Sedentary Behavior, Stress Level, Dietary Intake, and It`s Relationship with Blood Pressure among Hypertensive Adults in FELDA Terengganu

Abstract

Hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and its prevalence is predicted to increase by 60% by 2025 [1]. It is the major risk factor for cardiovascular disease and is responsible for most deaths worldwide. In Malaysia, at least three out of 10 adults have hypertension, and the prevalence has increased [2]. Sedentary behaviour, stress level, and dietary intake were the major cost-effective ways in reducing and controlling hypertension. However, there is lack of studies examining on sedentary behaviour and stress levels among hypertensive adults in FELDA.
 
 Thus, this cross-sectional study aimed to determine the relationship between sedentary behavior, psychosocial stress, and dietary intake with blood pressure among the hypertensive adults in FELDA Terengganu. A study was conducted among 51 adults aged between 38 to 64 years old in four FELDA in Terengganu which FELDA Neram 2, Kemaman, FELDA Selasih, Besut, FELDA Jerangau, Dungun and FELDA Belara, Kemaman. Socio-demographic, anthropometric, current blood pressure reading, sedentary behavior (smoking and physical activity level), stress level, and dietary factors were measured. The physical activity level was measured using International Physical Activity Questionnaire (IPAQ) short form version while stress level was measured using the Perceived Stress Scale questionnaire (PSS-10). Three days of 24 hours dietary recall was used for assessing dietary intake. Statistical analysis was conducted using IBM SPSS 22. 
 
 A total of 51 hypertensive participants (median age: 57.0 ± 7.0 years), where the majority of them were female (66.7%), married (80.4%), and received secondary education (60.8%) with monthly income less than RM 2500 participated in this study. Most of the participants were obese (66.7%) and did not have their blood pressure controlled (51.0%). However, only 9.8% were smokers. More than half of the participants had moderate physical activity (47.1%) and low stress levels (86.3%). The participants had excessive energy, protein, saturated fatty acid, sodium, iron and vitamin A intake.
 Among all the variables, we found that hip circumference (p=0.045) and not smoking (p=0.02) were showing a significant linear relation with systolic blood pressure while age (p=0.001), married (p=0.031), household income (p=0.041), and magnesium (p=0.05) were showing significant linear relation with diastolic blood pressure. However, there was no relation between stress and blood pressure.
 
 Excessive consumption of energy, protein, and saturated fatty acid (SFA) will result in increasing body weight thus leading to the development of obesity. In comparison with other Asian countries Malaysia has the highest rate of obesity [3]. Meanwhile, the study showed a linear relation between age and blood pressure since increase in age will increase the risk of getting hypertension [4].
 
 Blood pressure has become a global health problem. Therefore, an intervention aimed among adults was crucial and urgently needed so that it can increase the awareness of hypertension and community-wide health behavior interventions that were identified and known to be effective in reducing high blood pressure levels. Further studies should include more participants of general populations to have more accurate results.