Co-occurrence of Diabetes and Hypertension: Pattern and Factors Associated with Order of Diagnosis among Nigerians

BACKGROUND There is a high frequency of co-occurrence of diabetes and hypertension all over the world. Such association results in higher rate of cardiovascular complications. It is however not clear whether the order of occurrence distinguishes two different groups of patients and the implications of this on morbidity and mortality. The main objective of this study is to determine if there are any clinical and metabolic differences between those first diagnosed with diabetes (hypertensive diabetics) compared to those first diagnosed with hypertension (diabetic hypertensives). METHODOLOGY A total of 124 patients with co-existent diabetes and hypertension were consecutively recruited into the study. Demographic and clinical history was captured on a semi-structured questionnaire, followed by measurement of anthropometry and blood pressure. Records of fasting plasma glucose, urinalysis and electrolytes, urea and creatinine were obtained from the case records. RESULTS There were 83 (66.9%) females and 41 (33.1%) males with mean age of 61.1 (SD 11.1) years. Sixty or 49.6% was hypertensive diabetics while 52 or 43% was diabetic hypertensive. The rest had simultaneous diagnosis of diabetes and hypertension. The diabetic hypertensive subjects significantly had higher BMI (p= 0.04) while the hypertensive diabetics group had higher hip/waist ratio (p = 0.01). The diabetic hypertensive group had higher waist circumference statistically significant only in women (p = 0.04). Also significantly more people (21 or 42%; p = 0.04) in the diabetic hypertensive group used table salt often. A logistic regression performed showed that only use of table salt was independently associated with order of diagnosis of diabetes or hypertension. CONCLUSION There could be significant differences in some clinical characteristics of hypertensive diabetics and diabetic hypertensives, and use of table salt may be an important risk factor contributing to coexistence of both conditions.