High prevalence of dyslipidaemia among persons with diabetes mellitus and hypertension at a tertiary hospital in Blantyre, Malawi

Author:

Katundu Kondwani G.H.1,Mukhula Victoria2,Phiri Tamara3,Phiri Chimota4,Filisa-Kaphamtengo Florence5,Chipewa Pascal1,Chirambo George6,Mipando Mwapatsa6,Mwandumba Henry C.2,Muula Adamson S.7,Kumwenda Johnstone3

Affiliation:

1. Department of Biomedical Sciences, Kamuzu University of Health Sciences

2. Malawi-Liverpool Wellcome Program, Kamuzu University of Health Sciences

3. Department of Medicine, Kamuzu University of Health Sciences

4. Department of Medicine, Queen Elizabeth Central Hospital

5. Kamuzu Central Hospital

6. Blantyre to Blantyre Research Facility, Kamuzu University of Health Sciences

7. Department of Community and Environmental Health, Kamuzu University of Health Sciences

Abstract

Abstract Background Dyslipidaemia drives the process of atherosclerosis, and hence a significant modifiable risk factor complicating hypertension and diabetes. In Malawi, the prevalence, screening and management of dyslipidaemia among persons with diabetes mellitus have not been reported. This study aimed to investigate the prevalence, biochemical characteristics, screening and management practices for dyslipidaemia among persons with diabetes mellitus, hypertension, and diabetes mellitus and hypertension comorbidity at Queen Elizabeth Central hospital in Blantyre, Malawi. Methods This was a cross-sectional study conducted in 2021. A total of 256 adult participants (diabetes mellitus = 100); hypertension = 100; both conditions = 56) were included. Medical data and anthropometric measurements were recorded. Blood samples were analysed for HbA1C and serum lipids. Associated risk factors for dyslipidaemia were also assessed. Results Dyslipidaemia was prevalent in 58%, 55%, and 70% of participants with diabetes mellitus, hypertension, and both conditions. Low-density lipoprotein cholesterol (LDL-C) dyslipidaemia was the most common in all participant groups. Participants with both diabetes and hypertension had 2.4 times (95% CI 1.2–4.6) increased risk of LDL-C dyslipidaemia than those with diabetes alone (p < 0.02). Being overweight or obese and age over 30 years were risk factors for dyslipidaemia in patients with diabetes mellitus alone (OR 1.3 (95% CI 1.1–1.6), p < 0.04, and OR 2.2 (95% CI 1.2–4.7) (p < 0.01), respectively. Overweight and obesity predicted LDL-C dyslipidaemia in hypertensive patients (OR 3.5 (95% CI 1.2–9.9) p < 0.001). Poorly controlled hypertension was associated with a 1.8 times risk (95% CI 1.1–2.7) of dyslipidaemia in patients with both diabetes mellitus and hypertension (p < 0.01). Less than 1% of the participants had a lipogram performed before the study and on lipid-lowering therapy. Conclusions Dyslipidaemia with LDL-C derangement was highly prevalent, especially in individuals with both diabetes mellitus and hypertension, and there was absent use of lipid-lowering therapy. Screening and managing dyslipidaemia should be reinforced to reduce the risk of cardiovascular complications in this population at increased risk.

Publisher

Research Square Platform LLC

Reference51 articles.

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5. Ariyanti R, Besral B. Dyslipidemia associated with hypertension increases the risks for coronary heart disease: a case-control study in Harapan Kita Hospital, National Cardiovascular Center, Jakarta. Journal of lipids. 2019;2019.

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