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

Wawan Diyantana, Dono Indarto, Bhisma Murti

Abstract

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: wawandiyantana@gmail.com. Mobile: +628­13­2­8710205.

Journal of Epidemiology and Public Health (2020), 05(03): 270-180
https://doi.org/10.26911/jepublichealth.2020.05.03.02.

 

Full Text:

PDF

References

Alhawari HH, Al-Shelleh S, Alhawari HH, Al-Saudi A, Aljbour AD, Al-Faris L, Al-Ryalat SA (2018). Blood pressure and its association with gender, body mass index, smoking, and family history among university students. Int J Hypertens. 1–5. doi:10.1155/2018/41-86496.


Agnes A, Leo R (2020). Hubungan konsumsi laru, garam, sayur, dan buah terhadap risiko hipertensi pria dewasa Kupang. JIGK, 1(02): 1-9.


Amanda D, Martini S (2018). The relationship between demographical characteristic and central obesity with hypertension. JBE. 6(1): 43. doi:10.20473/be.v6i12018.43-50.


Amra RN, Aguslina Siregar F, Mutiara E (2020). Physical activity, obesity, family history, and their associations with hypertension among the elderly in Aceh Singkil, Aceh. J Epidemiol Public Health. 5(1): 45-51. https://doi.org/10.26911/jepublichealth.2020.05.01.05.


Arifin MHBM, Weta IW, Ratnawati NLKA (2016). Faktor-faktor yang berhubungan dengan kejadian hipertensi pada kelompok lanjut usia di wilayah kerja UPT Puskesmas Petang I Kabupaten Badung Tahun 2016. E-Jurnal Medika, 5(7): 1–22.


Bautista LE, Bajwa PK, Shafer MM, Malecki KMC, McWilliams CA, Palloni A (2019). The relationship between chronic stress, hair cortisol and hypertension. Int J Hypertens. 2: 100012. doi: 10.1016/j.ijchy.2019.10-0012.


Bhansali A, et al. (2015). Prevalence of and risk factors for hypertension in urban and rural India: The ICMR-INDIAB study. J Hum Hyperten. 29(3): 204–209. doi: 10.1038/jhh.2014.57.


Bhelkar S, Deshpande S, Mankar S, Hiwar-kar P (2018). Association between stress and hypertension among adults more than 30 years: A case-control study. Natl J Community Med; 9(6): 430-433.


Borgi L, Muraki I, Satija A, Willett WC, Rimm EB, Forman JP (2016). Fruit and Vegetable Consumption and the Incidence of Hypertension in Three Prospective Cohort Studies. Hyper tension, 67(2), 288–293. doi: 10.1161/hypertensionaha.115.06497.


Daştan İ, Erem A, Çetinkaya V (2017). Urban and rural differences in hypertension risk factors in Turkey. Anatol. J. Cardiol, 18(1), 39–47. doi: 10.14744/AnatolJCardiol.2017.7452.


Dinkes Kab Magelang (2019) Profil Keseha-tan Kabupaten Magelang. Magelang.


Gambardella J, Morelli MB, Wang X, Santulli G. (2020). Pathophysiological mechanisms underlying the beneficial effects of physical activity in hyperten-sion. J Clin Hypertens, 22(2), 291–295. doi:10.1111/jch.13804.


Grillo A, Salvi L, Coruzzi P, Salvi P, Parati G (2019). Sodium intake and hypertension. Nutrients, 11(9), 1–16. doi:10.-3390/nu11091970.


Ismail IM, Kulkarni AG, Meundi AD, Amruth M (2016). A community-based comparative study of prevalence and risk factors of hypertension among urban and rural populations in a coastal town of South India. Sifa Medical Journal, 3(2): 41. doi: 10.4103/2148-7731.182001.


Istyanto F, Mudigdo A, Rahardjo SS (2019). Path Analysis on the Biopsychosocial Factors Associated with Hypertension. J Epidemiol Public Health. 4(2) 70–80. doi: 10.26911/jepublichealth.2019.04.02.02.


Khanam R, Ahmed S, Rahman S, Al Kibria GM, Syed JRR, Khan AM, Moin SMI, Ram M, Gibson DG, Pariyo G, Baqui AH (2019). Prevalence and factors associated with hypertension among adults in rural Sylhet district of Bangladesh: a cross-sectional study.

BMJ Open 9:e026722. doi: 10.1136/bmjopen-2018-026722.


Kim J, Kim J (2018). Association between fruit and vegetable consumption and risk of hypertension in middle-aged and older Korean adults. J Acad Nutr Diet. 118(8): 1438–1449.e5. doi:10.1016/j.jand.2017.08.122.


Kurnianingsih M, Dewi YLR, Pamungkasari EP (2019). Risk factors of hypertension in high school students: Multilevel evidence of the contextual effect of school. J Epidemiol Public Health. 4(4): 259–269. doi: 10.26911/jepublichealth.2019.04.04.01.


Laxman S (2018). A Study of hypertension and its risk factors among rural population in the field practice area of Mahatma Gandhi Medical College and Hospital, Jaipur. J med sci clin res. 6(5). doi:10.18535/jmscr/v6i5.11.


Pardosi F, Rahardjo SS, Dewi YLR (2020). Overweight, alcohol, and tobacco con-sumption are associated with hypertension among police and military personnel: A meta-analysis. J Epidemiol Public Health. 5(1), 88–96. doi: 10.26911/jepublichealth.2020.05.01.-09.


Rohkuswara TD, Syarif S (2017). Hubungan obesitas dengan kejadian hipertensi derajat 1 di pos pembinaan terpadu penyakit tidak menular (Posbindu PTM) Kantor Kesehatan Pelabuhan Bandung Tahun 2016. Jurnal Epidemiologi Kesehatan Indonesia, 1(2). doi:10.7454/epidkes.v1i2.1805.


Sudaryanto S, Rahardjo SS, Indarto D (2019). Risk factors of hypertension among women in Sragen, Central Java. J Epidemiol Public Health. 4(2): 127–137. doi: 10.26911/jepublichealth.2019.04.02.08.


Susi DDA (2019). Hubungan antara kebia-saan merokok terhadap kejadian hipertensi essensial pada laki-laki usia di atas 18 tahun di RW 06, Kelurahan Medan Satria, Kecamatan Medan Satria, Kota Bekasi. Tarumanagara Medical Journal, 1(2): 434–441.


WHO (2015). QAs on hypertension. Retrieved from https://www.who.int/news-room/q-a-detail/q-as-on-hypertension (Accessed: 2 January 2020).


Wijaya IPA (2017). Factors affecting blood pressure increase in the event of hypertension indigenous community in Bualu. Caring, 1(04): 13–24.


Wu J, Li T, Song X, Sun W, Zhang Y, Liu Y, Li L, et al. (2018). Prevalence and distribution of hypertension and related risk factors in Jilin Province, China 2015: A cross-sectional study. BMJ Open, 8(3): 1–10. doi: 10.1136/bmj-open-2017-020126.


Xu RY, Zhou YQ, Zhang XM, Wan YP, Gao X (2018). Body mass index, waist circumference, body fat mass, and risk of developing hypertension in normal-weight children and adolescents. Nutr Metab Cardiovasc Dis 28(10) 1061–1066. doi: 10.1016/j.numecd.2018.05.015.


Zgheib NK, Sleiman F, Nasreddine L, Nasrallah M, Nakhoul N, Isma’eel, H, Tamim H (2018). Short telomere length is associated with aging, central obesity, poor sleep and hypertension in lebanese individuals. Aging Dis. 9(1): 77–89. doi: 10.14336/AD.2017.0310.

Refbacks

  • There are currently no refbacks.