Health after the pandemic: investigating risk factors for poorly controlled arterial hypertension and type 2 diabetes among elderly patients in primary care in Slovenia

Abstract

Background. Recently, arterial hypertension (AH) and type 2 diabetes (T2D) populations have shifted in occurrence, age patterns and healthcare strategies. However, poorly controlled AH and T2D persist, emphasising the importance of monitoring and predicting control rates. Objectives. To assess the prevalence of poorly controlled AH and T2D in elderly Slovenian population and identify risk factors associated with poor control. Material and methods. A multi-centre cross-sectional survey among elderly individuals with AH and T2D, treated in Slovenian primary care, was conducted. Socio-demographic, clinical and laboratory data were collected. Poorly controlled AH and T2D were defined as blood pressure (BP) ≥ 140/90 mm Hg and HbA1c ≥ 7.5%, respectively. Statistical analysis encompassed univariate tests and multivariate binary logistic regression. Results. A total of 137 participants, averaging 71.2 ± 4.5 years of age, with mean systolic BP of 137.2 ± 14.4 mm Hg and mean HbA1c of 7.2 ± 1.0%, were studied. Prevalence rates for poorly controlled AH and T2D stood at 41.6% and 36.5%, respectively. Multivariate logistic regression models, adjusted for relevant factors, revealed that living in an urban area (OR = 2.72, 95% CI: 1.15–6.47, p = 0.023) and AH duration (OR = 1.05, 95% CI: 1.01–1.10, p = 0.022) were significantly associated with poorly controlled AH. Conversely, female gender (OR = 2.47, 95% CI: 1.07–5.73, p = 0.035) and daily T2D pill count (OR = 1.96, 95% CI: 1.32–2.91, p = 0.001) were significantly associated with poorly controlled T2D. Conclusions. To improve AH and T2D control, integrated care models should incorporate risk-aware screening methods along with approaches such as increasing awareness, improving education and self-management support, increasing combination therapy usage and personalised treatment plans.