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

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: +628132- 8710205.