Beyond blood pressure and glucose: exploring potential biochemical predictors of cardiovascular disease risk in type 2 diabetes mellitus patients with co-morbid hypertension

Background Cardiovascular disease (CVD) remains a major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), particularly when complicated by hypertension. This study evaluated markers of glycaemic control, systemic inflammation, and lipid-related atherogenicity, and their relationship with CVD risk among a population of Nigerian patients with T2DM and co-morbid hypertension. Method This hospital-based cross-sectional analytical study was conducted over a period of 13 months among T2DM patients, including those with co-morbid hypertension. The 10-year estimated CVD risk was determined using the WHO CVD risk assessment chart validated for Western sub-Saharan Africa, while glycated haemoglobin (HbA1c), atherogenic index of plasma (AIP), and high-sensitivity C-reactive protein (hsCRP) were assessed as markers of glycaemic control, atherogenicity, and inflammation, respectively. Statistical analyses, including multivariable linear regression, were conducted using SPSS version 25, with significance set at p < 0.05. Results Hypertensive T2DM patients had significantly higher hsCRP (2.57 mg/L, IQR: 2.63 vs. 0.86 mg/L, IQR: 1.72; p < 0.001) and AIP (0.071, IQR: 0.39 vs. 0.002, IQR: 0.34; p = 0.015). They also had significantly higher mean WHO CVD risk scores (11.3 ± 4.7 vs. 7.2 ± 4.1; p < 0.001), with 60.0% (n = 75) classified as moderate-to-high risk. Following multivariable analysis and adjustment for potential confounders, only age (β = 0.801, p < 0.001) and systolic blood pressure (β = 0.333, p < 0.001) were independently associated with CVD risk scores, while hsCRP (β = 0.078, p = 0.152), AIP (β = 0.023, p = 0.669), and HbA1c (β = 0.026, p = 0.649) were not significant predictors. Conclusion Elevated hsCRP and AIP levels are prevalent among hypertensive T2DM patients but may not serve as reliable predictors of 10-year estimated CVD risk, while age and blood pressure were the primary determinants. This highlights the importance of early risk stratification and optimal blood pressure control in T2DM management, especially in resource-limited settings. Longitudinal, multicentre studies are needed to validate these findings and inform targeted interventions across sub-Saharan African populations.