Naidu, Balkish Mahadir
(2018)
Factors associated with hypertension stages among Malaysian adults using secondary data from national health and morbidity survey 2015.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: High blood pressure is a world’s classic problem and remains a major
global health burden. Either singly or combined with other metabolic diseases, high blood
pressure increased the risk of cardiovascular diseases. The epidemic was responsible for
7.4 million deaths due to coronary heart disease, and 6.7 million deaths due to stroke.
Objective: The objectives of this study was to determine the prevalence of hypertension
by stages and factors associated with hypertension stages among the adult population in
Malaysia.
Methods: The study used secondary data from the nationwide cross-sectional populationbased
survey using multistage stratified cluster sampling of the National Health and
Morbidity Survey 2015. Socio-demographic factors, clinical parameters, behavioural
characteristics and comorbidities risk factors were available for analysis. The average
blood pressure reading was categorised to four groups according to The 7th Report of The
Joint Committee on Prevention, Detection, Evaluation and Treatment of High Blood
Pressure (JNC7) (normal, prehypertension, stage 1 hypertension and stage 2
hypertension). Complex Sample Ordinal Logistic Regression was used for analysis.
Results: A total of 15,738 adults were included in the study with the mean age of 41.10
years (15.6 years). The prevalence of prehypertension, stage 1 hypertension and stage 2hypertension were 45.8% (95% CI: 44.66, 47.97), 15.1% (95% CI: 14.34, 15.92) and 5.9%
(95% CI: 5.44, 6.41), respectively. Factors associated with more severe hypertension were
observed among those in 30–39 years old (OR = 1.68, 95% CI: 1.47, 1.93), 40–49 years
old (OR = 2.92, 95% CI: 2.53, 3.36), 50–59 years old (OR = 4.67, 95% CI: 3.97, 5.49),
60 years old and above (OR = 8.09, 95% CI: 6.7, 9.76), rural residents (OR = 1.15, 95%
CI: 1.02, 1.28), male (OR = 2.15, 95% CI: 1.95, 2.38), the Malays (OR = 1.23, 95% CI:
1.07, 1.41), had non-formal education (OR = 1.73, 95% CI: 1.37, 2.20), had primary
education (OR = 1.41, 95% CI: 1.21, 1.64), had low income (OR = 1.31, 95% CI: 1.12,
1.53), married person (OR = 0.86, 95% CI: 0.77, 0.98), current smoker (OR = 0.84, 95%
CI: 0.76, 0.94), were physically inactive (OR = 0.91, 95% CI: 0.83, 0.97), had Diabetes
Mellitus (OR = 1.24, 95% CI: 1.10, 1.39), being overweight (OR = 2.06, 95% CI: 1.88,
2.26) and being obese (OR = 4.58, 95% CI: 4.03, 5.21).
Conclusion: Complex Sample Ordinal regression analysis revealed that age, locality,
gender, ethnic, income, educational level, marital status, Diabetes Mellitus and BMI were
the independent factors associated with severity of hypertension.
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