Diabetes mellitus (DM) is a chronic debilitating disease associated with the development of several

comorbidities like hypertension. Among diabetics, it is documented that hypertension is a leading cause of

predictors respectively with a p-value ≤ 0.05 recorded as statistical significance. The mean age of respondents

was 60.17±10.13 with 54.0% being female. Among the patients, 50.6% had hypertension. A multivariate

logistic regression analysis revealed that hypertension risk was higher for diabetes patients who had a family

history of diabetes (AOR = 0.34; p = 0.046), were overweight (AOR = 0.45; p = 0.045), or obese (AOR =

0.18; p < 0.001), were past smokers (AOR = 0.11; p = 0.003), earned > ₦50,000 (AOR = 0.25; p = 0.002), or

experienced moderate stress (AOR = 0.34; p = 0.046). It is evident that the prevalence of hypertension among

diabetes patients at was high and predicted by several factors including smoking, stress, and high body mass

index. It is thus important that interventions and clinical recommendations target these factors for better

treatment outcomes.

Diabetes Federation, 2021) and thus at a high risk of early morbidity and mortality due to predisposition to

other diseases, especially cardiovascular diseases (CVD) diseases like hypertension (Akalu & Belsti, 2020). It

is well-documented that hypertension is a leading CVD-attributable cause of morbidity and mortality among

diabetes patients (Akalu & Belsti, 2020).

The American Diabetes Association, defined hypertension among diabetes patients as blood pressure (BP) ≥

140/90 mmHg, and a target BP goal of < 130/80 mmHg is reasonable (de Boer et al., 2017). Despite

interventions, hypertension among diabetes patients is common in clinical practice and is said to be twice as

prevalent in diabetics than in non-diabetics with patients first presenting with one condition followed by the

later discovery of another, though they may be diagnosed simultaneously (Dan–Jumbo et al., 2019; Unadike et

al., 2011). The comorbidity of diabetes mellitus and hypertension is increasing globally (Nouh et al., 2017).

For individuals, the double burden of diabetes and hypertension is likely to impact their health-related quality

of life in all aspects (Aschalew et al., 2020; Snarska et al., 2020). Psychological, emotional, and social issues

are likely more pronounced in patients with diabetes and hypertension, thus limiting their functionality and

impacting their overall well-being. The high morbidity and mortality associated with comorbid diabetes and

hypertension (Akalu & Belsti, 2020) reduces workforce capacity, thus negatively impact the economy of

nations and overall health system.

The study ascertained the prevalence and predictors of hypertension among diabetes patients receiving care at

the University of Port Harcourt Teaching Hospital, so as to better triage, care and control hypertension among

diabetic.

Teaching Hospital

at the University of Port Harcourt Teaching Hospital

The Fischer’s formula (Charan & Biswas, 2013) ( 

sample size = 281 patients

A systematic random sampling technique was employed to select study participants. Since endocrine clinics

held every Wednesday, 25 patients were systematically sampled from the number of patients scheduled for the

week. After calculation of the weekly nth term,  

 the first participant

height, and blood pressure measurement was taken by nursing staff on duty.

An interviewer administered questionnaire consisting of two sections vis-à-vis sociodemographic profile and

risk factors was utilized in collecting data from patients. The questionnaire was workshopped among experts in

the field for face and content validity. Also, questionnaire was administered to a few diabetes patients at the

Rivers State University Teaching Hospital to ensure questions were comprehendible. To ensure reliability, key

segments of the questionnaire like the stress segment was adopted from the ISMA stress measuring scale

which is both reliable and valid for measuring stress.

Data collected using a structured interviewer administered questionnaire were entered into IBM (SPSS)

A total of 265 patients were reached out of the estimated 282 giving a response rate of 93.9%

As shown in Table 1, the mean age of diabetes patients receiving care at UPTH was 60.17±10.13 with 36.6%

of them aged between 57 – 67. Also highlighted is that 130 (49.1%) had tertiary education, 195 (73.6%) were

married, 143 (54.0%) were women, 110 (45.1%) earned above ₦50,000, and 51.4% of them were of the Igbo

ethnicity.

Table 1: Demographic characteristics of diabetes patients receiving care at UPTH

South-East

105

39.6

Mild Stress

63 (71.6)

= 0.25 [0.77 – 0.82] p = 0.002), or experience moderate stress (AOR [95% CI] = 0.34 [0.12 – 1.00] p = 0.046).

However, being underweight reduced the risk (AOR [95% CI] = 0.67 [0.13 – 1.35] p = 0.001)

Table 4: Logistic regression analysis of predictors of hypertension among diabetes patients

₦20,001 - ₦30,000

1.089

0.065

As highlighted in the literature, diabetes patients possess a high risk of developing hypertension which

subsequently triggers the development of major causes of death like renal, cardiac and cerebral dysfunctions.

population (Anizor & Azinge, 2015). In the current study, over half of the study participants had hypertension.

This is in agreement with the reports of studies conducted in Delta state Nigeria where it was reported that

57.4% of diabetes patients suffered from hypertension (Anizor & Azinge, 2015). Though slightly higher than

the 47.6% prevalence rate of a Sudanese study (Abdelbagi et al., 2021), and lower than the prevalence rate of

71.8% documented by Almalki et al. (2020) in their Saudi Arabian study, it is clear that hypertension is a

common comorbidity among the diabetic population. A double burden of hypertension and diabetes limits the

functionality of the sufferers has negative effects on the economy, especially when it involves the working age,

and increases the risk of mortality (Akalu & Belsti, 2020; Aschalew et al., 2020; Snarska et al., 2020). Thus,

to the current study, a multivariate analysis showed that those who were past smokers, had a family history of

diabetes, were overweight or obese, and perceived moderate life stress were likelier to develop hypertension.

With regards to smoking, the current report agrees with the reports of Husain et al. (2014) who stated that

smoking either past or present is a driver for the development of hypertension among diabetic patients.

Smoking which is known to induce endothelial dysfunction and early atherogenesis is linked to a variety of

cardiovascular disturbances, and its role in the development of hypertension is not a questionable one (Messner

& Bernhard, 2014). The study further corroborates the findings of the other studies as regards BMI. For

example Anizor & Azinge (2015) noted that overweight and obese status were significant risk factors for the

development of hypertension among diabetics. The primary justification why overweight and obesity are

poor with over 2/4 of the population leaving below the minimum wealth index (World Bank Group, 2025).

What that posits for the population is that dietary habits are likely to revolve around cheap and common

fall into the high-wealth category were 1.98 times more likely to be hypertensive in comparison to those who

were unemployed. These factors are not exclusive to any region, and thus demands actions if diabetes patients

must overcome the overwhelming burden of morbidity and mortality.

The strength of the study lies in its utilization of validated tools and instruments like the ISMA stress scale.

However, due to the use of cross-sectional design which does not account for cause-effect relationships careful

interpretation of factors and determinants is required. Also, subjectively measuring family history, alcohol use

and smokig status is likely to have caused an overestimation or underestimation of the true fact.