Profile of Cardiovascular Risk Factors among Patients with Type 2 Diabetes in Zaria, Northwestern Nigeria
Main Article Content
Keywords
Cardiovascular disease risk, hypertension, Dyslipidemia, Obesity, North-Western Nigeria, Type 2 diabetes mellitus
Abstract
Background: Cardiovascular disease is the leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus (T2DM). In Nigeria, the burden of diabetes-related cardiovascular disease is rising, yet data on the prevalence and clustering of cardiovascular risk factors remain limited. The study objective is to determine the prevalence and clustering of major cardiovascular risk factors among adults with T2DM in Northwestern Nigeria.
Methodology: We retrospectively reviewed medical records of 396 adults with T2DM at Ahmadu Bello University Teaching Hospital, Zaria, to assess hypertension, dyslipidaemia, obesity, proteinuria, and renal function.
Results: The mean age was 53.3 ± 11.3 years, and 49.2% were male. Dyslipidaemia (80.1%), hypertension (69.7%), and truncal obesity (61.9%) predominated. General obesity occurred in 32.6%, proteinuria in 26.3%, and reduced estimated glomerular filtration rate in 33.1%. Women had higher prevalences of hypertension, truncal obesity, and metabolic syndrome, whereas dyslipidaemia was more common in men. Renal abnormalities increased with age. High-risk clustering (≥4 factors) occurred in 64.7% of women and 40.0% of men. Truncal obesity predicted high-risk clustering, while older age and longer diabetes duration predicted reduced renal function.
Conclusions: Cardiovascular risk factors are highly prevalent and clustered among adults with T2DM in Northwestern Nigeria. Truncal obesity is a key driver of clustering, underscoring the need for integrated cardiovascular risk assessment and targeted interventions.
References
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27. Umoh A, Akpan V, Ekong E, Idung A. Hypertension among type 2 diabetic patients in Uyo, South East Nigeria. J Adv Med Med Res. 2018;26(6):1–6. http://doi:10.9734/JAMMR/2018/40604.
28. Jia G, Sowers JR. Hypertension in diabetes: an update of basic mechanisms and clinical disease. Hypertension. 2021;78(5):1197–1205. http://doi:10.1161/HYPERTENSIONAHA.121.17981.
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34. Reddy NLP, Kalakonda VR, Rahul NS, Busapogula DK. Prevalence of microalbuminuria in newly diagnosed type 2 diabetes mellitus and association with other risk factors. Int J Health Sci. 2022;6(Suppl 6):1818–1825. http://doi:10.53730/ijhs.v6nS6.9784.
35. Nata N, Rangsin R, Supasyndh O, Satirapoj B. Impaired glomerular filtration rate in type 2 diabetes mellitus subjects: a nationwide cross-sectional study in Thailand. J Diabetes Res. 2020;2020:6353949. http://doi:10.1155/2020/6353949.
36. Sana MA, Chaudhry M, Malik A, Iqbal N, Zakiuddin A, Abdullah M. Prevalence of microalbuminuria in type 2 diabetes mellitus. Cureus. 2020;12(12):e12318. http://doi:10.7759/cureus.12318.
37. Ohwo U, Ngozi JC, Kester AD, Godwin YD. Prevalence and risk factors of microalbuminuria among type 2 diabetes mellitus: a hospital-based study from Warri, Nigeria. Sahel Med J. 2016;19(1):16. http://doi:10.4103/1118-8561.181889.
38. Suleiman JI, Babale NS, Ahmad MB, Idris YM, Adamu F. Prevalence of microalbuminuria and associated risk factors among type 2 diabetic patients attending selected hospitals in Kano State, Nigeria. Sokoto J Med Lab Sci. 2025;10(1). Available from: https://sokjmls.com.ng/index.php/SJMLS/article/view/646.
39. Genovese G, Friedman DJ, Ross MD, Lecordier P, Uzureau P, Freedman BI, Bowden DW, Langefeld CD, Oleksyk TK, et al. Association of trypanolytic APOL1 variants with kidney disease in African Americans. Science. 2010;329(5993):841–845. http://doi:10.1126/science.1193032.
40. Digban K, Osakue O, Adejumo E, Enitan SS, et al. Assessment of cardiometabolic risk factors among type 2 diabetes mellitus patients in Minna, North-Central Nigeria. Sokoto J Med Lab Sci. 2022;6(4):82–93. http://doi:10.4314/sokjmls.v6i4.10.
41. Oguoma VM, Nwose EU, Richards RS. Prevalence of cardiometabolic syndrome in Nigeria: a systematic review. Public Health. 2015;129(5):413–423. http://doi:10.1016/j.puhe.2015.01.017.
42. Atun R, Davies JI, Gale EAM, Bärnighausen T, Beran D, Kengne AP, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017;5(8):622–667. http://doi.org/10.1016/S2213-8587(17)30181-X.
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44. World Health Organization. Global report on hypertension: the race against a silent killer. Geneva: World Health Organization; 2023. Available from: https://www.who.int/publications/i/item/9789240081062.
2. Uloko AE, Musa BM, Ramalan MA, Gezawa ID, Puepet FH, Uloko AT, et al. Prevalence and risk factors for diabetes mellitus in Nigeria: a systematic review and meta-analysis. Diabetes Ther. 2018 Jun;9(3):1307–16. http://doi.org/10.1007/s13300-018-0441-1.
3. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol. 2018;17(1):83. http://doi:10.1186/s12933-018-0728-6.
4. Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, Mitch W, Smith SC Jr, Sowers JR. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999;100(10):1134–1146. http://doi:10.1161/01.cir.100.10.1134.
5. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S20–S42. doi: 10.2337/dc24-S002.Available from: https://diabetesjournals.org/care/article/47/Supplement_1/S20/153019.
6. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021–3104. http://doi:10.1093/eurheartj/ehy339.
7. National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res. 1998 Sep;6(Suppl 2):51S–209S.Available from: https://pubmed.ncbi.nlm.nih.gov/9813653.
8. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes Federation. Diabetic Medicine. 2006;23(5):469–80. https://doi.org/10.1111/j.1464-5491.2006.01858.x.
9. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation. 2002;106(25):3143–3421. http://doi:10.1161/circ.106.25.3143.
10. Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, Witztum JL; American Diabetes Association; American College of Cardiology Foundation. Lipoprotein management in patients with cardiometabolic risk: consensus statement from the American Diabetes Association and the American College of Cardiology Foundation. Diabetes Care. 2008;31(4):811–822. http://doi:10.2337/dc08-9018.
11. Dobiasova M. Atherogenic index of plasma [log(triglycerides/HDL-cholesterol)]: theoretical and practical implications. Clin Chem. 2004;50(7):1113–1115. http://doi:10.1373/clinchem.2004.033175.
12. Levey AS, Coresh J, Balk E, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139(2):137–147. http://doi:10.7326/0003-4819-139-2-200307150-00013.
13. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–612. http://doi:10.7326/0003-4819-150-9-200905050-00006.
14. Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014;2014:943162. http://doi:10.1155/2014/943162.
15. Thomas GN, Schooling CM, McGhee SM, et al. Metabolic syndrome increases all-cause and vascular mortality. Diabetes Care. 2007;30(9):2381–2386. http://doi:10.2337/dc07-0423.
16. Hashempour Z, Esmaeili F, Tabatabaei-Malazy O, Mosallanejad A, Panahi G. Worldwide prevalence of dyslipidemia in diabetes: an umbrella overview of meta-analysis studies. Endocr Metab Immune Disord Drug Targets. 2025 May 26. http://doi:10.2174/0118715303375795250521041740.
17. Ekpor E, Addo-Mensah D, Akyirem S. Prevalence of dyslipidemia among persons with type 2 diabetes in Africa: a systematic review and meta-analysis. Ann Med Surg (Lond). 2024;86(6):3468–3477. http://doi:10.1097/MS9.0000000000002122.
18. Bello-Ovosi BO, Ovosi JO, Ogunsina MA, Asuke S, Ibrahim MS. Prevalence and pattern of dyslipidemia in patients with type 2 diabetes mellitus in Zaria, Northwestern Nigeria. Pan Afr Med J. 2019; 34:123. http://doi:10.11604/pamj.2019.34.123.18717.
19. Jisieike-Onuigbo NN, Unuigbe EI, Oguejiofor CO. Dyslipidemias in type 2 diabetes mellitus patients in Nnewi, South-East Nigeria. Ann Afr Med. 2011;10(4):285–289. http://doi:10.4103/1596-3519.87045.
20. Taskinen MR. Diabetic dyslipidaemia: from basic research to clinical practice. Diabetologia. 2003;46(6):733–749. https://doi.org/10.1007/s00125-003-1111-y.
21. Goldberg IJ. Diabetic dyslipidemia: causes and consequences. J Clin Endocrinol Metab. 2001;86(3):965–971. https://doi.org/10.1210/jcem.86.3.7304.
22. Lastra G, Syed S, Kurukulasuriya LR, Manrique C, Sowers JR. Type 2 diabetes mellitus and hypertension: an update. Endocrinol Metab Clin North Am. 2014;43(1):103–122. http://doi:10.1016/j.ecl.2013.09.005.
23. Tsimihodimos V, Gonzalez-Villalpando C, Meigs JB, Ferrannini E. Hypertension and diabetes mellitus: coprediction and time trajectories. Hypertension. 2018;71(3):422–428. http://doi:10.1161/HYPERTENSIONAHA.117.10546.
24. Hinneh T, Akyirem S, Bossman IF, Lambongang V, Ofori-Aning P, Ogungbe O, Commodore-Mensah Y. Regional prevalence of hypertension among people diagnosed with diabetes in Africa: a systematic review and meta-analysis. PLoS Glob Public Health. 2023;3(12):e0001931. http://doi:10.1371/journal.pgph.0001931.
25. Unadike BC, Eregie A, Ohwovoriole AE. Prevalence of hypertension amongst persons with diabetes mellitus in Benin City, Nigeria. Niger J Clin Pract. 2011;14(3):300–302. http://doi:10.4103/1119-3077.86772.
26. Basil B, Mohammed JA, Mba IN. Hypertension in type 2 diabetes mellitus: prevalence, patterns, determinants and implications for cardiovascular risk prediction in a population of Nigerian patients. Cardiovasc Diabetol Endocrinol Rep. 2025;11:23. http://doi:10.1186/s40842-025-00225-9.
27. Umoh A, Akpan V, Ekong E, Idung A. Hypertension among type 2 diabetic patients in Uyo, South East Nigeria. J Adv Med Med Res. 2018;26(6):1–6. http://doi:10.9734/JAMMR/2018/40604.
28. Jia G, Sowers JR. Hypertension in diabetes: an update of basic mechanisms and clinical disease. Hypertension. 2021;78(5):1197–1205. http://doi:10.1161/HYPERTENSIONAHA.121.17981.
29. Ferrannini E, Cushman WC. Diabetes and hypertension: the bad companions. Lancet. 2012;380(9841):601–610. http://oi:10.1016/S0140-6736(12)60987-8.
30. Després JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126(10):1301–1313. http://doi:10.1161/CIRCULATIONAHA.111.067264.
31. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–1645. http://doi:10.1161/CIRCULATIONAHA.109.192644.
32. Afkarian M, Zelnick LR, Hall YN, et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988–2014. JAMA. 2016;316(6):602–610. http://doi:10.1001/jama.2016.10924.
33. Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR; UKPDS Study Group. Risk factors for renal dysfunction in type 2 diabetes: UK Prospective Diabetes Study 74. Diabetes. 2006;55(6):1832–1839. http://doi:10.2337/db05-1620.
34. Reddy NLP, Kalakonda VR, Rahul NS, Busapogula DK. Prevalence of microalbuminuria in newly diagnosed type 2 diabetes mellitus and association with other risk factors. Int J Health Sci. 2022;6(Suppl 6):1818–1825. http://doi:10.53730/ijhs.v6nS6.9784.
35. Nata N, Rangsin R, Supasyndh O, Satirapoj B. Impaired glomerular filtration rate in type 2 diabetes mellitus subjects: a nationwide cross-sectional study in Thailand. J Diabetes Res. 2020;2020:6353949. http://doi:10.1155/2020/6353949.
36. Sana MA, Chaudhry M, Malik A, Iqbal N, Zakiuddin A, Abdullah M. Prevalence of microalbuminuria in type 2 diabetes mellitus. Cureus. 2020;12(12):e12318. http://doi:10.7759/cureus.12318.
37. Ohwo U, Ngozi JC, Kester AD, Godwin YD. Prevalence and risk factors of microalbuminuria among type 2 diabetes mellitus: a hospital-based study from Warri, Nigeria. Sahel Med J. 2016;19(1):16. http://doi:10.4103/1118-8561.181889.
38. Suleiman JI, Babale NS, Ahmad MB, Idris YM, Adamu F. Prevalence of microalbuminuria and associated risk factors among type 2 diabetic patients attending selected hospitals in Kano State, Nigeria. Sokoto J Med Lab Sci. 2025;10(1). Available from: https://sokjmls.com.ng/index.php/SJMLS/article/view/646.
39. Genovese G, Friedman DJ, Ross MD, Lecordier P, Uzureau P, Freedman BI, Bowden DW, Langefeld CD, Oleksyk TK, et al. Association of trypanolytic APOL1 variants with kidney disease in African Americans. Science. 2010;329(5993):841–845. http://doi:10.1126/science.1193032.
40. Digban K, Osakue O, Adejumo E, Enitan SS, et al. Assessment of cardiometabolic risk factors among type 2 diabetes mellitus patients in Minna, North-Central Nigeria. Sokoto J Med Lab Sci. 2022;6(4):82–93. http://doi:10.4314/sokjmls.v6i4.10.
41. Oguoma VM, Nwose EU, Richards RS. Prevalence of cardiometabolic syndrome in Nigeria: a systematic review. Public Health. 2015;129(5):413–423. http://doi:10.1016/j.puhe.2015.01.017.
42. Atun R, Davies JI, Gale EAM, Bärnighausen T, Beran D, Kengne AP, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017;5(8):622–667. http://doi.org/10.1016/S2213-8587(17)30181-X.
43. World Health Organization. Global report on diabetes. Geneva: World Health Organization; 2016. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf.
44. World Health Organization. Global report on hypertension: the race against a silent killer. Geneva: World Health Organization; 2023. Available from: https://www.who.int/publications/i/item/9789240081062.
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Mar 6, 2026
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Bello-Ovosi, B., Ovosi, J., Shehu, A., Ogunsina, M., Adeshokan, T., Bawa, P., & Emiola, S. (2026). Profile of Cardiovascular Risk Factors among Patients with Type 2 Diabetes in Zaria, Northwestern Nigeria. Nigerian Medical Journal, 66(6), 2227–2239. https://doi.org/10.71480/nmj.v66i6.1205
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