Determinant Analysis of Hypertension in Type 2  Diabetes Mellitus Patients: A Cross-Sectional Study  in Medan, North Sumatera, Indonesia

Mariaman Tjendera; Gusbakti; Linda Chiuman; Ade Indra Mukti; Dewi Sartika

doi:10.26911/theijmed.2025.10.2.831

Authors

Mariaman Tjendera Postgraduate Master of Clinical Medicine, Faculty of Medicine, Dentistry and Health Science, Prima Indonesia University, Medan
Gusbakti Faculty of Medicine, Dentistry and Health Science, Universitas Prima Indonesia, Medan
Linda Chiuman Faculty of Medicine, Dentistry and Health Science, Universitas Prima Indonesia, Medan
Ade Indra Mukti Department of Surgery, Faculty of Medicine, Dentistry and Health Science, Prima Indonesia University, Medan
Dewi Sartika Department of dermatology venerealology, Faculty of Medicine, Dentistry and Health Science, Prima Indonesia University, Medan

DOI:

https://doi.org/10.26911/theijmed.2025.10.2.831

Abstract

Background: Type 2 diabetes mellitus (T2DM) and hypertension are two chronic conditions that frequently co-occur and pose a significant health burden. At Padang Bulan Primary Healthcare Center in Medan, out of 260 Prolanis participants, 117 T2DM patients sought treatment, and 90 of them were diagnosed with hypertension. This study aimed to analyze the determinants of hypertension in T2DM patients receiving care at Padang Bulan Primary Healthcare Center in Medan.

Subjects and Method: An analytical cross-sectional study was conducted on 100 T2DM patients selected through consecutive sampling. Data were collected using structured question¬naire, anthropometric measurement, and blood pressure and blood glucose examinations. The variables studied included sociodemographic characteristics (gender, education, occupation, marital status) and clinical characteristics (body mass index, duration of T2DM, blood glucose levels, family history). Data analysis was performed using Chi-square test.

Results: The majority of respondents were women (62%), highly educated (79%), and obese (87%). The prevalence of hypertension in T2DM patients was notably high (>70%) across all groups. However, bivariate analysis showed no statistically significant relationship between any of the studied variables and the incidence of hypertension (p>0.05).

Conclusion: There was no significant relationship between sociodemographic and clinical factors with the incidence of hypertension in T2DM patients. Nevertheless, the high prevalence of hypertension indicates the importance of a comprehensive approach in managing both conditions

Keywords:

Determinants, type 2 diabetes mellitus, hypertension, sociodemographic factors,, primary care

References

Almalki ZS, Albassam AA, Alhejji NS, Alotaibi BS, Al-Oqyali LA, Ahmed NJ (2020). Prevalence, risk factors, and management of uncontrolled hyper-tension among patients with diabetes: A hospital-based cross-sectional study. Prim Care Diabetes. 14(6): 610–615. https://doi.org/10.1016/j.p-cd.2020.02.004.

Anjajo EA, Workie SB, Tema ZG, Wolde-georgis BZ, Bagino EA (2023). Deter-minants of hypertension among dia-betic patients in southern Ethiopia: a case-control study. BMC Cardiovasc Disord. 23(1): 233. https://doi.org/: 10.1186/s12872-023-03245-4.

Ayutthaya SS, Adnan N (2020). Faktor Risiko Hipertensi pada Penderita Diabetes Mellitus Tipe 2 (Risk Factors of Hypertension in Patients with Type 2 Diabetes Mellitus). Jurnal Ilmu Kesehatan Masyarakat. 9(2): 60. https://doi.org/10.33221/jikm.v9i02.512

Belew MA, Abate TW, Berhie AY, Abeje ED, Ayele DA, Abete MD, Getu RA, et al (2022). Determinants of hypertension among diabetes patients attending selected comprehensive specialized hospitals of the Amhara Region, Ethiopia: An unmatched case-control study. PLoS One. 17(12): e0279245. https://doi.org/10.1371/journal.pone.0279245.

Cannata F, Vadala G, Russo F, Papalia R, Napoli N, Pozzili P (2020). Beneficial effects of physical activity in diabetic patients. J Funct Morphol Kinesiol. 5(3): 70. https://doi.org/10.3390/jf-mk5030070.

Centers for Disease Control and Prevention (2020). National Diabetes Statistics Report. U.S. Dept of Health and Human Services. https://www.cdc.-gov/diabetes/php/data-research/-index.html

De Marco V, Aroor A, Sowers J (2014). The pathophysiology of hypertension in patients with obesity. Nat Rev Endo-crinol. 10(6): 364–376. https://doi-.org/10.1038/nrendo.2014.44

Devanaganvi A, Shriharsha C, Natekar DS (2020). Modifiable risk factors of hypertension: A hospital based case – control study at Bagalkot. Indian J Public Health Res Dev. 11(7): 46–53. https://doi.org/10.37506/ijphrd.v11-i7.10054

International Diabetes Federation (2021). IDF diabetes atlas, 10th edition. https://www.ncbi.nlm.nih.gov/books/NBK581934/

Jia G, Sowers J (2021). Hypertension in diabetes: an update of basic mecha-nisms and clinical disease. Hyper-tension. 78(5): 1197-1205. https://-doi.org/10.1161/hypertensionaha.-121.17981.

Kementerian Kesehatan (2019). Laporan nasional RISKESDAS 2018. Badan Penelitian dan Pengembangan Kese-hatan. http://www.depkes.go.id/re-sources/download/info terkini/mate-ri_rakorpop_2018/Hasil%20Riskesdas%202018.pdf

Mayl JL, German CA, Bertoni AG, Upadhya B, Bhave PD, Yeboah J Singleton MJ (2020). Association of alcohol intake with the ACCORD trial. J Am Heart Assoc. 9(18): e017334. https://doi.-org/10.1161/JAHA.120.017334.

Megantari S, Masriadi M, Mahmud N (2023). Determinan kejadian hiper-tensi stage i pada penderita diabetes melitus tipe 2 di Puskesmas Bungoro Kab. Pangkep (Determinants of the incidence of stage I hypertension in patients with type 2 diabetes mellitus at the Bungoro Health Center, Pang-kep Regency). J Muslim Community Health. 4(4): 112-119. https://doi-.org/10.52103/jmch.v.

Mubarak F, Erika S, Froelicher H, Kamel M (2008). Hypertension among 1000 patients with type 2 diabetes attend-ing a national diabetes center in Jordan. Ann Saudi Med. 28(5):346-51. https://doi.org/10.5144/0256-4-947.2008.346.

Naseri MW, Esmat HA, Bahee MD (2022). Prevalence of hypertension in Type-2 diabetes mellitus. Ann Med Surg (Lond). 78: 103758. https://doi.org/-10.1016/j.amsu.2022.103758.

Nawfal E, Unson C, Okeke C, Abada E (2017). Predictive factors associated with hypertension alone, diabetes alone and the coexistence of both among adults in Ghana. International Journal of Scientific & Technology Research. 11: 99-112. https://www.-academia.edu/100177213/Predictive_Factors_Associated_With_Hypertension_Alone_Diabetes_Alone_And_The_Coexistence_Of_Both_Among_Adults_In_Ghana

Oparil S, Amin Zaman M, David AC (2009). Pathogenesis of Hypertension. Ann Intern Med, 139(9):761-776. https://-doi.org/10.7326/0003-4819-139-9-200311040-00011.

Petrie J, Guzik T, Touyz R (2018). Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Can J Cardiol. 34(5): 575-584. https://doi.org/10.1016/j.cjca.-2017.12.005.

Poljičanin T, Ajduković D, Šekerija M, Pibernik-Okanović M, Metelko Z, Mavrinac GV (2010). Diabetes melli-tus and hypertension have compa-rable adverse effects on health-related quality of life. BMC Public Health. 10:12. https://doi.org/10.1186/1471-2458-10-12.

Sayed-Tabatabaei FA, Oostra BA, Isaacs A, van Dujian CM, Witteman JCM (2006). ACE Poly-morphisms. Circu-lation Research. 98(9): 1123–1133. https://doi.org/10.1161/01.RES.000-0223145.74217.e7

Sowers JR (2013). Diabetes mellitus and vascular disease. Hypertension. 61(5): 943-7. https://doi.org/10.1161/hyper-tensionaha.111.00612.