FREQUENCY OF UNDIAGNOSED HYPERTENSION AMONG DIABETIC PATIENTS WITH MICROVASCULAR COMPLICATIONS

Abstract

Background: Hypertension and diabetes mellitus often coexist, creating a synergistic effect that accelerates the development of vascular complications.

Objective: This study aimed to determine the frequency of undiagnosed hypertension among diabetic patients with microvascular complications and to identify associated risk factors.

Methodology: This cross-sectional analytical study was conducted at the Department of General Medicine, King Edward Medical University/Mayo Hospital, Lahore from November 2024 to April 2025. A total of 213 diabetic patients aged 18–75 years with microvascular complications were included through non-probability consecutive sampling. Blood pressure was monitored every 8 hours over a 72-hour period, and undiagnosed hypertension was defined as systolic BP >140 mmHg or diastolic BP >95 mmHg on two occasions, 8 hours apart.

Results: The mean age of participants was 54.3 ± 9.8 years, and the mean duration of diabetes was 10.8 ± 5.6 years. Among all participants, 124 (58.2%) had diabetic nephropathy, 68 (31.9%) had retinopathy, and 21 (9.9%) had both. The overall frequency of undiagnosed hypertension was 22.1%. It was significantly associated with older age (p = 0.03), higher BMI (p = 0.04), longer duration of diabetes (p = 0.02), and the presence of diabetic nephropathy (p = 0.01), while no significant difference was found between genders (p = 0.64).

Conclusion: Approximately one in five diabetic patients with microvascular complications had undiagnosed hypertension, particularly those who were older, overweight, or had diabetic nephropathy. Routine and repeated blood pressure monitoring should be integrated into diabetes management programs to enable early detection and prevention of further vascular damage.