Serial cross-sectional assessment of glycaemic and blood pressure profiles at a KwaZulu-Natal tertiary hospital: A 5-year analysis (2021–2025)

Abstract

Background: Diabetes, hypertension and HIV-associated multimorbidity contribute substantially to South Africa’s cardiometabolic disease burden. We described five years of screening for dysglycaemia, glycaemic control, blood pressure control and retroviral disease (RVD)-associated multimorbidity at a KwaZulu-Natal tertiary hospital. Methods: Annual single-day cross-sectional audits were conducted from 2021 to 2025 among outpatient attendees and volunteering hospital staff. Participants underwent point-of-care testing (POCT) of glycated haemoglobin (HbA1c) and seated brachial blood pressure measurement. Dysglycaemia was defined as HbA1c ≥ 5.7% in participants without known diabetes, glycaemic control in known diabetes as HbA1c < 7.0%, and blood pressure control as < 140/90 mmHg. Proportions were reported with Wilson 95% confidence intervals. Results: Among 411 records, known diabetes was present in 98/407 participants (24.1%; 95% CI 20.2–28.5) and known hypertension in 149/334 (44.6%; 95% CI 39.4–50.0). Among participants without known diabetes, 138/298 had dysglycaemia (46.3%; 95% CI 40.7–52.0), including 49/298 with diabetes-range HbA1c (16.4%; 95% CI 12.7–21.1). Glycaemic control was achieved in 37/98 participants with known diabetes (37.8%; 95% CI 28.8–47.6). In years with reconcilable data, 41/107 participants with known hypertension achieved blood pressure control (38.3%; 95% CI 29.7–47.8). In 2025, RVD-positive status was recorded in 29/101 participants (28.7%; 95% CI 20.8–38.2), with overlap between RVD, diabetes and hypertension. Conclusion: This selected hospital-based population had a high burden of dysglycaemia and suboptimal diabetes and blood pressure control. RVD-associated multimorbidity supports standardised screening, confirmatory testing and integrated chronic disease follow-up. Contribution: This 5-year serial screening analysis demonstrates a substantial burden of dysglycaemia, incomplete glycaemic control and suboptimal BP control in a selected hospital-based screening population. RVD-associated cardiometabolic multimorbidity was observed in 2025, supporting the need for standardised opportunistic screening, confirmatory testing pathways and integrated chronic disease follow-up within public-sector services.