|dc.description.abstract||Background: Globally, there are about 972 million adults with hypertension and this
figure is expected to rise to about 1.56 billion by the year 2025. Diabetic hypertensive
patients are more vulnerable to cardiovascular and renal complications compared to nondiabetic
hypertensive patients. Nevertheless, optimal blood pressure control is paramount
in these two patient populations.
Broad Objective: To evaluate the management of hypertension among diabetic and nondiabetic
patients at the Kenyatta National Hospital, Medical Outpatient Clinic.
Methodology: A tertiary hospital based cross-sectional study was carried. This study
comprised of two study groups: diabetic hypertensive patients and non-diabetic
hypertensive patients. A total of 96 adult patients were enrolled into the study, with each
group comprising of 48 patients. Convenience sampling method was used to select the
Data Collection and Analysis: Patient interviews were conducted and additional data
was obtained from the patient's hospital file. Data was ana lysed using SPSS version 19.0
software. Results were presented in form of percentages, frequency distribution tables
and graphs. Measures of central tendencies were calculated for the social demographic
data and cross tabulations were also done to compare data between the two study groups.
The level of significance was determined using Pearson chi square set at 0.05 and pvalues
~ 0.05 were considered to be statistically significant.
Results: Of the 96 patients enrolled, the male to female ratio was 1:2, the mean age was
57 years (±11.1) and the mean duration of hypertension was 7.7 years (±6.3). Overall,
70% of the entire study population had inadequate blood pressure control. Among the
diabetic patients, 75% had inadequate blood pressure control compared to 65% of the
non-diabetic patients. Ninety percent of the diabetic patients were unaware of their ideal
blood pressure target.compared to 92% of the non-diabetic patients. Equal numbers of
patients (54%) from both the study groups were unaware of the duration for their
antihypertensive drug therapy. Most of the patients reported to be able to maintain a
constant supply of their blood pressure medications and attend all their clinic
appointments. Even so, 52% of the diabetic patients and 73% of the non-diabetic patients,
reported to sometimes miss to take some of the doses oftheir blood pressure medications.
More than 80% of the patients reported to be adherent to at least 4 lifestyle modification
strategies, however, most of them still had inadequate blood pressure control. Three
quarters of the diabetic patients were on 2 or more antihypertensive drugs compared to
98% of the non-diabetic patients. The most commonly prescribed antihypertensive drug
class in the two study groups was angiotensin converting enzyme inhibitors / angiotensin
Conclusion: Only 30% of the entire study population was found to have adequate BP
control. The management of hypertension, therefore, is still a challenge to both diabetic
and non-diabetic patients and is largely associated with the negative influence of patient related
factors. There was, however, no statistically significant difference of this
observation between the two study groups.
Recommendations: Patient involvement and understanding on hypertension is essential
in the management of hypertension. There is, therefore, need for continuous patient
education and counseling in order to improve the overall management of hypertension.||en_US
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya||