparing with Eighth Joint National Committee (JNC-8) hypertension treatment guidelines.Methods: A prospective observational study was carried out on 110 hypertensive type 2 diabetic patients of age 41-80 years visiting outpatient department of Medicine at G.S. Medical College and Hospital, UP, India for 4 months. JNC-8 hypertension management guideline was considered while evaluating the prescribed drugs. All the relevant data was collected from the prescription card of the patient on a preformed performa and analyzed using descriptive statistics.Results: Total of 176 drugs was prescribed to the study patients among which two drug combination therapy (55.45%) was mostly used. The most common group prescribed was angiotensin receptor blocker (ARB) (29.45%) and ARB+CCB (calcium channel blockers) (34.92%) were the commonest fixed drug combination. Overall, it was amlodipine (21.47%) that was most frequently prescribed among all antihypertensive drugs.Conclusions: ARB was the most commonest class, ARB+CCB was the most frequent fixed drug combination prescribed to the study patient while amlodipine was the highly utilized individual antihypertensive drug in the study. Prescriptions evaluation revealed that 94.88% prescription were rational and were in accordance with the JNC-8 hypertension treatment guidelines except the use of beta blockers (5.12%).

Shortening Activated Partial Tromboplastin Time (APTT) Between Hypertension and Nonhypertension in Diabetic Mellitus Patients with Bevacizumab Intravitreal Injection

Introduction :
 Bevacizumab intravitreal injection could be detectable in plasma that might interfere the coagulopathy and hemostasis condition. The purpose of this study was to investigate the difference of APTT between hypertensive and nonhypertensive diabetic mellitus patients with bevacizumab intravitreal injection.
 Methods :
 This was cohort study conducted at Sardjito General Hospital from March 2019 to June 2019. Thirty-two hypertension patients and 30 nonhypertension patients with diabetes mellitus who underwent bevacizumab intravitreal injection were included. Value of APTT was measured using ACLTOP300 machine prior and 1 week after IVB. The difference in mean APTT value prior and after IVB, range APTT value between two groups were assessed using independent t-test. The percentage of patients who had shortening of APTT in both groups was tested by two populations proportion test.
 Results : 
 Mean APTT before IVB in hypertensive patients was 36.47 ± 2.92 seconds and in nonhypertensive patients was 36.33 ± 4.39 seconds with p value > 0.05. Mean value of APTT after IVB in hypertension patients was 35.42 ± 3.63 seconds and in nonhypertensive patients was 35.60 ± 3.13 seconds with p value > 0.05. APTT shortening in hypertensive patients was -1.03 ± 3.65 and nonhypertensive patients was -0.73 ± 2.55 with p value > 0.05. The risk of APTT shortening in hypertensive patients was 1.370 (0.831-2.258). The risk of APTT shortening in hypertensive patients who used antihypertensive drugs regularly was 0.538 (0.331- 0.874).
 Conclusion :
 There was no difference in shortening of APTT value 1 week after intravitreal bevacizumab injection between hypertensive and nonhypertensive groups in patients with diabetes mellitus. Hence, administration of IVB in hypertensive patients with regular antihypertensive therapy might be safe.

Positive association between baseline brachial\u2013ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients

BackgroundThere is no clearly defined temporal relationship between arterial stiffness and diabetes. We aimed to investigate the prospective association between baseline brachial–ankle pulse wave velocity (baPWV) and the risk of new-onset diabetes during follow-up, and examined whether there were effect modifiers, in hypertensive patients.MethodsWe included 2429 hypertensive patients with all the pertinent data but without diabetes at the baseline, who were part of the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose (FG) ≥ 126.0 mg/dL at the exit visit.ResultsDuring a median follow-up duration of 4.5 years, 287 (11.8%) participants developed diabetes. There was a significant positive association between baseline baPWV and the risk of new-onset diabetes (per SD increment; OR, 1.33; 95% CI 1.13, 1.56). Consistently, when baPWV was assessed as quartiles, a significantly higher risk of new-onset diabetes was found in participants in quartiles 2–4 (≥ 15.9 m/s; OR, 1.80; 95% CI 1.22, 2.65) compared with those in quartile 1 (< 15.9 m/s). The positive association was consistent in participants with (per SD increment; OR, 1.29; 95% CI 1.06, 1.56) or without (per SD increment; OR, 1.40; 95% CI 1.15, 1.71) impaired fasting glucose (IFG, FG ≥ 100.8 and < 126.0 mg/dL, P-interaction = 0.486).ConclusionsIn this sample of hypertensive patients, we found a significant positive association between baseline baPWV and the risk of new-onset diabetes.Clinical trial registration Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008

SERUM LIPID AND TRACE MINERAL PROFILES AMONG TYPE 2 DIABETICS AND HYPERTENSIVE DIABETICS AT THE BAMENDA REGIONAL HOSPITAL

Objective: Diabetes mellitus has become a clinical condition of public health importance, especially in developing countries due to its high mortality and morbidity. The aim of this study was to measure and compare the lipid and serum trace mineral profile among type 2 diabetics and hypertensive diabetics with controls.&#x0D; Methods: This cross-sectional study was carried out at the Regional Hospital, Bamenda, involving 50 diabetic normotensives, 50 hypertensive diabetics, and 50 normal recruited subjects. Serum levels of lipids and minerals were determined using standard methods.&#x0D; Results: Of the four trace elements assessed, except for copper (Cu) whose mean values in diabetics were abnormally increased (p=0.01), zinc (Zn), magnesium (Mg), and chromium (Cr) showed significantly decreased mean values in diabetics compared to the controls (p&lt;0.05). The mean levels of these trace elements were also significantly reduced in hypertensive diabetic patients (p&lt;0.05). In diabetics, there was no significant difference in the lipid levels. However, only total cholesterol (TC) and low-density lipoprotein mean values were significantly higher in hypertensive diabetic patients compared to the normal controls. There was also a positive significant correlation between the body mass index and Cr (r=+0.3, p=0.045) in diabetics.&#x0D; Conclusion: This study saw statistically significant differences in the serum lipid and trace element levels between diabetics, hypertensive diabetics, and controls: With diabetic and diabetic hypertensive patients having higher serum Cu levels and decreased serum Mg, Zn, and Cr levels compared to the normal controls. The lipid profile levels in diabetics and hypertensive diabetics were not significant differences within the study groups for all lipid profile estimations except for TC and LDL which were significantly higher only in hypertensive diabetic patients.

Potential impact of exercise versus irisin on hypertension, and visceral adiposity in a rat model of type 2 diabetes mellitus

Background: Type 2 diabetes mellitus (T2DM) is associated with obesity, insulin resistance, and hypertension. Exercise may play important role in combating obesity and diabetic complications. Irisin is a newly discovered exercise-induced myokine. Its role in mediating the beneficial effects of exercise is questionable. Aim: The present study was performed to reveal the beneficial effects of moderate-intensity exercise on diabetic-induced visceral obesity, and hypertension in a rat model of T2DM, as well as the potential role of irisin relative to exercise and the mechanisms-involved. Materials and methods: Rats were allocated into 4 groups; control, type 2 diabetes mellitus (T2DM), exercise-T2DM and irisin-T2DM groups. Body weight (BW), body mass index (BMI), perirenal fat (PF), systolic (SBP), diastolic (DBP), and mean blood pressures (MBP), fasting blood glucose (FBG), insulin, nitrite, and HOMA-insulin resistance (IR) and histology of adipose tissue were determined. Results: Exercise attenuated the adverse effects of T2DM, whereas PF, PF index, serum nitrite, plasma insulin, and HOMA-IR comparable to controls; however, FBG, SBP, DBP and MBP still significantly higher. Partial browning of white adipose tissue demonstrated. Irisin-T2DM rats showed a remarkable effect compared to exercise intervention documented by a reduction in BW, BMI, PF, PF index, DBP, FBG, and insulin, with increase in nitrite, and complete browning of adipose tissue. Conclusion It is concluded that exercise and irisin treatment can improve visceral adiposity and hypertension; however, the protective effect of irisin is more obvious. These data suggest irisin as a potential new strategy to combat obesity and hypertension in diabetic patients.

The Favourable Effects Of Betablockers Treatment On The Diabetic Hypertensive Patients With Nocturnal Non-Dipper Profile.

Background and Aims: This study wants to show the influence of the treatment on hypertension profiles and nocturnal heart frequency. We compare the mean heart rate (MHR) and mean arterial pressure (MAP) on hypertensive diabetic patients with different dipper profiles.

Hypertension and Diabetic Retinopathy

Diabetic retinopathy is the most specific microangiopathy related to diabetes. Furthermore, hypertension is frequently associated with diabetes. The aim of our study was to analyze the prevalence of diabetic retinopathy in hypertensive diabetic patients. Our descriptive retrospective study was conducted in 125 diabetic patients hospitalized in our department. Each patient had a complete clinical examination, a standard biological assessment and fundus to evaluate possible retinal involvement. The age was 53.78 ± 11.2 years, 24.6% were smokers. The mean duration of diabetes progression was 11 ± 7.41 years, HbA 1c = 8.9 ± 3.19%. Overweight or obesity was found in 49.9% of patients. Among our hypertensive patients, 46.9% received a monotherapy and 36.2% a dual therapy. Angiotensin converting enzyme inhibitors were the most prescribed (38.1%) followed by diuretics (19.1%). The most common association was an angiotensin II receptor antagonist + a diuretic (59% of associations). Diabetic retinopathy was found in 47% of patients. 36% of patients suffered from mild non-proliferative diabetic retinopathy (NPDR), 27% from moderate NPDR, 25% from severe NPDR and 12% from proliferative diabetic retinopathy. Maculopathy was present in 7.2% of cases. Complicated diabetic retinopathy was present in 1.7% of cases, and 5% of patients had a Laser treatment for retinopathy. Uncontrolled glycaemia and blood pressure have a synergistic effect on the development and progression of diabetic retinopathy. In addition to glycemic control, the management of hypertension is essential to prevent its onset and slow its progression.

Analysis of the associations between anthropometric parameters, arterial hypertension and dyslipidemia among type 2 diabetic patients

To assess the relationships between anthropometric parameters, arterial hypertension and dyslipidemia in patients with type 2 diabetes mellitus. Our cross-sectional study included 457 patients with type 2 diabetes mellitus. We measured the systolic and diastolic blood pressures, weight, height and waist circumference (WC). Body mass index (BMI) and waist to height ratio (WHtR) were calculated. We performed ROC curves for each anthropometric parameter to assess its discriminant power to distinguish between hypertensive and normotensive diabetic patients and between patients with and without dyslipidemia. Obesity, arterial hypertension and dyslipidemia were observed in 49.2%, 61.1% and 67.1% of diabetics. In diabetic women, blood pressure, total cholesterol and triglyceride levels were significantly correlated with studied anthropometric parameters. In contrast, in diabetic men, a weak correlation between diastolic blood pressure and BMI was observed. Weight, BMI, WC and WHtR had areas under the curve between 0.543 and 0.664. Cut-off values of anthropometric parameters for predicting the presence of high blood pressure or dyslipidemia were higher in women than in men. In our study, anthropometric parameters had a poor discriminant power in the distinction between hypertensive and normotensive patients and between patients with and without dyslipidemia. However, the parameters evaluating visceral fat seemed to have relatively better discriminative power.

Arterial hypertension and diabetes association in the elderly

High blood pressure is common in the elderly diabetic, responsible for an increase in cardiovascular risk and an acceleration of the degenerative complications of diabetes. The aim of this study was to determine the characteristics of hypertension in elderly diabetic subjects and to study its repercussions. Our descriptive study was performed in 60 hypertensive diabetic patients over than 65 years of age, followed in our department. Hypertension was defined as arterial pressure ≥ 140/90 mmHg. A complete clinical examination and a standard biological assessment were performed for each patient. The mean age of the patients was 68.72 years; 61.2% of patients were between 60 and 65 years of age. The mean duration of diabetes progression was 14.2 years and 72% of patients received insulin therapy. The majority (91%) of these patients had uncontrolled diabetes; the average HbA1c was 10.2%. The diagnosis of diabetes preceded that of hypertension in 73.6% of cases. Thirty-three percent of our population had an uncontrolled hypertension. Patients had on a salt-free diet in 18.1% of cases and a dietary salt restriction in 21.2% of cases. Among our hypertensive patients, 29.9 received a monotherapy and 44.2% a dual therapy. Dyslipidemia was found in 51.6% of our patients. A microalbuminuria was noted in 32.3% of patients. Retinopathy was found in 48% of patients, neuropathy in 34.6%. There is a history of stroke in 3.8% of cases and a history of myocardial infarction in 2.2% of cases. Coronary insufficiency was confirmed in 5.8% of cases, unexplored chest pain was found in 26.6% of cases. Intermittent claudication was noted in 24.2% of cases. This claudication was explored and confirmed in 2% of cases. Vascular metabolic complications are serious in hypertensive elderly diabetic subjects; thus, multidisciplinary care and regular monitoring is required to detect these complications early and improve life expectancy.

Antihypertensive Treatment in Diabetic Kidney Disease: The Need for a Patient-Centered Approach.

Diabetic kidney disease affects up to forty percent of patients with diabetes during their lifespan. Prevention and treatment of diabetic kidney disease is currently based on optimal glucose and blood pressure control. Renin–angiotensin aldosterone inhibitors are considered the mainstay treatment for hypertension in diabetic patients, especially in the presence of albuminuria. Whether strict blood pressure reduction entails a favorable renal outcome also in non-albuminuric patients is at present unclear. Results of several clinical trials suggest that an overly aggressive blood pressure reduction, especially in the context of profound pharmacologic inhibition of the renin–angiotensin–aldosterone system may result in a paradoxical worsening of renal function. On the basis of this evidence, it is proposed that blood pressure reduction should be tailored in each individual patient according to renal phenotype.

Plasma selenium levels and risk of new-onset diabetes in hypertensive adults

ObjectiveThe association between plasma selenium and new-onset diabetes in hypertensive adults is still unclear. We aimed to evaluate the relationship of baseline plasma selenium with new-onset diabetes and examine possible effect modifiers in a post-hoc analysis of the China Stroke Primary Prevention Trial (CSPPT). MethodsA total of 2367 hypertensive, non-diabetic patients with plasma selenium measurements at baseline were included. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during the follow-up period, or fasting glucose (FG) ≥126.0 mg/dL at the exit visit. ResultsAt baseline, higher FG levels were found among participants with plasma selenium in quartile 4 (≥94.8 μg/L) (β, 1.64 mg/dL; 95%CI: 0.54, 2.73) compared to those in quartiles 1–3. During a median follow-up duration of 4.5 years, new-onset diabetes occurred in 270 (11.4%) participants. Graphic plot showed a positive association between baseline selenium levels and risk of new-onset diabetes. This was further confirmed by adjusted regression analyses; the odds ratios (OR) for new-onset diabetes comparing quartile 4 (≥94.8 μg/L) to quartiles 1–3 was 1.36 (95%CI: 1.01, 1.83). No clear trend was evident across quartiles 1–3. ConclusionsOur data suggest that high plasma selenium (≥94.8 μg/L) was associated with increased risk of new-onset diabetes in hypertensive patients.

Comparative Effects of Telmisartan versus Valsartan on serum Leptin level, in hypertensive type 2 diabetes mellitus patients

Objective: The aim of this study was to compare the effects of telmisartan and valsartan onblood pressure and serum leptin in hypertensive type 2 diabetesMellitus patients. Study design:A randomized control comparative clinical trial with open label design. Study period: From 1st February, 2012 to 30th March, 2013. Patients and method: Eighty eight type 2 diabetic hypertensive patients were randomly assigned to received either telmisartan (n = 46) or valsartan (n = 42) with body mass index (BMI) 31.52±4.73 kg/m², 30.39±3.95 kg/m² respectivly. Forty one diabetic normotensive patients (n=41), age, sex, BMI, duration of diabetic disease, duration of diabetic treatment matched to the diabetic hypertensive patients groups were kept as control group. blood pressure (BP), leptin levels were measured at baseline and after 2 months of treatment. Results: The study showed a significant higher systolic blood pressure (SBP), diastolic blood pressure (DBP) and serum leptin in the diabetic hypertensive patients before starting therapy as compared with the diabetic normotensive patients. Both telmisartan and valsartan significantly reduced serum leptin and BP. More reduction in DBP seen with valsartan than with telmisartan. Conclusion: Monotherapy with telmisartan and valsartan produce a beneficial reduction effects on BP and reduce leptin level. The improvement of leptin sensitivity may play a role directly or indirectly in the induction of hypertension control.

STUDY OF PREVALENCE OF DEPRESSION AMONG HYPERTENSIVE AND DIABETIC SUBJECTS

Hypertension, Diabetes mellitus and depression are among the group of the most common chronic diseases worldwide, and according to numerous studies they are oftentimes associated. Patients suffering from lifestyle diseases may have increased depression levels in relation with long-term management of these diseases. This study was conducted to determine the prevalence of depression among diabetes mellitus and hypertensive patients

Antihypertensive therapy and adequacy of blood pressure control among adult hypertensive diabetic patients with chronic kidney disease in a tertiary referral hospital

ABSTRACTBackground: Tight blood pressure control retards the development of end-stage renal disease in hypertensive diabetic patients with chronic kidney disease. There is limited literature on blood pressure control among this patient population in a resource-limited setting.Research design and methods: A tertiary hospital-based cross-sectional study with 237 hypertensive diabetic patients with chronic kidney disease was conducted. A pre-tested questionnaire was used to assess patients’ awareness of their ideal blood pressure. Data on blood pressure readings and antihypertensive therapies were abstracted into predesigned data collection forms and analyzed using STATA software version 13.0.Results: The participants’ mean age was 61.8 ± 12.7 years and 106 (44.7%) patients were aware of the blood pressure targets. Adequate blood pressure control was found in 30.8%. Most (58.7%) were using ≥ 3 antihypertensive drug classes. Calcium channel blockers (51.1%), with principally amlodipine (26.2%) and nifedipine (24.1%), were the most preferred agents. Bivariate analysis showed enalapril (p = 0.009) and nifedipine (p = 0.022) being associated with adequate blood pressure control. However, nifedipine (AOR 2.79; 95% CI: 1.12–6.9, p = 0.028) and awareness of ideal blood pressure targets (AOR 4.57; 95% CI: 1.25–16.7, p = 0.022) were independent predictors of good control.Conclusion: Adequacy of blood pressure among hypertensive diabetic patients with chronic kidney disease is low and may be attributable to unawareness of its target level and using inappropriate therapy. Future studies should correlate level of blood pressure control with patient-, clinician-, and hospital-related factors.

Study of prescribing pattern of antihypertensive drugs in diabetic patients in a tertiary care centre, Vizianagaram, India

Background: Diabetes mellitus (DM) and Hypertension (HTN) are the two major chronic disorders frequently coexisting, with increased incidence with age. HTN is about twice as common in patients with DM. Prescribing pattern are powerful tools to ascertain the role of drugs in society. There are many variations in prescribing patterns of antihypertensive drugs in patients with HTN and DM. Since these patients requires lifelong treatment it has enormously increased the burden of patients particularly in developing countries like India. Physician needs to be more concerned while choosing drugs for the patients with HTN and DM. In a tertiary care hospital, there is a real need for drug utilization study to determine the appropriate, more safe and effective patterns of drug therapy among diabetic hypertensive patients.Methods: A Cross sectional observational study was conducted in Maharajah’s Institute of Medical Sciences from December 2016 to May 2018. A total of 360 prescriptions of the patients with hypertension and coexisting diabetes were analyzed. The prescriptions prescribed to these patients were collected, assessed and the following parameters were noted. The treatment pattern of different group of drugs for HTN with co-existing DM was evaluated. The intended work was divided into three steps: Step 1: To collect the prescriptions of hypertensive patients with DM. Step 2: To separate the prescriptions prescribing anti hypertensive Drugs. Step 3: To statistically analyze the prescriptions. Relevant information was recorded in a structured proforma &amp; data was evaluated.Results: In this study it was found that 36% of the patients were in the age group of 51-60 years with female preponderance among diabetic hypertensive patients. 77% of patients were treated with single antihypertensive drug and 23% of patients were treated with antihypertensive drug combinations. In monotherapy, telmisartan was most commonly prescribed. In combination therapy, amlodipine and telmisartan followed by amlodipine and atenolol were used.Conclusions: In this study monotherapy was preferred compared to combination therapy and adherence to the JNC 7 guidelines was good except in case of usage of diuretics.

Blood pressure control in diabetes-the Indian perspective.

A tremendous increase in the coexistence of diabetes and hypertension has been observed recently in India. Apart from lifestyle and genetic factors, socioeconomic status, age, gender, occupation and lack of awareness are also contributing to the tremendous increases in the prevalence of both the diseases. Hypertension has been long recognised as one of the major risk factors for chronic disease burden, morbidity and mortality in India, attributable to 10.8% of all deaths in the country. Even though microvascular complications are frequently linked to hyperglycaemia, studies have also proven the critical involvement of hypertension in the development of these co-morbidities. The co-occurrence of hypertension in diabetic patients considerably escalates the risks of coronary heart disease, stroke, nephropathy and retinopathy. The annual expenditure for diabetes for the Indian population was estimated to be 1541.4 billion INR ($31.9 billion) in 2010. The expense of diabetes care further escalates in the presence of complications or co-morbidities. Generally, a diabetic patient with hypertension spent an average of 1.4 times extra than a diabetic patient without hypertension. Even though diabetes and hypertension are considered as important risk factors for cardiovascular and chronic kidney diseases, the awareness about the prevention, treatment and control of these diseases remains alarmingly low in the developing countries like India. The healthcare system in India should focus on better hypertension screening and control, especially in diabetic patients, to minimise the burden of the dual epidemic.

Patient Awareness, Prevalence, and Risk Factors of Chronic Kidney Disease among Diabetes Mellitus and Hypertensive Patients at Jimma University Medical Center, Ethiopia

Background There is an alarming rise of chronic kidney disease (CKD) prevalence globally, which is associated with significant morbidity and mortality necessitating special attention as one of the major public health problems. The burden of CKD disproportionately impacts low-income countries like Ethiopia where hypertension and diabetes mellitus, the two most important risk factors for CKD growth rate, are greatest. Objective The aim of this study is to assess patient awareness, prevalence, and risk factors of chronic kidney disease among hypertensive and diabetes mellitus patients. Methods Hospital based cross-sectional study design was conducted at Jimma University Medical Center among adult (≥18 years) hypertensive and diabetes mellitus patients. Informed written consent was obtained from each participant and data was collected by interview and chart review; blood and urine samples were collected for CKD screening. Glomerular filtration rate (GFR) was estimated from serum creatinine using CKD epidemiology collaboration (CKD-EPI) equation, and CKD was defined using estimated GFR (e-GFR) and albuminuria. Multivariate logistic regression was used to identify independent predictors of CKD and p-value <0.05 considered statistically significant. Result Mean (±SD=standard deviation) age of participants was 54.81 ± 12.45 years and 110 (52.9%) of them were male. Only 59 (28.4%) of the participants had awareness about CKD and its risk factors. The prevalence of CKD was 26% (95% CI; 20.3%-31.8%). Factors associated with chronic kidney disease were uncontrolled blood pressure (adjusted odds ratio (AOR)=2.22,95% CI=1.01-4.76), fasting blood sugar ≥ 150 mg/dl, (AOR=3.70,95% CI=1.75-7.69), angiotensin converting enzyme inhibitors (ACEIs) nonusers, (AOR=4.35 ,95% CI=1.96-10.0), poor knowledge of CKD (AOR=3.69, 95% CI=1.48-9.20), and long duration of hypertension (AOR=4.55, 95%CI=1.72-11.11). Conclusion Our study found out low level of patient awareness and high prevalence of CKD. The predictors of CKD were uncontrolled blood pressure, fasting blood sugar> 150 mg/dl, long duration of hypertension, ACEIs nonusers, and poor knowledge about CKD.