SMOKING AS A LIFESTYLE RISK FOR PREHYPERTENSION IN TYPE 2 DIABETES

Abstract

Type 2 diabetes mellitus and hypertension are lifestyle-related diseases of major public health concern. Preventive strategies have increasingly shifted toward addressing pre-disease stages. Prehypertension, defined as systolic 120–139 mmHg and/or diastolic 80–89 mmHg, is particularly important in T2DM as it increases cardiovascular risk. This study examined the prevalence and associated factors of prehypertension among T2DM patients in Kelantan using 2022 National Diabetes Registry data. Out of 8,657 clinical audit records, 825 non-hypertensive T2DM patients were identified. Prehypertension was present in 73.5% of this group. Logistic regression analysis revealed age (aOR 1.02; 95% CI: 1.003–1.03), female sex (aOR 1.54; 95% CI: 1.10–2.15), and smoking (aOR 2.19; 95% CI: 1.02–4.73) as significant predictors. Although only 6.8% of patients were smokers, smoking more than doubled the risk of prehypertension. In conclusion, prehypertension is highly prevalent among T2DM patients in Kelantan. Both non-modifiable factors (age, sex) and a key modifiable lifestyle factor (smoking) contribute to the increased risk. These findings underscore the need for targeted lifestyle interventions, particularly smoking cessation programs, to prevent progression to hypertension and reduce cardiovascular complications in this vulnerable population.