Cardiovascular Risk and Hypertension Knowledge Among Patients With Coexisting Hypertension and Diabetes Mellitus: A Cross-Sectional Cohort Analysis At Gandhinagar, Gujarat

Abstract

Background: Hypertension (HTN) and diabetes mellitus (DM) frequently coexist and substantially increase cardiovascular (CV) risk. This highlights the need for management beyond blood pressure control. Pharmacist-led care requires understanding patients’ CV risk and hypertension knowledge to guide effective monitoring and counselling.

Objective: To characterize Framingham CV risk and hypertension knowledge (HKLS) among patients with coexisting HTN and DM, and identify prevalent misconceptions and accurate beliefs relevant to pharmacist-led care.

Methods: A cross-sectional baseline cohort analysis was conducted among 205 patients with HTN and DM attending a diabetic clinic in Gandhinagar, Gujarat. Demographic characteristics, CV risk factors, comorbidities, disease duration, and hypertension knowledge were assessed. Descriptive statistics were used to summarize CV risk distribution and domain-level HKLS performance.

Results: The mean age was 53.5 years, with males comprising 63.9%. Mean 10-year Framingham CV risk was 17.3%, with a considerable proportion having a vascular age >80 years. Modifiable risk factors included overweight/obesity (35.6%), current smoking (24.9%), dyslipidemia (17.6%), and physical inactivity (6.8%). Mean HKLS score was 12.0/22 (54.5%), with lowest performance in diet (35.0%), drug compliance (50.0%), and complications (56.0%). Major misconceptions included believing diet alone cannot control HTN (77.1%), lack of awareness of renal complications (64.9%), discontinuing medicines after BP normalization (57.1%), and considering missed doses inconsequential (56.6%). Correct beliefs included routine BP monitoring (76.1%), lifestyle modification (74.6%), and the HTN–heart attack association (74.6%).

Conclusion: Patients with coexisting HTN and DM demonstrated elevated CV risk, multiple modifiable risk factors, and substantial knowledge gaps, particularly regarding diet, medication compliance, and complications. These findings provide specific targets for pharmacist-led education and monitoring.