Screening twin epidemic in Pakistan; (step) study

Objective: The primary objective of the study was to determine the prevalence of diagnosed and undiagnosed diabetes and hypertension in patients from major cities of Pakistan and to identify the associated risk factors. Method: This cross-sectional STEP study was conducted in seven cities of Pakistan.Diabetes was assessed according to American Diabetes Association 2012 guidelines and hypertension was defined by the Joint National Committee’s 7th Report guidelines. Total 884 patients were enrolled from 100 sites. Patient’s data including demographics, lifestyle factors, medical history and laboratory diagnostic results were collected by the investigators through study questionnaire. Result: In this study conducted during November 2013 – January 2015, 884 patients were eligible, of them 55.5% were males and 42.2% were females with a mean age of 48.3 (±12.6) years fromseven sites. However, from those 392 (44.3%) patients had diabetes, out of them 38.3% were known diagnosed cases and 9.7% were newly diagnosed with diabetes. 579 (65.5%) patients were diagnosed with hypertension. Prevalence of hypertension in out-patient was estimated to be 43.9% and the incidence was 38.5%. Prevalence of coexistence diabetes and hypertension was estimated in (40.5%) patients A direct association has been reported among diabetes and hypertension with age, family history of both, cardiovascular risks, along with other co-morbid. Conclusion: This study suggests that there is a high burden of twin epidemic; Diabetes and hypertension in Pakistan, its coexistence and modifiable cardiovascular risk factors with a poor level of glycemic and blood pressure control.