Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review

Figures & data

Figure 1 Flow diagram of review and inclusion/exclusion (Preferred Reporting Items for Systematic reviews and Meta-Analyses [PRISMA]).

Notes: ^aData of interest = incidence or prevalence of hypertension and/or obesity among adults with T2DM (searches one and two) or risk association of hypertension/obesity with long-term micro- or macrovascular complications of T2DM (search one only); ^bdoes not exclude patients hospitalized with T2DM complications; ^cpublication types excluded were commentaries, case studies, interim reports when end-of-study data were available, and reviews for which primary data were already included; ^done article (Thomas and Atkins²⁹) reported on two studies, for a total of 78 studies in 77 articles.
Abbreviations: NHS EED, National Health Service Economic Evaluation Database; T2DM, type 2 diabetes mellitus.

Figure 2 Hypertension (HTN) prevalence rates among patients with type 2 diabetes mellitus.

Notes: Superscript numbers correspond to reference numbers. For countries with more than one reference citation, the citations are provided in the following order: study presenting the low estimate; study presenting the high estimate; and, if applicable, study or studies presenting mid-range value(s). Mid-range values are not shown in the figure. ^aMean ages in the study by Hassing et al⁵⁹ were 83.1–84.0 years; ^bSuh et al⁷⁶ provided both low and high estimates; ^cThomas and Atkins²⁹ provided both low and high estimates (two studies in one report); ^dthe low estimate in South America used an atypical definition of hypertension (the proportion of patients with systolic blood pressure >144 mmHg).⁸²

Figure 3 Prevalence of obesity defined by body mass index (BMI) among patients with type 2 diabetes mellitus.

Notes: Superscript numbers correspond to reference numbers. For countries with more than one reference citation, the citations are provided in the following order: study presenting the low estimate; study presenting the high estimate; and, if applicable, study or studies presenting mid-range value(s). Mid-range values are not shown in the figure. ^aThomas and Atkins²⁹ provided both low and high estimates (two studies in one report).

Figure 4 Prevalence of obesity defined by waist circumference (WC) among patients with type 2 diabetes mellitus.

Notes: Superscript numbers correspond to reference numbers. For countries with more than one reference citation, the citations are provided in the following order: study presenting the low estimate; study presenting the high estimate. ^aKoehler et al³² provided both low and high estimates; ^bBosevski et al⁷² provided both low and high estimates.

Table 1 Prevelence (%) of body mass index (BMI) classes of obesity

Region/Country	Prevalence by BMI Class
Africa
Nigeria^Citation85	BMI Classes 1 and 2:a 14.3
	BMI Class 3:b 4.3
Europe
UK^Citation91	BMI Class 1:c 20.9
	BMI Classes 2 and 3:d 9.6
UK^Citation9	BMI Class 1:e 29
	BMI Class 2:f 21.3
	BMI Class 3:b 13.8
North America
US (Alaskan Natives and American Indians)^Citation100	BMI Class 1:e 30.9 (in 1995); 28.9 (in 2004)
	BMI Class 2:f 16.7 (in 1995); 20.4 (in 2004); P < 0.001
	BMI Class 3:b 11.5 (in 1995); 20.3 (in 2004); P < 0.001
US (national population sample)^Citation96	BMI Class 3:b 8.6 (in NHANES II); 20.7 (in NHANES 2005–2006); P < 0.0001
Asia
Taiwan^Citation54	BMI Class 1:g 33.5
	BMI Class 2:h 7.1

Notes:

a BMI 30–39.9 kg/m²;

b BMI ≥ 40 kg/m²;

c BMI 30–34 kg/m²;

d BMI ≥ 35 kg/m²;

e BMI 30–34.9 kg/m²;

f BMI 35–39.9 kg/m²;

g BMI 25–29.9 kg/m²;

h BMI ≥ 30 kg/m².

Abbreviations: NHANES, National Health and Nutrition Examination Survey; UK, United Kingdom; US, United States.

Figure 5 Prevalence of hypertension among obese adults with type 2 diabetes mellitus.

Abbreviations: AHD, antihypertensive drug; BP, blood pressure; DBP, diastolic blood pressure; SBP, systolic blood pressure.

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