Beyond blood pressure and glucose: exploring potential biochemical predictors of cardiovascular disease risk in patients with type 2 diabetes mellitus and co-morbid hypertension.

Abstract

Background: Cardiovascular disease (CVD) remains a major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), particularly when complicated by hypertension. This study explored markers of glycaemic control, systemic inflammation, and lipid-related atherogenicity, and their relationship with CVD risk among a population of Nigerian patients with T2DM and co-morbid hypertension.

Method: This hospital-based cross-sectional analytical study was conducted over a period of 13 months among patients with T2DM, including those with co-morbid hypertension. The 10-year estimated CVD risk was determined using the WHO CVD risk assessment chart validated for Western sub-Saharan Africa, while glycated haemoglobin (HbA1c), atherogenic index of plasma (AIP), and high-sensitivity C-reactive protein (hsCRP) were assessed as markers of glycaemic control, atherogenicity, and inflammation, respectively. Statistical analyses, including binary logistic regression, were conducted using SPSS version 25, with significance set at p < 0.05.

Results: Hypertensive patients with T2DM had significantly higher hsCRP (2.57 mg/L, IQR: 2.63 vs. 0.86 mg/L, IQR: 1.72; p < 0.001) and AIP (0.071, IQR: 0.39 vs. 0.002, IQR: 0.34; p = 0.015). They also had significantly higher mean WHO CVD risk scores (11.3 ± 4.7 vs. 7.2 ± 4.1; p < 0.001), with 60.0% (n = 75) classified as moderate-to-high risk. However, after adjusting for potential confounders in the multivariable analysis, HbA1c (OR = 0.82, p = 0.062), hsCRP (OR = 1.01, p = 0.905), and AIP (OR = 2.22, p = 0.293) did not emerge as significant predictors.

Conclusion: Although hsCRP and AIP levels were elevated in higher CVD risk categories, they did not independently predict risk among patients with T2DM and hypertension. This highlights the limited utility of traditional biochemical markers in this group and the need for early risk assessment and aggressive blood pressure control. Further multicentre studies are needed to validate these results and inform targeted interventions in resource-limited settings.