Prevalence of Diabetes Mellitus Comorbidity in Hypertension Patients: Indonesian National Health Insurance Data
DOI:
https://doi.org/10.47701/amkz2w85Keywords:
Hypertension, Diabetes Mellitus, Comorbidity Prevalence, Cross-Sectional Studies, National Health ProgramsAbstract
Managing hypertension becomes significantly more complex when diabetes mellitus co-occurs, often leading to poorer clinical outcomes and higher healthcare costs. This research investigated the prevalence of diabetes comorbidity among hypertensive patients at advanced referral health facilities and its relationship with patient age. Using a cross-sectional approach, we analyzed 5,505 records from the 2025 Indonesian National Health Insurance (BPJS Kesehatan) sample data for patients presenting with a primary diagnosis of hypertension. The overall prevalence of comorbid diabetes was 9.3% (510 cases). Within this cohort, 57.6% (3,172) were non-elderly (<60 years) and 42.4% (2,333) were elderly (?60 years). Diabetes prevalence was 9.6% in the elderly group and 9.0% in the younger demographic. The Pearson Chi-Square analysis confirmed no significant association between age category and diabetes (p = 0.459). These findings suggest that the risk of comorbid diabetes among referred hypertensive patients remains consistent regardless of age. Therefore, we recommend universal endocrine screening for all hypertensive referrals to prevent delayed diagnosis and improve targeted interventions, rather than relying on age-based screening protocols.
References
1. Prisie MYN. ANTARA [Internet]. 2025 [cited 2026 Mar 19]. p. 1. BPJS Kesehatan berupaya tekan angka penyakit kronis dengan Prolanis. Available from: https://www.antaranews.com/berita/5186021/bpjs-kesehatan-berupaya-tekan-angka-penyakit-kronis-dengan-prolanis
2. Wahidin M, Achadi A, Besral B, Kosen S, Nadjib M, Nurwahyuni A, et al. Projection of diabetes morbidity and mortality till 2045 in Indonesia based on risk factors and NCD prevention and control programs. Sci Rep. 2024 Mar 5;14(1):5424. doi:10.1038/s41598-024-54563-2
3. Qadir HR. Hypertension and Diabetes: A Common Comorbidity: A Comprehensive Review. International Journal for Multidisciplinary Research [Internet]. 2025 Sep;7(5):1–6. Available from: www.ijfmr.com
4. Hartopo AB, Inggriani MP, Jhundy BW, Fachiroh J, Rosha PT, Wardani RK, et al. Modifiable risk factors for coronary artery disease in the Indonesian population: a nested case-control study. Cardiovascular Prevention and Pharmacotherapy. 2023 Jan 31;5(1):24–34. doi:10.36011/cpp.2023.5.e3
5. Kristanti D, Rahajeng E, Sulistiowati E, Kusumawardani N, Dany F. Determinants of diabetes comorbidities in Indonesia: a cohort study of non-communicable disease risk factor. Universa Medicina. 2021 Jan 5;40(1):3–13. doi:10.18051/UnivMed.2021.v40.3-13
6. Amin A, Asri Y, Maharani AS. Association Between Diabetes Mellitus and Hypertension Severity at a Primary Health Care Center in Indonesia. Vitamin: Jurnal ilmu Kesehatan Umum. 2026 Jan 26;4(1):103–12. doi:10.61132/vitamin.v4i1.2045
7. Hustrini NM, Susalit E, van Diepen M, Rotmans JI. Perceived barriers to management of patients with diabetes mellitus and hypertension in primary care centers in Indonesia. Frontiers in Health Services. 2026 Jan 15;5. doi:10.3389/frhs.2025.1715125
8. Santika EF. databoks [Internet]. 2024 [cited 2026 Mar 19]. Prevalensi Hipertensi Indonesia Turun Jadi 30,8% pada 2023. Available from: https://databoks.katadata.co.id/layanan-konsumen-kesehatan/statistik/8a60c7f555dd1ac/prevalensi-hipertensi-indonesia-turun-jadi-308-pada-2023
9. Prihantini NN, Kurniyanto, Putri PMK. Study of Incidence of Hypertension in Type II Diabetes and It’s Correlation. Asian Journal of Advanced Research and Reports. 2025 Feb 20;19(3):70–9. doi:10.9734/ajarr/2025/v19i3922
10. Badan Kebijakan Pembangunan Nasional. Prevalence, Impact, and Efforts In Controlling Hypertension & Diabetes in Indonesia the Result of Indonesian Health Survey 2023 Figure 1. Discrepancy in Treatment-Seeking Behavior for Hypertension Among Productive-Age and Elderly Individuals Diagnosed with Hypertension [Internet]. 2024 [cited 2026 Mar 19]. Report. Available from: https://repository.badankebijakan.kemkes.go.id/id/eprint/5531/1/07%20factsheet%20PTM_English.pdf
11. Oktaviyani P, Salman, Sari MHN, Frisilia M, Munazar, Satria A, et al. Prevalence and Risk Factors of Hypertension and Diabetes Mellitus among the Indonesian Elderly. Makara Journal of Health Research. 2022 Apr 26;26(1). doi:10.7454/msk.v26i1.1329
12. Public Relations of BKPK. Kemenkes BPK [Internet]. 2024 [cited 2026 Mar 19]. The Danger of Hypertension Lurks Among Indonesian Youth. Available from: https://www.badankebijakan.kemkes.go.id/en/bahaya-hipertensi-mengintai-anak-muda-indonesia/
13. Nasution SA, Ginanjar E, Lydia A, Sukrisman L, Alwi I, Wijaya IP, et al. Cardiovascular-kidney-metabolic syndrome in Indonesia: a commentary on the need for integrated management and policy action. Front Public Health. 2026 Jan 13;13. doi:10.3389/fpubh.2025.1707551
14. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018 Feb 8;14(2):88–98. doi:10.1038/nrendo.2017.151
15. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020 Apr 5;16(4):223–37. doi:10.1038/s41581-019-0244-2
16. 16. Kemenkes RI. Badan Penelitian dan Pengembangan Kesehatan. 2019. Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2018.
17. Sun D, Zhou T, Heianza Y, Li X, Fan M, Fonseca VA, et al. Type 2 Diabetes and Hypertension. Circ Res. 2019 Mar 15;124(6):930–7. doi:10.1161/CIRCRESAHA.118.314487
18. de Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P, et al. Diabetes and Hypertension: A Position Statement by the American Diabetes Association. Diabetes Care. 2017 Sep 1;40(9):1273–84. doi:10.2337/dci17-0026
19. Tsimihodimos V, Gonzalez-Villalpando C, Meigs JB, Ferrannini E. Hypertension and Diabetes Mellitus. Hypertension. 2018 Mar;71(3):422–8. doi:10.1161/HYPERTENSIONAHA.117.10546
20. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol. 2018 Jan;6(1):69–80. doi:10.1016/S2213-8587(17)30186-9
21. Tanoey J, Becher H. Diabetes prevalence and risk factors of early-onset adult diabetes: results from the Indonesian family life survey. Glob Health Action. 2021 Jan 13;14(1). doi:10.1080/16549716.2021.2001144
22. Hill MA, Yang Y, Zhang L, Sun Z, Jia G, Parrish AR, et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism. 2021 Jun; 119:154766. doi: 10.1016/j.metabol.2021.154766
23. Petrie JR, Guzik TJ, Touyz RM. Diabetes, Hypertension, and Cardio Vascular Disease: Clinical Insights and Vascular Mechanisms. Canadian Journal of Cardiology. 2018 May;34(5):575–84. doi: 10.1016/j.cjca.2017.12.005
24. Jia G, Aroor AR, Hill MA, Sowers JR. Role of Renin-Angiotensin-Aldosterone System Activation in Promoting Cardiovascular Fibrosis and Stiffness. Hypertension. 2018 Sep;72(3):537–48. doi:10.1161/HYPERTENSIONAHA.118.11065
25. Lastra G, Syed S, Kurukulasuriya LR, Manrique C, Sowers JR. Type 2 diabetes mellitus and hypertension: an update. Endocrinol Metab Clin North Am. 2014 Mar;43(1):103–22. doi: 10.1016/j.ecl.2013.09.005 PubMed PMID: 24582094.
26. Chen G, McAlister FA, Walker RL, Hemmelgarn BR, Campbell NRC. Cardiovascular Outcomes in Framingham Participants with Diabetes. Hypertension. 2011 May;57(5):891–7. doi:10.1161/HYPERTENSIONAHA.110.162446
27. Tune JD, Goodwill AG, Sassoon DJ, Mather KJ. Cardiovascular consequences of metabolic syndrome. Translational Research. 2017 May; 183:57–70. doi: 10.1016/j.trsl.2017.01.001
28. Bazo-Alvarez JC, Quispe R, Peralta F, Poterico JA, Valle GA, Burroughs M, et al. Agreement Between Cardiovascular Disease Risk Scores in Resource-Limited Settings. Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine. 2015 Jun;14(2):74–80. doi:10.1097/HPC.0000000000000045
29. BPJS Kesehatan. BPJS Kesehatan [Internet]. 2024 [cited 2026 Mar 19]. Laporan Pengelolaan Program JKN-KIS Tahun 2023. Available from: https://web.bpjs-kesehatan.go.id/uploads/information/05072024032036-d0e43b7b-4628-4963-8cb4-a2104605a2e6.pdf.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Resa Paksi Mandariska, Adzka Fahma Rodliya, Siti Hanisa Khaira

This work is licensed under a Creative Commons Attribution 4.0 International License.






