Hypertension in type 2 diabetes mellitus: prevalence, patterns, determinants and implications for cardiovascular risk prediction in a population of Nigerian patients

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM), with hypertension, a common comorbidity, being a major contributor to adverse cardiovascular outcomes. In Nigeria, where the burden of T2DM and its associated cardiovascular complications is rising, there is a need to strengthen hypertension control efforts. This study evaluates the prevalence, patterns, and determinants of hypertension in T2DM patients in North Central Nigeria, with a focus on its impact on CVD risk status to inform targeted prevention and management strategies. This hospital-based cross-sectional analytical study was conducted among T2DM patients over 13 months. Data on socio-demographic characteristics, medical history, clinical findings and laboratory parameters were collected using a structured proforma. Hypertension was classified based on the 2017 ACC/AHA hypertension guidelines, and 10-year estimated CVD risk was determined using the WHO CVD risk assessment chart for Western sub-Saharan Africa. Statistical analyses, including binary and ordinal logistic regression, were conducted using SPSS version 25, with significance set at p < 0.05. The prevalence of hypertension in this cohort was 65.5%, with diabetes duration (OR = 1.162, 95% CI: 1.053–1.283; p = 0.003) and high-sensitivity C-reactive protein (hsCRP) (OR = 1.351, 95% CI: 1.098–1.663; p = 0.004) identified as independent predictors. Systolic BP (OR = 1.189, 95% CI: 1.141–1.239; p < 0.001) and use of antihypertensive therapy (OR = -0.323, 95% CI: 0.245–0.871; p = 0.017) were significant determinants of 10-year CVD risk in the study population. Hypertension is highly prevalent among T2DM patients in North Central Nigeria and is associated with systemic inflammation, prolonged diabetes duration, and elevated CVD risk. These findings emphasize the need for enhanced blood pressure control, routine inflammatory marker monitoring, and early interventions to reduce the long-term risk of cardiovascular complications in resource-limited settings.