Frequency of undiagnosed hypertension among diabetic patients with micro vascular complications

To determine the frequency of undiagnosed hypertension among the diabetic patients with micro vascular complications.

This is a descriptive case series conducted at Department of Medicine, Ghurki Trust Teaching Hospital, in this six month stud which enrolled 213 patients between 18-60 years from March 28, 2021 to September 28, 2021, having diabetes with microvascular complications. These patients were not previously diagnosed as hypertensives. Patient was diagnosed as hypertensive if SBP or DBP was ≥l40 or ≥90 mmHg respectively. The frequency of undiagnosed hypertension was noted and compared across various subgroups of patients.

The mean age of the patients was 49.3±9.7 years. The mean BMI of these patients was 28.3±3.5 Kg/m2 and 67 (31.5%) patients were obese. The mean duration of disease was 8.2±3.9 years. Majority (62.4%) of the patients had diabetic retinopathy while 37.6% patients had diabetic nephropathy. Undiagnosed hypertension was observed in 42 (19.7%) patients with diabetic micro vascular complications. The frequency of undiagnosed hypertension was significantly higher among obese as compared to non-obese patients (28.4% vs. 15.8%; p-value=0.032). There was no statistically significant difference in the frequency of undiagnosed hypertension across various subgroups based on patient's age (p-value=0.750), gender (p-value=0.902), type of micro vascular complication (p value=0.783) and duration of diabetes (p-value=0.763).

In the present study, a substantial proportion of patients with diabetic micro vascular complications suffered undiagnosed hypertension which is alarming and advocates routine blood pressure monitoring of such patients so that timely identification and anticipated management of underlying hypertension may improve the outcome of such cases in future clinical practice.