Risk Management and Healthcare Policy (May 2021)
Incidence and Predictors of Cardiovascular Disease among Type 1 and Type 2 Diabetes Mellitus in a Tertiary Health Care Setting of Ethiopia: 8-Year Retrospective Follow-Up Study
Abstract
Gebiso Roba Debele,1 Bilisumamulifna Tefera Kefeni,1 Shuma Gosha Kanfe,2 Tadesse Awoke Ayele,3 Haileab Fekadu Wolde,3 Melaku Kindie Yenit,3 Mohammedjud Hassen Ahmed2 1Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia; 2Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia; 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Gebiso Roba Debele Tel +251 922042777Email [email protected]: Cardiovascular disease (CVD) is a major cause of death and disability among people with diabetes in the world and it is proving to be a major barrier to sustainable human development. Despite CVD continuing to devastate human survival, few studies in Ethiopia have focused on its prevalence which alone are insufficient to assess the risk of incident cardiovascular events. Therefore, we determined the incidence and predictors of cardiovascular disease among diabetic patients in a selected tertiary healthcare setting of Ethiopia.Methods: A retrospective cohort study using secondary data was conducted on 399 randomly selected diabetes patients. Data were entered using Epi-Data and analyzed using Stata version 14. Multivariable Weibull proportional hazards regression analysis was used to identify the predictors of CVDs (namely, coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD)) at 5% level of significance.Results: After a median follow-up of 5.9 years, the overall incidence rate of CVD per 100 person–years (PY) was 2.71 (95% CI=16.9– 17.6). The multivariable Weibull proportional hazard regression analysis showed a significant association of chronic kidney disease (CKD); (adjusted hazard ratio (AHR) [95% CI]=2.53 [1.36– 4.72]), systolic blood pressure (SBP)≥ 140; (AHR [95% CI]=4.30 [2.12– 8.73]) and triglyceride (TG)≥ 200 mg/dL; (AHR [95% CI[=5.10 [2.02– 12.89]) with risk of incident CVD.Conclusion: CVD is a public health problem among diabetic patients in Ethiopia. SBP≥ 140, chronic kidney disease, and high triglyceride were independent predictors of new CVD among diabetic patients. These findings emphasize the need of attention for CVD patients with CKD and hypertension (HTN) comorbidities and a longer follow-up period using a prospective study design to determine the long-term effects of predictors of CVD among diabetic patients.Keywords: incidence, cardiovascular disease, predictors, type 1 and type 2 diabetes
