Pakistan's Dual Burden of Diabetes and Hypertension: An Appeal for Integrated Public Health Interventions

Authors

  • Muhammad Mehr Ali Northwest School Of Medicine,Peshawar ,Pakistan Author
  • Imad Khan Northwest School of Medicine Author
  • Abdul Muqeet Ahmad Northwest School of Medicine Author

DOI:

https://doi.org/10.69723/njms.05.01.0716

Keywords:

Diabetes Mellitus, Hypertension, Dual Burden of Disease

Abstract

Abstract

Background: Among the most common cardiovascular risk factors in the world, diabetes mellitus and hypertension often co-occur as part of the cardiometabolic or cardiorenal metabolic syndrome. This "syndemic" is a serious public health issue with significant economic ramifications, fueled by rising obesity and inactive lifestyle rates. Intensive blood pressure (BP) control, aiming for a systolic BP of less than 120 mm Hg, can significantly reduce major cardiovascular events in diabetic patients, according to international research like the BPROAD study. However, putting such strategies into practice in settings with limited resources is still a difficult task.

Discussion: Among the most common cardiovascular risk factors in the world, diabetes mellitus and hypertension often co-occur as part of the cardiometabolic or cardiorenal metabolic syndrome. This "syndemic" is a serious public health issue with significant economic ramifications, fueled by rising obesity and inactive lifestyle rates. Intensive blood pressure (BP) control, aiming for a systolic BP of less than 120 mm Hg, can significantly reduce major cardiovascular events in diabetic patients, according to international research like the BPROAD study. However, putting such strategies into practice in settings with limited resources is still a difficult task.

Conclusion: Among the most common cardiovascular risk factors in the world, diabetes mellitus and hypertension often co-occur as part of the cardiometabolic or cardiorenal metabolic syndrome. This "syndemic" is a serious public health issue with significant economic ramifications, fueled by rising obesity and inactive lifestyle rates. Intensive blood pressure (BP) control, aiming for a systolic BP of less than 120 mm Hg, can significantly reduce major cardiovascular events in diabetic patients, according to international research like the BPROAD study. However, putting such strategies into practice in settings with limited resources is still a difficult task.

References

. Tsimihodimos V, Gonzalez-Villalpando C, Meigs JB, Ferrannini E. Hypertension and diabetes mellitus: coprediction and time trajectories. Hypertension. 2018;71(3):422–428. doi: 10.1161/HYPERTENSIONAHA.117.10546. PMID: 29335249.

2. Naha S, Gardner MJ, Khangura D, Kurukulasuriya LR, Sowers JR. Hypertension in diabetes. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. [Updated 2021 Aug 7; cited 2025 Jan 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279027/. PMID: 25905256.

3. World Health Organization. Hypertension [Internet]. Geneva: WHO; 2023 [cited 2025 Jan 24]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension

4. International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels: IDF; 2021 [cited 2025 Jan 24]. Available from: https://www.diabetesatlas.org

5. Basit A, Fawwad A, Qureshi H, Shera AS; NDSP Members. Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan (NDSP), 2016–2017. BMJ Open. 2018;8(8):e020961. doi: 10.1136/bmjopen-2017-020961. PMID: 30082350.

6. Basit A, Tanveer S, Fawwad A, Naeem N; NDSP Members. Prevalence and contributing risk factors for hypertension in urban and rural areas of Pakistan; a study from second National Diabetes Survey of Pakistan (NDSP) 2016–2017. Clin Exp Hypertens. 2020;42(3):218–224. doi: 10.1080/10641963.2019.1619753. PMID: 31151358.

7. Javed M, Asim M, Ishfaq H, Ikram N, Shamim U, Shahid M, Syed SK. Prevalence of hypertension in diabetic patients in Pakistan. J Clin Pract. 2024;8(1):28–32.

8. Khangura D, Kurukulasuriya LR, Whaley-Connell A, Sowers JR. Diabetes and hypertension: clinical update. Am J Hypertens. 2018;31(5):515–521. doi: 10.1093/ajh/hpy025. PMID: 29459239.

9. Bi Y, Li M, Liu Y, et al.; BPROAD Research Group. Intensive blood-pressure control in patients with type 2 diabetes. N Engl J Med. 2025;392(12):1155–1167. doi: 10.1056/NEJMoa2412006. PMID: 39555827.

10. Elahi A, Ali AA, Khan AH, Samad Z, Shahab H, Aziz N, Almas A. Challenges of managing hypertension in Pakistan – a review. Clin Hypertens. 2023;29:17. doi: 10.1186/s40885-023-00245-6. PMID: 37316940.

11. Basit A, Fawwad A, Siddiqui SA, Baqa K. Current management strategies to target the increasing incidence of diabetes within Pakistan. Diabetes Metab Syndr Obes. 2019;12:85–96. doi: 10.2147/DMSO.S141356. PMID: 30643443.

12. Petrie JR, Guzik TJ, Touyz RM. Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Can J Cardiol. 2018;34(5):575–584. doi: 10.1016/j.cjca.2017.12.005. PMID: 29459239.

Downloads

Published

03/29/2026

How to Cite

Pakistan’s Dual Burden of Diabetes and Hypertension: An Appeal for Integrated Public Health Interventions. (2026). NORTHWEST JOURNAL OF MEDICAL SCIENCES, 5(1), 1-2. https://doi.org/10.69723/njms.05.01.0716