EC Gynaecology

Introduction: The prevalence of hypertension and diabetes mellitus together has been increasing in developing countries like Nepal. A study conducted in France reported the prevalence of hypertension in almost one in every 4 diabetes cases and England shows the prevalence of Hypertension and Diabetes accounting for 46% of respondents. The prevalence of Diabetes and hypertension together account for approximately 4% in China and ranges from 2% to 32% in Nepal.  

Objective: The objective of this study is to examine the prevalence of hypertension among diabetic patients and their associated factors in the selected diabetic centers within Kathmandu Valley.

Methodology: A cross-sectional analytical study design was conducted to interview the diabetic patients in the diabetic centers within Kathmandu Valley with a sample size of 218. A lottery method from Simple Random Sampling was used for the selection of the study area and purposive sampling was used to select sample units. All the patients 20 year and older seeking services from diabetic centers were taken for the study. The exclusion and inclusion criteria were properly determined before the data collection. A semi-structured questionnaire was used for data collection and a face-to-face interview was conducted as a data collection technique. KOBO Toolbox was used for the data collection while IBM SPSS was used for data entry and analysis. Relevant descriptive statistics were computed for all variables and the association between two categorical variables was computed using a non-parametric test (Chi-square test). Ethical approval was taken from the Institutional Review Committee (IRC) of the institution. Approval was taken from diabetic centers before conducting the research. Informed consent was taken from the respondents prior to collecting data.

Result: The mean age of the respondent was 50 years and S.D was 9.4. Among 219 respondents, males (55.7%) were found to be higher than females. A maximum of them (91.3%) were Hindu, and the majority (95.9%) of them were married. Most of the respondents (50.2%) had completed their secondary level of education and more than half of them lived in Kathmandu Valley (60.3%). The maximum number of respondents were housewives (27.9%). Alcohol consumption was found to be highest (25.1%) among respondents followed by tobacco and cigarette smoking. According to this study, the prevalence of hypertension among diabetic patients is 46.6% with the majority of them (18.7%) belonging to 60-65 years of age. Similarly, the prevalence of hypertension among diabetic patients was positively associated with age (p-value = 0.0001) family history of Diabetes (p-value = 0.002), family history of hypertension (p-value = 0.0001), family history of both Diabetes mellitus and Hypertension (p-value = 0.012), Smoking Cigarettes (p-value = 0.011) and duration of diabetes incidence (p-value = 0.0001).

Conclusion: According to this study, the prevalence of hypertension among diabetic patients was nearly half (46.6%) of the study population. Age, family history, smoking cigarettes, and duration of diabetes mellitus incidence were statistically associated with the prevalence of hypertension among diabetic patients. There is a critical need for awareness of hypertension and diabetes comorbidity and their common risk factors.

 Keywords: Non-communicable Disease; Diabetes; Hypertension; Comorbidity

1. Marre M., et al. “Hypertension and diabetes mellitus”. Biomedicine and Pharmacotherapy 2-3 (1993): 61-66.
2. Mujica-Mota RE., et al. “Common patterns of morbidity and multi-morbidity and their impact on health-related quality of life: evidence from a national survey”. Quality of Life Research 4 (2015): 909-918.
3. Wang Z., et al. “Prevalence of diabetes and hypertension and their interaction effects on cardio-cerebrovascular diseases: a cross-sectional study”. BMC Public Health1 (2021): 1224.
4. Pandey AR., et al. “Prevalence and determinants of comorbid diabetes and hypertension in Nepal: evidence from non communicable disease risk factors STEPS survey Nepal 2013”. Journal of Nepal Health Research Council 29 (2015): 20-25.
5. Rr D., et al. “Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey”. BMJ Open7 (2021): e047665.
6. Shakya B., et al. “An epidemiological study of diabetes mellitus in productive aged urban Nepalese of Makalbari Area of Gokarneshwor Municipality”. Nepal Medical College Journal 3 (2020): 173-180.
7. Shrestha N., et al. “Prevalence of diabetes mellitus and associated risk factors in Nepal: findings from a nationwide population-based survey”. BMJ Open2 (2022): e060750.
8. Demographics of Nepal. In: Wikipedia (2023).
9. Population | National Population and Housing Census 2021 Results (2023).
10. Non-communicable diseases (2022).
11. Kibria GMA., et al. “Prevalence and associated factors of pre-hypertension and hypertension in Nepal: Analysis of the Nepal Demographic and Health Survey 2016”. Health Science Reports 10 (2018): e83.
12. Dhungana RR., et al. “Prevalence and associated factors of hypertension: a community-based cross-sectional study in municipalities of Kathmandu, Nepal”. International Journal of Hypertension (2016): e1656938.
13. Karki P., et al. “Prevalence of non-insulin dependent diabetes mellitus in urban areas of eastern Nepal: a hospital based study”. Southeast Asian Journal of Tropical Medicine and Public Health 1 (2000): 163-166.
14. Comorbidity - an overview | ScienceDirect Topics (2023).
15. Chowdhury SR., et al. “Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis”. EClinicalMedicine 57 (2023): 101860.
16. Balogun WO and Salako BL. “Co-occurrence of diabetes and hypertension: pattern and factors associated with order of diagnosis among Nigerians”. Annals of Ibadan Postgraduate Medicine 2 (2011): 89-93.
17. Ryan A., et al. “Multimorbidity and functional decline in community-dwelling adults: a systematic review”. Health and Quality of Life Outcomes 13 (2015): 168.
18. Ferrannini E and Cushman WC. “Diabetes and hypertension: the bad companions”. The Lancet9841 (2012): 601-610.
19. Gupta P., et al. “Burden, patterns, and impact of multimorbidity in North India: findings from a rural population-based study”. BMC Public Health1 (2022): 1101.
20. Alsaadon H., et al. “Hypertension and its related factors among patients with type 2 diabetes mellitus - a multi-hospital study in Bangladesh”. BMC Public Health1 (2022): 198.
21. Mihardja L., et al. “Prevalence and clinical profile of diabetes mellitus in productive aged urban Indonesians”. Journal of Diabetes Investigation 5 (2014): 507-512.
22. Bhandari GP., et al. “State of non-communicable diseases in Nepal”. BMC Public Health1 (2014): 23.
23. Vaidya A., et al. “Prevalence of hypertension in Nepalese community triples in 25 years: a repeat cross-sectional study in rural Kathmandu”. Indian Heart Journal 2 (2012): 128-131.
24. Hasan M., et al. “Prevalence and determinants of hypertension among adult population in Nepal: Data from Nepal Demographic and Health Survey 2016”. PLOS ONE5 (2018): e0198028.
25. Shah A and Afzal M. “Prevalence of diabetes and hypertension and association with various risk factors among different Muslim populations of Manipur, India”. Journal of Diabetes and Metabolic Disorders 1 (2013): 52.