Incidence and risk factors of hypertension among Saudi type 2 diabetes adult patients: an 11-year prospective randomized study.
OBJECTIVE
Insofar as hypertension is a risk factor for cardiovascular morbidity and mortality in Type 2 diabetes mellitus (T2DM), this study investigated the incidence of hypertension and associated risk factors in Saudi T2DM patients.


METHODS
A hospital-based, 11-year (1993-2004) prospective study of 916 adult originally normotensive T2DM Saudi patients (488 male and 428 female). T2DM was diagnosed as per World Health Organization (WHO) criteria, while hypertension was assessed according to the Seventh Joint National Criteria for Hypertension Classification (JNVII). Risk factors were analyzed on those who developed hypertension.


RESULTS
The hypertension incidence was 17.2/100 person-years, based on 2833.63 person-years of cohort group follow-up. Age-adjusted Cox regression coefficient showed that the significant risk factors for developing hypertension were older age, higher HbA(1c), BMI, elevated triglycerides (>1.8 mmol/l) and creatinine (>115 mmol/l), smoking, proteinuria, microalbuminuria, lack of physical exercise, and retinopathy, while anti-platelet and lipid-lowering drugs had lower hypertension hazard ratios. Cox proportional hazard showed that older age, male gender, higher BMI, diabetes duration (<5 years), and retinopathy were independent predictors of hypertension, while exercise, lipid-lowering, and anti-platelet medications were associated with reduced hypertension incidence rate.


CONCLUSIONS
Incidence of hypertension in Saudi T2DM patients is comparable to other communities, with older age, male gender, higher BMI, diabetes duration of <5 years and retinopathy being strong predictors for hypertension development.
Salman
Rabha A
RA
Diabetes Centre, Medical College, King Saud University, Riyadh, Saudi Arabia. drrabha@batelco.com.bh
Al-Rubeaan
Khalid A
KA
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology; D011446:Prospective Studies; D011897:Random Allocation; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
D003404:Creatinine; D006442:Glycated Hemoglobin; D014280:Triglycerides