Incidence and predictors of cardiovascular disease among hypertension patients in, Ethiopia: a retrospective follow-up study

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among hypertensive patients worldwide including Ethiopia. The World Health Organization (WHO) predicts a rapid rise in CVDs in Sub-Saharan Africa by 2030, though the region has often been overlooked in CVD research. The incidence and predictors of CVD among hypertensive patients in North Shoa, Amhara, Ethiopia, are not well studied. This research aimed to investigate these factors among hypertensive patients attending a medical referral clinic in 2024. A retrospective follow-up study was applied from 2015 to 2023 in the referral medical clinics of North Shoa Zone. Secondary data were collected by using checklists from records of 355 randomly selected hypertensive patients. Data was analyzed by using STATA version 14. The goodness of fitness of the model was checked by using the Cox-Snell residual plot. Finally, Multivariable Cox regression was applied to calculate the adjusted hazard ratios, and variables with a significance level of less than 0.05 were identified as predictors of CVDs. The incidence of cardiovascular diseases (CVD) among hypertensive patients was 1.98 cases per 1,000 person-years, with a median survival time of 5 years. Multivariable Cox regression revealed that patients with mental illness had a 2.01 times higher risk of developing CVD (AHR: 2.01, 95% CI: 1.04–3.05). Additionally, those with diabetes mellitus (DM) had a 2.5 times higher risk compared to patients without DM (AHR: 2.5, 95% CI: 1.12–5.46). The incidence of cardiovascular disease among hypertensive patients was high, and mental illness and diabetes mellitus were significant predictor of it. Therefore, early identification and integrated care for these high-risk patients are crucial. Targeted cardiovascular screening, mental health support, strict glycemic control, and health education promoting lifestyle modification and treatment adherence can reduce CVD risk.