Os 33-05 high prevalence and poor control of hypertension and associated cardiovascular risk facors in diabetic patients in a rural hospital in Kenya.
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OBJECTIVE: The prevalence of diabetes mellitus (DM) is rapidly increasing in Africa with a projected increase in diabetics from 12.1 million in 2010 to 23.9 million in 2030, predominantly type 2 DM (T2DM). The major consequence of diabetes is cardiovascular (CV) disease. T2DM occurs with a constellation of other CV risk factors (RF). Awareness and control of all risk factors is therefore critical in reducing the burden from diabetes. The rising burden has hitherto been an urban phenomenon; however there is evidence of rising burden in rural areas. We studied diabetic patients attending a rural hospital in Kenya. DESIGN AND METHOD: Ambulatory T2DM patients on follow up at Nyeri level 5 hospital were consecutively sampled. BP measurement was taken as per the standard protocol. Height and weight for body mass index (BMI) calculation was measured and waist and hip circumference for waist hip ratio (WHR). Measurements for HBA1c, albuminuria, serum creatinine and fasting lipid profile were done. RESULTS: 385 patients were studied, age 63.3 years, 65.5% female. 60.5% had HBA1c above 7%. 76.6% were hypertensve while only 37.4% had BP of < 140/90 mmHg. 77.1% had LDL cholesterol above 1.7 mmol/L. 40% were overweight and 33% were obese, while 92.7% had undesirable WHR.32% had albuminuria while 39% had chronic kidney disease stage 3 and above. CONCLUSIONS: There is an extremely high prevalence of cardiometabolic risk factors in the cohort of diabetics from a rural community. This suggests an extension of the epidemiologic transition to rural Africa. This poses a challenge as health systems in rural Africa are designed around communicable diseases and are usually ill equipped to handle non-communicable diseases (NCDs). This data calls for reorientation and strengthening of the health system to be able to handle the increasing burden of NCDs.
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