Factors Affecting Hypertension among the Malaysian Elderly

Anthropometric indices, but not birth weight, are associated with high blood pressure risk among Malay adolescents in Kuala Lumpur

Background

With the high prevalence of hypertension, it is important to determine its predictors early. The aim of this study was to determine the association between blood pressure with anthropometric indices and birth weight among a population of Malay adolescents in Kuala Lumpur.

Design and methods

This cross-sectional study was carried out among 254 primary and secondary school adolescents aged 10 to 16 years. Anthropometric measurements and blood pressure were determined through standardized protocols, while participants' birth weight was obtained from birth certificate. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and a body shape index (ABSI) were calculated.

Results

Boys had significantly higher weight, height, WC, WHtR and systolic blood pressure (SBP) than girls (p < 0.05). SBP was moderately correlated with body weight (r = 0.60), WC (r = 0.55), BMI (r = 0.54), height (r = 0.47), WHtR (rs = 0.36) and WHR (r = 0.30). Moderate correlations were found between diastolic blood pressure (DBP) with BMI (r = 0.26), WC (r = 0.23) and body weight (r = 0.20). Participants with BMI > +1SD had higher odds of being prehypertensive or hypertensive (aOR 8.97; 95% CI 3.16, 25.48), followed by participants with WC ≥ 90th percentile (aOR 6.31; 95% CI 2.48, 16.01) and participants with WHtR > 0.5 (aOR 5.10; 95% CI 2.05, 12.69). Multiple linear regression showed BMI was positively associated with both SBP and DBP. No significant association was found between birth weight and BP.

Conclusion

BMI had the best predictive ability for SBP and DBP. These findings strongly emphasize the importance of primary prevention of hypertension in adolescents, especially among those with high BMI.

Mental distress along the cascade of care in managing hypertension

Hypertension might be a contributing factor of mental illness. The aim of this study was to investigate the association between different levels of hypertension care and mental distress among hypertensive individuals in Malaysia. We constructed a hypertension care cascade using data of 6531 hypertensive individuals aged ≥ 35 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory. We examined the association between the status of hypertension care and mental distress using multiple logistic regressions. Respondents who had not been screened for hypertension and those who had uncontrolled blood pressure (BP) had higher odds of depression, anxiety and, stress compared to those who had been screened and those who had controlled BP, respectively. Respondents who were not taking antihypertensive medication had lower odds of depression and anxiety compared to those who were on medication. There was an association between different levels of hypertension care and mental distress. The application of a hypertension care cascade may help improve the provision of mental health support in primary care clinics. Specific mental health interventions could be provided for patients with particular needs along the cascade.

Health Education With Audiovisual Media and Relaxation Massage in Lowering Blood Pressure and Improved Sleep Quality for the Elderly

Intruduction: The aging process results in a progressive decline in physiological functions with age, including a decrease in productivity. Hypertension is a major problem in public health in Indonesia and in developing countries. Hypertension is a common cause of disturbed sleep patterns, due to structural and functional changes in the peripheral vascular system. The purpose of this study was the effect of health education with audiovisual methods and relaxation massage to reduce blood pressure and sleep quality disorders in the elderly. Materials and Methods: Experimental research (community trial) with pretest-posttest control group design. The target population in this study is the elderly who are included in the elderly age group, namely > 50 years in Selemadeg District, Tabanan Regency. The sample size is 90 elderly, determined based on the results of previous studies with a standard deviation (σ) = 0.51, the difference in the mean of cognitive changes (μ1- 2) = 0.30. divided into two groups, the treatment group and the control group. The independent variable is health education using audiovisual media and Relaxation Massage and the dependent variable is blood pressure. Data collection tools in the form of sphygmomanometer, observation sheet. Data analysis used independent t-test, paired t-test and Multivariate ANOVA test. Result: The blood pressure of the treatment group before the intervention mostly had grade I hypertension (53.3%), and after the intervention most of the blood pressure improved to normal (57.8%), and this result was statistically significant (0.000). In the treatment group before the intervention, many had poor sleep quality (46.7%), and after the intervention improved sleep quality in the good category (53.3%), and this result was statistically significant (0.000). Conclotion: It is concluded that the provision of health education with audiovisual methods and massage relaxation can reduce blood pressure and improve sleep quality in the elderly.

Knowledge, Attitude and Practice (KAP) of Malay Elderly on Salt Intake and Its Relationship With Blood Pressure

Hypertension is a worldwide problem and a major global health burden with high salt intake as one of the factors often related to it. Public exposure to a high salt diet has contributed to the increase in prevalence of hypertension among the Malaysian population. Improving the knowledge, attitudes and practices (KAP) related to salt intake is a key component of effective blood pressure control. Therefore, this study was aimed to determine the association of KAP of healthy salt intake toward blood pressure among the elderly residing in a semi urban area of Klang Valley Malaysia. A cross-sectional study using convenience sampling was conducted among Malay elderly, aged 60–81 years old residing in Bandar Baru Bangi. Subjects were required to answer the questionnaire via face to face interview regarding KAP of Salt Intake, together with sociodemographic and health profiles. Anthropometry parameters and blood pressure were measured. A total of 94 elderly [57.5% women with mean Body Mass Index (BMI) of 26. 46 ± 4.16, 42.5% men with mean BMI of 27.31 ± 5.19] have participated in the study. Results indicated that the overall KAP score was average (57.4%). However, majority showed a positive attitude toward reducing the salt intake. BMI was found to have significant correlation with blood pressure (r = 0.278, p < 0.05). Higher education level was significantly (p < 0.05) associated with good knowledge scores while younger subjects have a positive attitude toward healthy intake of salt (p < 0.05). Subjects with higher knowledge scores were also observed to have the more controlled blood pressure compared to those who scored less. Attitude and practices score showed no significance difference (p > 0.05) with blood pressure. Younger age, higher level of education and living partner or elderly was significantly (p < 0.05) associated with lower systolic and diastolic blood pressure. Overall, this study showed that knowledge toward healthy salt intake, BMI, education level, and living with others were significantly associated with the blood pressure among the elderly. Further education and intervention is required to improve knowledge on healthy salt intake among elderly as part of the prevention from hypertension.

Knowledge, attitude and practice regarding hypertension among residents in a housing area in Selangor, Malaysia

Background and aims

Hypertension is becoming a global epidemic and threat to the world population. This cross-sectional study was carried out at a housing area in Selangor, Malaysia to study the knowledge, attitude and practice (KAP) regarding hypertension among the residents.

Methods

A total of 110 respondents aged 18 years old and above were selected by convenience sampling. Data was collected using a structured interviewer-guided questionnaire with Likert-scale choices of answers.

Results

All respondents were Malay with the mean age of 41 years [Standard Deviation (SD)=11.828]. The total mean and SD of knowledge, attitude and practice scores were 74.33 (SD=6.25), 44.22 (SD=5.05) and 27.55 (SD=2.86), respectively. There were significant positive correlations between knowledge with attitude (r=+0.393; p<0.001) and practice (r=+0.378; p<0.001). However, there was no significant correlation between attitude and practice (r=+0.120; p=0.212). There were significant fair positive correlations between age with knowledge (r=+0.402; p<0.001), attitude (r=+0.265; p=0.005) and practice (r=+0.337; p<0.001) regarding hypertension. Meanwhile, gender, educational level, employment status and family history had no significant association with knowledge, attitude and practice regarding hypertension.

Conclusion

This study revealed that KAP regarding hypertension were associated with age, but not with other socio-demographic characteristics studied. The awareness, prevention and control programs of hypertension in their community should be increased, so that the residents could enjoy and maintain the healthy lifestyle.