Multilevel Analysis: The Contextual Effect Village on The Risk Hypertension in Magelang, Central Java

Wawan Diyantana, Dono Indarto, Bhisma Murti


Background: Hypertension affects one billion people worldwide. Death due to hypertension in the world is estimated at 9.4 million people every year. Factors related to lifestyle can increase the risk of hypertension. In addition, demographic and topographic factors of resi­den­ce also affect the risk of hypertension. This stu­dy aimed to ana­ly­ze the contextual effect of the village on the risk of hypertension.

Subjects and Method: This study was an observational analytic research study with a cross-­sectional approach. This study was con­duc­­ted in July 2020. A sample of 200 patients who treated at the health cen­ter was selected by purposive sam­pling. The dependent variable was hy­per­­ten­sion. The independent variables were obe­sity, smoking habit, salt consumption, ge­ne­tic history, age, physical activity, low fiber diet, and stress. Blood pressure was measured with a sphyg­mo­ma­nometer, obesity was measured by body mass in­dex measured by weight scales and stature meters, and other variables with ques­tionnaire. The data analysis used multi­va­riate multiple lo­gis­tic regression using Stata 13.

Results: The risk of hypertension increased with obesity (BMI ≥25 kgBW/m2) (OR= 5.33; 95% CI= 1.81 to 15.74; p= 0.002), smoking ha­bit (OR= 6.28; 95% CI= 2.05 to 19.30; p= 0.001), excessive salt consumption (OR= 2.84; 95% CI= 0.99 to 8.11; p= 0.051), genetic history (OR= 3.95; 95% CI= 1.37 to 11.44; p= 0.011), age ≥45 years (OR= 17.71; 95% CI= 5.81 to 53.99; p <0.001), lack of physical activity (OR= 3.49; 95% CI= 1.19 to 10.17; p= 0.022), low fiber diet (OR= 12.42; 95% CI= 1.87 to 82.49; p= 0.009), and stress (OR= 7.59; 95% CI= 2.22 to 25.89; p= 0.001). Village had contextual effect on the risk of hypertension with ICC= 21.65%.

Conclusion: The risk of hypertension increa­ses with obesity, smoking habit, excessive salt con­sumption, genetic history, age ≥45 years, lack of phy­sical activity, low fiber diet and stress. Village has contextual effect on the risk of hypertension.

Keywords: contextual effect, village, hypertension

Correspondence: Wawan Diyantana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile: +628­13­2­8710205.

Journal of Epidemiology and Public Health (2020), 05(03): 270-180


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