Arterial pressure and diabetes mellitus are two common pathologies worldwide.1 In 2015, 1 in 4 men and 1 in 5 women had hypertension.2 According to the latest data, an estimated 1.13 billion people worldwide have hypertension.2 Arterial hypertension has long been considered as the “silent killer,” as patients are often asymptomatic.3,4 The presence of hypertension is related to the incidence of diseases that decrease the lifespan such as coronary heart disease, cerebrovascular stroke, and kidney disease.3 However, healthy administration by health care professionals (such as public campaigns), along with good patient compliance, can prevent the occurrence of these diseases.5,6
Another aspect of global health, alongside arterial hypertension, is that of diabetes mellitus. In 2015, the estimated world prevalence of diabetes in adults (20–79 years) was 8.8%, and it is expected to rise to 10.4% by 2040.1 Also in 2015, it was estimated that 1 in 11 adults had diabetes (415 million), while by 2040 it is estimated that 1 in 10 adults will have diabetes (642 million).7 Diabetes mellitus was considered an independent factor for cardiovascular diseases, and accompanied by other comorbidities such as hypertension, can further increase this risk.8,9 Through monitoring glycemic status, it is possible to achieve optimal blood glucose control.8,10
Approximately 75% of all patients with diabetes have concomitant arterial hypertension.9,11 The incidence of hypertension was higher in diabetic patients than in nondiabetic patients.12 Out of 16%–46% hypertensive cases, the prevalence of diabetes mellitus is significantly higher at around 20%–39% than among normotensive subjects.12 Data suggest that it may have more benefit in controlling blood pressure than in lowering blood sugar in patients with diabetes.13
Especially, in terms of a rapid transition, countries such as Kosovo or Albania have dealt with serious health complications due to hypertension.14,15 Unfortunately, in Kosovo, there are no relevant data due to its political status as a postwar country for several years. This is the first study conducted in Kosovo that pertains to the link between arterial pressure and glycemia prevalence. The purpose of this paper was to observe the prevalence of arterial pressure and glycemia in Kosovo and to provide free screening service through health promotion campaigns.
A prospective study was carried out for the period 2017–2019. Data collection was performed taking a random sample of 7254 citizens in 11 cities of Kosovo, performed by AAB College staff. The idea for this paper originated from the International Day of Nursing, when for an entire week in a month, there were offered free services such as blood pressure and glycemia measurement by AAB college teachers and nursing students. General information such as socio-demographic data, age, gender, and city, as well as arterial pressure and glycemia measurements, were gathered. The JNC-V/ADA classification of average sBP 2140 mmHg and/or dBP 2 90 mmHg, according to The Fifth Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure was considered as hypertension;16 whereas high glycemic level is considered to be 2 7 mmol/L according to current guidelines.
The mean value for blood pressure, glycemic level, age, and gender were evaluated. Data were presented as mean values for continuous variables and as a percentage for discrete variables. The statistical analyses were performed using the STATA 15.1 statistical calculation program. Quantitative analyses consisted of data distribution, a chi square test to compare discrete variables, and
In total, 7254 participants participated in the study. No age limit criteria were considered when sampling the population. Gender was another important component when analyzing glycemic status and arterial pressure level. Out of the total participants, the majority was male (5129, 70%), while the remaining (2125, 30%)were female. Arterial pressure of females had a tendency to increase with age (r = 0.3552,
The comparison in years (2017–2018–2019) for arterial pressure and glicemia measurements.
Year | Arterial pressure | Glicemia | Age | ||||||
---|---|---|---|---|---|---|---|---|---|
Min | Mean | Max | Min | Mean | Max | Min | Mean | Max | |
2017 | 80/50 | 133/83 | 200/120 | 3.4 | 7.06 | 30.9 | 19 | 51 | 82 |
2018 | 70/50 | 132/83 | 200/120 | 2.2 | 6.91 | 32.5 | 16 | 54 | 88 |
2019 | 80/60 | 131/83 | 210/120 | 3.8 | 7.10 | 29.6 | 18 | 56 | 87 |
Descriptive data for arterial pressure and glicemia as regards cities of Kosovo in 2017.
Cities | Arterial pressure | Glicemia | ||||
---|---|---|---|---|---|---|
min | mean | max | min | mean | max | |
Prishtinë | 90/60 | 134/84 | 190/110 | 3.9 | 6.70 | 29.0 |
Drenas | 90/60 | 131/84 | 190/120 | 3.8 | 6.37 | 13.7 |
Ferizaj | 80/50 | 131/83 | 180/110 | 3.4 | 7.000 | 19.7 |
Klinë | 100/70 | 131/82 | 200/120 | 3.8 | 7.3 | 19.5 |
Malishevë | 100/60 | 124/80 | 180/120 | 4.2 | 7.39 | 21.6 |
Mitrovicë | 90/55 | 132/83 | 200/105 | 4.1 | 7.21 | 22.8 |
Pejë | 100/60 | 134/82 | 175/110 | 4.1 | 6.71 | 22.0 |
Prizren | 100/60 | 136/83 | 200/120 | 3.9 | 7.40 | 30.9 |
Skënderaj | 100/70 | 131/81 | 180/110 | 3.4 | 6.79 | 19.8 |
Suharekë | 110/75 | 135/84 | 185/120 | 4.4 | 7.49 | 23.9 |
Descriptive data for arterial pressure and glicemia as regards cities of Kosovo in 2018.
Cities | Arterial pressure | Glicemia | ||||
---|---|---|---|---|---|---|
min | mean | max | min | mean | max | |
Prishtinë | 90/50 | 128/82 | 200/120 | 2.2 | 6.26 | 25.5 |
Drenas | 80/50 | 130/82 | 200/120 | 3.5 | 6.82 | 30.1 |
Ferizaj | 80/60 | 137/85 | 200/120 | 3.6 | 7.21 | 26.3 |
Klinë | 70/60 | 129/81 | 180/120 | 3.5 | 6.47 | 21.6 |
Malishevë | 100/60 | 135/87 | 200/120 | 3.7 | 6.11 | 14.2 |
Mitrovicë | 100/60 | 136/82 | 200/110 | 3.2 | 7.37 | 24.2 |
Pejë | 90/60 | 134/85 | 180/120 | 3.6 | 6.88 | 18 |
Gjakove | 90/60 | 131/82 | 190/100 | 4.1 | 7.71 | 24.3 |
Kaqanik | 90/50 | 131/85 | 190/100 | 3.4 | 6.47 | 21.3 |
Lipjan | 80/60 | 80/60 | 200/120 | 3.9 | 6.78 | 23.5 |
Descriptive data for arterial pressure and glicemia as regards cities of Kosovo in 2019.
Cities | Arterial pressure | Glicemia | ||||
---|---|---|---|---|---|---|
min | mean | max | min | mean | max | |
Prishtinë | 90/60 | 129/82 | 180/110 | 3.8 | 6.89 | 24.9 |
Drenas | 80/60 | 141/88 | 200/120 | 3.8 | 7.35 | 23.9 |
Ferizaj | 80/60 | 133/83 | 180/110 | 3.9 | 7.40 | 22.9 |
Gjilan | 85/60 | 127/82 | 190/120 | 4.0 | 7.59 | 24.8 |
Malishevë | 90/60 | 131/84 | 200/120 | 3.7 | 7.08 | 26.6 |
Mitrovicë | 100/60 | 135/85 | 200/120 | 4.4 | 7.92 | 27.2 |
Pejë | 100/60 | 133/83 | 200/120 | 3.8 | 7.17 | 25.2 |
Gjakove | 100/60 | 133/85 | 170/100 | 4.1 | 7.67 | 29.3 |
Kaqanik | 80/60 | 134/84 | 210/120 | 3.9 | 7.22 | 20.9 |
Lipjan | 100/60 | 130/85 | 180/120 | 3.8 | 6.66 | 25.9 |
Klinë | 100/60 | 134/81 | 180/120 | 3.9 | 6.50 | 19.3 |
Glycemia had a significant correlation with systolic arterial pressure values (r = 0.19;
The prevalence of arterial pressure and glycemia was also measured based on geographical distribution. However, no significant differences were noticed between the major cities (
This study analyzed the link between arterial pressure and glycemia, in order to increase awareness toward health risk factors and timely screening of citizens, and to reflect nursing care through comparing the results in years. It was difficult to find similar studies to compare the results, since this study is the first of its kind conducted in Kosovo considering the prevalence of cardiovascular diseases and glycemia and the link between them. Kosovo, as a postwar country, is undergoing a rapid demographic and epidemiological transition. In all such transitions, lifestyle and timely diagnostics are key components and play an important role.
The findings of this study are in line with researches conducted in other Western Balkan countries and farther.15,17,18,19 In a similar study conducted in Kosovo, there were identified significant correlates of hypertension such as male gender, older age, physical inactivity, smoking, and hostility (
A significant correlation was noticed between the participants’ age and arterial pressure (
The overall prevalence of glicemia was registered at 9.2% (out of 7254 adults). Similarly, many other studies concluded prevalence values from 6% among young people to 19% among elderly people.14,26,27,28,29 An Albanian study after considering the 1999 WHO diagnostic criteria reported unadjusted prevalence of glicemia at 9.7%, which is similar to our study.14 Also, other studies toward diagnosed diabetes reported low glicemia values of 9% and 6%, respectively, for Italy and Netherlands.30 In line with this study, the overall prevalence for 2019 worldwide was nearly 9.3% (estimated at half-a-billion adults aged 20–79 years).31
A significant correlation between glycemia and systolic pressure value was noticed (
In conclusion, the prevalence of arterial pressure and glycemia was lower than expected in Kosovo, compared with other European countries. This result could be due to a younger average population in our country, and could not be attributed to developed prevention programs. It is a must for policymakers to consider the risk factors of hypertension in postwar Kosovo, in order to manage them properly.
The study included the majority of Kosovo cities, thus being representative of the whole population. By measuring the prevalence of arterial pressure and glycemia, this study quantified and analyzed data not only in years but also related to gender, age, and geographical distribution. Furthermore, through highlighting the importance of free screening in time for patients and continuous educational programs for nurses, it delivers high academic and practical value, enriches the local literature, and reduces risks from cardiovascular diseases and diabetes mellitus.
This study had several limitations. First of all, there are no other relevant data to compare the results within Kosovo. This study was the first of its sort to address the prevalence of arterial hypertension and diabetes mellitus. The lack of data in years, due to the political situation in Kosovo, contributed to the lack of epidemiological data. The cohort analysis was based on a time period of only 3 years (2017–2019). To get in-depth analysis and more reliable results, conducting a longer period of study is often necessary. Another limitation of the study was that measurements were done only in 1 day, excluding the possibility of obtaining several values for one person at different times. A future possible research may consider a study design for a longer time period. Also, another future research that can be undertaken may consist of a comparative analysis between different countries within the region or abroad.