Abstract
INTRODUCTION: Type 2 diabetes mellitus increases the risk of atherosclerotic cardiovascular disease (ASCVD) and microvascular complications, which are further exacerbated by hypertension. This study examined the prevalence of uncontrolled blood pressure (BP) and its associated factors among diabetic patients in primary care clinics in Bahrain. METHODS: A cross-sectional study was conducted among diabetic patients attending specialized primary care clinics in Bahrain. Data were extracted from electronic medical records, with uncontrolled BP defined as systolic BP ≥130 mmHg or diastolic BP ≥80 mmHg. Associations were analyzed using the Chi-square test, and logistic regression was used to calculate the unadjusted and adjusted odds ratios. RESULTS: Among the 538 patients, 67% had uncontrolled BP. Patients aged >60 years (aOR = 1.68; 95% CI: 1.07-2.63), obese individuals (aOR = 1.72; 95% CI: 1.09-2.73), those on ≥3 antihypertensives (aOR = 2.52; 95% CI: 1.24-5.35), and those with elevated fasting blood sugar (aOR = 2.52; 95% CI: 1.24-5.35) had significantly higher odds of uncontrolled BP. Sex, lipid levels, and other comorbidities showed no significant association. DISCUSSION: The high prevalence of uncontrolled BP is consistent with regional studies, but exceeds rates in high-income settings, possibly due to the use of stricter targets. Identified risk factors, including aging, obesity, and glycemic dysregulation, align with global trends and highlight challenges in managing resistant hypertension. CONCLUSION: Two-thirds of diabetic patients in Bahrain's primary care clinics have uncontrolled BP, which is associated with older age, obesity, multiple antihypertensive medications, and poor glycemic control. These findings highlight the potential impact of integrated management strategies, weight management interventions, and more strict glucose control.