00000ctm a22000004a 4500 UP-1685523046125428692 Buklod 20230503092606.0 a r |||| u| ta 071031s xx d r |||| u| (iLib)UPMNL-00000056111 LG995 1999 E62 S89 Suwandee, Ratchanee. Hypertension among non-insulin-dependent diabetes mellitus (NIDDM) patients at OPD Diabetic Clinics in Srinagarind and Khon Kaen Hospitals, Khon Kaen, Thailand Ratchanee Suwandee. 134 leaves. Thesis (Master of Science in Epidemiology)--University of the Philippines Manila. This cross-sectional study estimated the prevalence of hypertension among non-insulin-dependent diabetes mellitus (NIDDM) patients, compared the prevalence of hypertension among categories of selected socio-demographic, behavioral and medical factors; and determined the association between hypertension and selected behavioral factors, namely, alcohol consumption, cigarette smoking and salt intake. The study was conducted among 639 NIDDM patients aged 30 years old and over who consulted at the Out Patient Diabetic Clinics and Srinagarind and Khon Kaen Hospitals in Khon Kaen, Thailand from February to June 1999.The prevalence of hypertension among the study population was 31.4(95CI 34-48). The prevalence of hypertension wsa highest among the = 65 year-old respondents (38.4, 95CI 29-48). It was higher among females (36.1, 95CI 32-41) than in males (28.7, 95CI 22-36), among those with low education (35.2, 95CI 31.39) compared with high education (17.5, 95CI 8-33), among overweights (i.e., with BMI23 kg/m?) than the non-overweights (40, 95CI 35-45versus 20.9, 95CI 16-27), and among those who were undergoing diabetic treatment without insulin (35.0, 95CI 31-39) compared with those given insulin (29.9, 95CI 21-40).The results of logistic regression analysis showed that age, duration of diabetes and BMI status modified the effect of alcohol consumption on hypertension. The OR for hypertension among alcohol drinkers relative to non-drinkers was highest among the 55-64-year-old subjects while the ORs were almost the same between the 30-54 and = 65 years old. The absence of a monotonic relationship between age and hypertension prevalence could be due to chance, survivor or misclassification biases.The magnitude of ORs increased with increasing diabetes chronicity. The data further suggested that increased body weight further increased the risk of hypertension especially among the 55-64-year-old chronically diabetic (i.e., diabetes duration of 5 years or longer) patients. The results clearly suggested the importance of controlling body weight among relatively older, alcohol-drinking NIDDM patients who have been diabetics for longer than four years. The odds of hypertension among this already high-risk drinkers was between 8-10 times that of the odds among non-alcohol drinkers. Although this study did not purposely investigate (as an exposure variable of interest) the role of body mass index on hypertension, these results revealed that excess weight considerably increased the odds of hypertension among this particular group of subjects.The ORs among non-overweights were in general lower than the ORs among overweight subjects. In a few instances, alcohol even appeared to offer some protection against hypertension among non-overweight NIDDM patients. Since obesity and excessive alcohol consumption are also known to be associated with diseases other than hypertension among NIDDM patients, it is quite prudent to emphasize to NIDDM patients the importance of modifying these two high-risk behaviors. The association between cigarette smoking and hypertension was modified by age and family income. Among volunteers who belong to the middle or the high income groups, smoking appeared to confer a small and insignificant degree of protection against hypertension regardless of the subject's age after controlling for the effect of sex, education, obesity and duration of diabetes. Smokers who belong to the 55-64-year age group were three times more likely to have hypertension (95CI 0.77-12.2). The estimate of the strength of association between smoking and hypertension could have been underestimated by biases due to small sample size, survivor bias and misclassification of smoking.In this study, duration of diabetes and alcohol consumption were effect modifiers of the association between salt intake and hypertension. Among alcohol drinkers who have been diabetics for 5-9 years and who use low to high amounts of salty appetizers, the risk of hypertension was about twice to almost six times that of subjects who use the least amount of salt. Although moderate consumption of salty appetizers seemed to increase the risk of hypertension by almost four times compared to subjects who use the least amount of salty appetizers, no corresponding increases were seen among those who use the greatest amount of salty appetizers. This apparent underestimation of the effect of salt intake may be due to biases due to sampling variation, selection and misclassification errors. Among non-drinkers, salt intake appears to be not associated with hypertension.Based on this study, the awareness of NIDDM patients regarding the importance of modification (i.e., elimination or reduction) of unhealthy practices such as alcohol drinking, cigarette smoking and salt intake should be enhanced so they can avoid the occurrence of hypertension and other diabetes-related complications. Similar studies in the future should validate the seemingly protective effect of smoking on hypertension seen in this study especially among younger NIDDM patients. Future studies should also strive to collect accurate quantitative measures of alcohol, smoking and salt consumption, and use adequate sample sizes especially among older subjects and patients with longer duration of diabetes. Lastly, future studies should consider the role of other potential confounders in elucidating the causation of hypertension among NIDDM patients. Non-insulin-dependent diabetes. Hypertension. UPMNL CPH LG995 1999 E62 S89 Thesis