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

Mee Sook Lee

doi:10.5720/kjcn.2015.20.4.291

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

Research Article

Korean J Community Nutr 2015;20(4):291-300.

Published online: 20 January 2015

DOI: https://doi.org/10.5720/kjcn.2015.20.4.291

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

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 24 July 2015 Revised 14 August 2015 Accepted 20 August 2015

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.

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

References

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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
Meats	< 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
Eggs	< 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
Fishes	< 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
Doenjang etc.	< 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
Legumes	< 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
Milks	< 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
Fruits & juices	< 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
Energy	< 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
Protein	< 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
Calcium	< 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
Potassium	< 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
Iron	< 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
Zinc	< 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
Vitamin A	< 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
Thiamin	< 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
Riboflavin	< 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
Niacin	< 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
Vitamin B₆	< 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
Folate	< 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
Vitamin C	< 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

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