Cardiovascular Journal of Africa: Vol 29 No 4 (July/August 2018)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 4, July/August 2018 AFRICA 223
Microalbuminuria was not associated with hypertension in
this study, despite the fact that it is one of the major CVD risk
factors. Okpere et al., in a cross-sectional study among young
people in the community, found contradictory evidence,51 but the
population they studied was not diabetic.
Type 2 DM and hypertension share several common
risk factors, such as physical inactivity and unhealthy diet.
Overweight and obesity are potentially amenable to behavioural
modification. The benefits of prevention and care extend beyond
cardiovascular disease to related conditions of public health
importance. They are the focus of efforts to ensure greater
prioritisation of NCDs on the global research agenda as well
as of development agencies and in the health and development
policies of low-income countries.
Limitations
In the diagnosis of hypertension, we did not perform ambulatory
blood pressure monitoring, which is the gold standard, according
to guidelines for the diagnosis of hypertension.29 This was due
to lack of capacity. A non-diabetic control group would have
provided better comparison, however in this study we assessed
the prevalence and associated factors of hypertension but not its
risk factors among diabetics. The recruitment time between June
2014 and January 2015 was relatively short due to limitations in
logistics. This could have obscured seasonal differences.
Conclusion
The prevalence of hypertension was high in this population
of newly diagnosed diabetics, who had little knowledge of
hypertension, and very few patients were on appropriate
treatment. Both modifiable and non-modifiable risk factors were
associated with hypertension in this group. Therefore, routine
assessment, treatment and control of hypertension among
diabetics is necessary to prevent CVD complications and death.
Pharmacotherapy should be combined with lifestyle changes to
address the modifiable risk factors.
Research reported in this manuscript was supported by the Fogarty
International Center of the National Institutes of Health under award
number R24TW008861. Dr Mudda was also supported by the Fogarty
International Center and the National Heart, Lung, and Blood Institute
(NHLBI) at the National Institutes of Health under the Global Health Equity
Scholars Consortium at Yale University (D43TW010540). The content is
solely the responsibility of the authors and does not necessarily represent
the official views of the National Institutes of Health. The authors are grate-
ful to the following persons for their invaluable support: Professors Nelson
Sewankambo and Moses R Kamya, the staff of Ward 4B Endocrine, Diabetic
Clinic, and the echocardiography and clinical laboratory of Mulago Hospital.
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