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The Prevalence of Hypertension and Related Nutritional Risk Factors of Elderly Living in a Rural Area


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The Prevalence of Hypertension and Related Nutritional Risk Factors of Elderly Living in a Rural Area

Article information

Korean J Community Nutr. 2015;20(4):291-300
Publication date (electronic) : 2015 January 20
doi : https://doi.org/10.5720/kjcn.2015.20.4.291
Mee Sook Lee
Department of Food and Nutrition, Hannam University, Daejeon, Korea
†Corresponding author Mee Sook Lee Department of Food and Nutrition, Hannam University, 1646 Yuseong-ro, Yuseong-gu, Daejeon 34430, Korea Tel: (042) 629-8794 Fax: (042) 629-8789 E-mail: meesook@hnu.kr

This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education, Science and Technology (2011–0011070).

Received 2015 July 24; Revised 2015 August 14; Accepted 2015 August 20.

Abstract

Abstract

Objectives: The prevalence of hypertension in Korean rural elderly was significantly higher than that of the general population. Determining the potential risk factors of hypertension would be useful for managing and improving the treatment and prevention of hypertension in rural areas. Methods: We studied 336 elderly individuals 110 males, 226 females) aged between 65 years and 95 years residing in the rural area, S-gun Jeonbuk. Health-related habits, frequency of intake of food groups, nutrient intakes, anthropometric and biochemical measurements were assessed. Subjects were defined as hypertensive if SBP was ≥ 140 mmHg or if DBP was ≥ 90 mmHg or take an antihypertensive drug. Results: The rate of prevalence of hypertension in the study group was 51.8% (male 40.0%, female 57.5%). The risk of occurrence of hypertension was higher among females (OR, 1.98), 75 years old or older (OR, 1.62), BMI ≥ 25 kg/m2 (OR, 2.84), acceptable range (upper end) of body fat (OR, 2.29) and unhealthy (too high) range of body fat (OR, 3.28), hypertriglyceridemia (OR, 2.17) and hypercholesterolemia (OR, 5.42), low protein intakes (OR, 1.78). However, health related habits, frequencies of intake of food groups and most nutrient intakes except for protein did not show any significant relationship with the occurrence of hypertension. Conclusions: To reduce the risk of occurrence of hypertension among elderly individuals in rural areas, it is needed to avoid increase of body fat, 25 or higher BMI (kg/m2) and hyperlipidemia and low intake of proteins.

Keywords: elderly; hypertension; risk factor; protein intake

The number of study subjects

Anthropometric and biochemical measurements of normotensive and hypertensive subjects

Odds ratios of the anthropometric and biochemical risk factors for hypertension

Odds ratios of the health-related habits for hypertension

Odds ratios of the frequencies of intake of food groups and the nutrient intakes for hypertension

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Article information Continued

Copyright © 2015 Journal of the Korean Society of Community Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Table 1.

The number of study subjects

  Male Female Total
Normotensive subject1) 66 (160.0)2) 96 (142.5) 162 (148.2)
Hypertensive subject3) 44 (140.0) 130 (157.5) 174 (151.8)
Total 110 (100.0) 226 (100.0) 336 (100.0)
1)

Normotensive subject: SBP < 140 mmHg and DBP < 90 mmHg 2) N (%) 3) Hypertensive subject: SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or take a antihypertensive drug

Table 2.

Anthropometric and biochemical measurements of normotensive and hypertensive subjects

  Male Female
Norm1) (n=66) HP2) (n=44) P-value Norm (n=96) HP (n=130) P-value
Age (years) 874.0± 85.23) 875.6± 85.7 0.141 874.9± 85.6 875.6± 86.0 0.375
Anthropometric measurements
Height (cm) 163.4± 86.2 162.0± 86.0 0.262 147.5± 85.6 147.7± 86.2 0.835
Body weight (kg) 856.9± 10.6 859.2± 88.3 0.234 848.8± 87.2 850.8± 88.3 0.064
Body fat (%) 820.7± 87.3 824.5± 86.8 0.007∗∗ 828.9± 87.0 831.4± 87.2 0.009∗∗
BMI (kg/m2) 821.4± 83.6 822.5± 82.8 0.084 822.4± 82.7 823.2± 83.4 0.043∗
Waist circumference (cm) 881.0± 89.8 884.8± 87.7 0.037∗ 879.6± 88.1 881.7± 88.2 0.059
Biochemical measurements
Albumin (g/dL) 884.8± 85.3 884.1± 80.3 0.423 884.2± 80.2 884.2± 80.3 0.462
Triglyceride (mg/dL) 120.9± 62.3 119.3± 74.7 0.906 123.0± 55.9 138.2± 73.7 0.078
Total cholesterol (mg/dL) 162.7± 37.9 167.9± 39.0 0.488 179.7± 33.8 174.7± 38.0 0.303
HDL-cholesterol (mg/dL) 843.0± 11.3 845.0± 11.3 0.366 847.1± 11.6 844.8± 89.6 0.114
LDL-cholesterol (mg/dL) 895.1± 32.7 899.8± 33.0 0.462 106.2± 32.8 101.0± 32.3 0.238
Fasting blood glucose (mg/dL) 897.1± 32.1 888.3± 15.9 0.059 894.1± 38.6 890.9± 18.1 0.450
HbA1C (%) 886.2± 81.0 886.0± 80.4 0.220 886.0± 80.6 886.0± 80.5 0.770
1)

Normotensive group: SBP < 140 mmHg and DBP < 90 mmHg 2) Hypertensive group: SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or take a antihypertensive drug 3) Mean± SD ∗: p < 0.05, ∗∗: p < 0.01

Table 3.

Odds ratios of the anthropometric and biochemical risk factors for hypertension

  N (%) Crude OR (95% CI) Adjusted OR1) (95% CI)
Sex
Male 110 (32.7) 1.00 1.00
Female 226 (67.3) 2.03 (1.28–3.23)∗∗ 1.98 (1.24–3.16)∗∗
Age (years)
65–74 174 (51.8) 1.00 1.00
75–84 140 (41.7) 1.65 (1.05–2.59)∗ 1.62 (1.03–2.55)∗
≥ 85 22 (66.5) 2.10 (0.84–5.27) 1.96 (0.77–4.96)
Anthropometric risk factors
Body fat (%)
M: 6–15, F: 9–23 (acceptable-lower end) 56 (16.7) 1.00 1.00
M: <15-<25, F: <23-<32 (acceptable-upper end) 155 (46.1) 2.45 (1.28–4.69)∗∗ 2.29 (1.17–4.47)∗
M: ≥ 25, F: ≥ 32 (unhealthy-too high) 125 (37.2) 3.68 (1.88–7.22)∗∗∗ 3.28 (1.65–6.52)∗∗∗
BMI (kg/m2)      
< 18.5 32 (69.5) 1.00 1.00
18.5–22.9 160 (47.6) 1.29 (0.60–2.79) 1.29 (0.58–2.85)
23–24.9 74 (22.0) 1.92 (0.83–4.45) 2.06 (0.85–4.98)
≥ 25 70 (20.8) 2.47 (1.05–5.82)∗ 2.84 (1.14–7.05)∗
Waist circumference (cm)
M: < 90, F: < 85 234 (69.6) 1.00 1.00
M: ≥ 90, F: ≥ 85 102 (30.4) 1.90 (1.18–3.06)∗∗ 2.10 (1.27–3.48)∗∗
Biochemical risk factors
Triglycerides (mg/dL)
< 150 240 (71.4) 1.00 1.00
150–199 60 (17.9) 0.92 (0.52–1.62) 0.87 (0.49–1.56)
≥ 200 36 (10.7) 1.97 (0.94–4.11) 2.17 (1.02–4.63)∗
Total cholesterol (mg/dL)
< 200 256 (76.2) 1.00 1.00
200–239 67 (19.9) 1.01 (0.59–1.74) 0.93 (0.53–1.62)
≥ 240 13 (63.9) 5.42 (1.18–24.92)∗ 5.42 (1.15–25.47)∗
HDL-cholesterol (mg/dL)
M: ≥ 40, F: ≥ 50 136 (40.5) 1.00 1.00
M: < 40, F: < 50 200 (59.5) 1.60 (1.03–2.48)∗ 1.31 (0.82–2.09)
LDL-cholesterol (mg/dL)
< 130 273 (81.3) 1.00 1.00
130–159 49 (14.6) 0.98 (0.53–1.79) 0.86 (0.46–1.62)
≥ 160 14 (64.2) 1.25 (0.42–3.69) 1.21 (0.40–3.67)
Fasting blood glucose (mg/dL)
< 126 316 (94.0) 1.00 1.00
≥ 126 20 (66.0) 0.48 (0.19–1.24) 0.48 (0.18–1.27)
HbA1C (%)
< 7 313 (93.2) 1.00 1.00
≥ 7 23 (66.8) 0.58 (0.24–1.37) 0.61 (0.25–1.49)
1)

Values are adjusted for age and sex. ∗: p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0001

Table 4.

Odds ratios of the health-related habits for hypertension

  N (%) Crude OR (95% CI) Adjusted OR1) (95% CI)
Smoking
None 257 (76.5) 1.00 1.00
Ex-smoking 44 (13.1) 0.59 (0.31–1.12) 0.71 (0.33–1.54)
Smoking 35 (10.4) 0.31 (0.14–0.67) 0.40 (0.17–0.93)
Alcohol drinking
None 256 (76.2) 1.00 1.00
Drinking 80 (23.8) 1.11 (0.67–1.83) 1.62 (0.92–2.84)
Drinking frequency (times/week)
None 256 (76.2) 1.00 1.00
< 1 18 (65.4) 1.91 (0.70–5.24) 2.24 (0.79–6.34)
≥ 1 – <4 30 (68.9) 0.73 (0.34–1.56) 1.06 (0.47–2.40)
≥ 4 32 (69.5) 1.23 (0.59–2.57) 1.97 (0.86–4.51)
Physical activity (hours/day)
< 1 129 (38.4) 1.00 1.00
1 – < 3 60 (17.9) 1.12 (0.60–2.08) 1.10 (0.58–2.09)
≥ 3 147 (43.8) 0.57 (0.36–0.92)∗ 0.70 (0.42–1.16)
Exercise (times/week)
None 247 (73.5) 1.00 1.00
1 – 4 40 (11.9) 1.11 (0.57–2.18) 1.26 (0.63–2.50)
≥ 5 49 (14.6) 1.59 (0.85–2.98) 1.64 (0.86–3.11)
Exercise duration (min/time)
None 232 (69.0) 1.00 1.00
< 30 35 (10.4) 1.02 (0.50–2.08) 1.09 (0.52–2.26)
30 – < 60 26 (67.7) 0.83 (0.37–1.87) 0.91 (0.39–2.09)
≥ 60 43 (12.8) 1.48 (0.76–2.87) 1.72 (0.86–3.44)
1)

Values are adjusted for age and sex. ∗: p < 0.05

Table 5.

Odds ratios of the frequencies of intake of food groups and the nutrient intakes for hypertension

    N (%) Crude OR (95% CI) Adjusted OR1) (95% CI)
Eating habits (consumption frequency/week)
Meats ≥ once 107 (31.8) 1.00 1.00
< once 229 (68.2) 1.50 (0.95–2.39) 1.29 (0.80–2.09)
Eggs ≥ once 147 (43.8) 1.00 1.00
< once 189 (56.3) 1.11 (0.72–1.71) 1.04 (0.67–1.63)
Fishes ≥ once 144 (42.9) 1.00 1.00
< once 192 (57.1) 1.25 (0.81–1.93) 1.14 (0.73–1.78)
Doenjang etc. ≥ once 302 (89.9) 1.00 1.00
< once 34 (10.1) 1.57 (0.76–3.26) 1.50 (0.71–3.16)
Legumes ≥ once 203 (60.4) 1.00 1.00
< once 133 (39.6) 0.87 (0.56–1.34) 0.87 (0.55–1.36)
Milks ≥ once 99 (29.5) 1.00 1.00
< once 237 (70.5) 0.76 (0.48–1.22) 0.77 (0.47–1.25)
Fruits & juices ≥ once 212 (63.1) 1.00 1.00
< once 124 (36.9) 1.15 (0.74–1.80) 1.11 (0.70–1.75)
Nutrient intakes (KDRI)2)
Energy ≥ EER 134 (39.9) 1.00 1.00
< EER 202 (60.1) 1.18 (0.77–1.83) 1.17 (0.75–1.83)
Protein ≥ EAR 267 (79.5) 1.00 1.00
< EAR 69 (20.5) 1.86 (1.07–3.20)∗ 1.78 (1.02–3.12)∗
Calcium ≥ EAR 76 (22.6) 1.00 1.00
< EAR 260 (77.4) 1.35 (0.81–2.25) 1.13 (0.66–1.92)
Potassium ≥ AI 59 (17.6) 1.00 1.00
< AI 277 (82.4) 1.72 (0.97–3.05) 1.42 (0.47–2.66)
Iron ≥ EAR 313 (93.2) 1.00 1.00
< EAR 23 (66.8) 1.23 (0.52–2.88) 1.11 (0.27–2.65)
Zinc ≥ EAR 251 (74.7) 1.00 1.00
< EAR 85 (25.3) 1.21 (0.74–1.98) 1.12 (0.67–1.87)
Vitamin A ≥ EAR 206 (61.3) 1.00 1.00
< EAR 130 (38.7) 0.69 (0.45–1.08) 0.69 (0.44–1.08)
Thiamin ≥ EAR 150 (44.6) 1.00 1.00
< EAR 186 (55.4) 1.25 (0.82–1.93) 1.10 (0.71–1.72)
Riboflavin ≥ EAR 57 (17.0) 1.00 1.00
< EAR 279 (83.0) 0.68 (0.38–1.22) 0.66 (0.36–1.19)
Niacin ≥ EAR 124 (36.9) 1.00 1.00
< EAR 212 (63.1) 1.30 (0.84–2.00) 1.07 (0.66–1.73)
Vitamin B6 ≥ EAR 188 (56.0) 1.00 1.00
< EAR 148 (44.0) 1.11 (0.55–2.24) 1.15 (0.74–1.80)
Folate ≥ EAR 170 (50.6) 1.00 1.00
< EAR 166 (49.4) 0.79 (0.51–1.21) 0.77 (0.50–1.20)
Vitamin C ≥ EAR 154 (45.8) 1.00 1.00
< EAR 182 (54.2) 0.94 (0.61–1.45) 0.89 (0.57–1.39)
1)

Values are adjusted for age, sex and % body fat. 2) KDRI: Korean Dietary Reference Intakes: EER (estimated energy requirement), EAR (estimated average requirement), AI (adequate intake) ∗: P < 0.05