Prevalence of Hypertension and Its Associated Factors Among Patients with Type 2 Diabetes in Southern Afghanistan: A Multi-Center Cross-Sectional Study

Muhammad Haroon Stanikzai,1 Mohammad Essa Amirzada,2 Niamatullah Ishaq,3 Kamil Ahmad Kamil,4 Zabihullah Anwary,5 Asadullah Farzad,6 Ahmad Haroon Baray,1 Hadia Sayam1 1Department of Public Health, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan; 2Department of Surgery, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan; 3Department of Radiology, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan; 4Internal Medicine Department, Mirwais Regional Hospital, Kandahar, Afghanistan; 5Clinic Department, Faculty of Medicine, Bost University, Lashkar Gah, Helmand, Afghanistan; 6Para-clinic Department, Faculty of Medicine, Bost University, Lashkar Gah, Helmand, AfghanistanCorrespondence: Muhammad Haroon Stanikzai, Department of Public Health, Faculty of Medicine, Kandahar University, District # 10, Kandahar, 3801, Afghanistan, Tel +93704775578, Email [email protected]: Hypertension among patients with type 2 diabetes results in higher rates of cardiovascular complications and deaths. However, there is limited data on the prevalence of hypertension and its associated factors among patients with type 2 diabetes in Afghanistan.Objective: Our study aims to determine the prevalence of hypertension and its associated factors among patients with type 2 diabetes in southern Afghanistan.Methods: This was a multi-center hospital-based cross-sectional study employed from January to June 2024 in southern Afghanistan. A total of 609 randomly selected patients with type 2 diabetes were included in the analysis. Diabetes patients were examined for the presence/absence of hypertension diagnosis using a criterion set by the American Heart Association. The binary logistic regression analysis was performed to test for risk factors associated with hypertension among patients with type 2 diabetes.Results: Among the 609 patients with diabetes included in the study, 55.3% (95% CI: 51.2%– 59.3%) had hypertension. According to the results of binary logistic regression, female gender [AOR, adjusted odds ratio =1.73, 95% CI (1.09– 2.74)], age of ≥ 50 years [4.35 (2.78– 2.6.81)], having diabetes for five or more years [2.13 (1.37– 3.31)], poor glycemic control [1.80 (1.18– 2.75)], and the presence of depressive symptoms [3.25 (2.59– 4.80)] were associated with hypertension among patients with diabetes.Conclusion: Due to the high prevalence (55.3%) of hypertension among patients with type 2 diabetes in Afghanistan, it is imperative to develop targeted interventions aimed at early detection and ensuring adequate care, especially for those most at risk for hypertension.Keywords: Afghanistan, diabetes patients, hypertension, risk factors, type 2 diabetes