Association of Age, Physical Activity, Dietary Patterns, and Smoking Behavior with Hypertension Among Residents of Plosojenar Village, Ponorogo

Downloads
Background: Hypertension is an increasing global health concern, including particularly among adults in community settings. At this stage of life, unhealthy lifestyle habits such as low physical activity and high intake of salty or processed foods directly increase the risk of early hypertension.
Objectives: This study aims to analyze the relationship of age, physical activity, diet, and smoking habits with the incidence of hypertension in Plosojenar Village, Ponorogo.
Methods: This study employed an observational analytic design with a case-control method involving 154 respondents, consisting of 77 individuals with hypertension and 77 individuals in the control group. Data were collected through interviews and questionnaires, then analyzed using the chi-square test. The physical activity questionnaire included three items related to exercise, daily physical movement, and routine activities. The dietary pattern questionnaire included seven items related to high-fat foods, fried foods, fast food, instant food, salted foods, fruit intake, and coffee consumption.
Results: The study showed that age above 45 years (p-value 2.2E-16, OR 71.191710) and lack of physical activity (p-value 3.8E-03, OR 15.73508) was significantly associated with hypertension. Dietary patterns also showed a significant effect (p-value 1.8E-02), although with a more moderate strength of association. In contrast, smoking habits did not show a significant relationship with the incidence of hypertension (p-value 6.2E-01).
Conclusions: Age and physical activity are the main risk factors for hypertension in Plosojenar Village. Therefore, public health interventions should focus on prevention through promoting physical activity and improving diet. With 77 cases of hypertension, including one adolescent case, early prevention efforts and risk management in vulnerable groups are necessary to reduce the future prevalence of hypertension.
Battista, F., Ermolao, A., van Baak, M. A., Beaulieu, K., Blundell, J. E., Busetto, L., Carraça, E. V, Encantado, J., Dicker, D., Farpour-Lambert, N., Pramono, A., Bellicha, A., & Oppert, J. M. (2021). Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat—A systematic review and meta-analysis. Obesity Reviews, 22(S4), e13269. https://doi.org/10.1111/OBR.13269
Bell, C. S., Samuel, J. P., & Samuels, J. A. (2019). Prevalence of Hypertension in Children: Applying the New American Academy of Pediatrics Clinical Practice Guideline. Hypertension, 73(1), 148–152. https://doi.org/10.1161/HYPERTENSIONAHA.118.11673/SUPPL_FILE/HYP_HYPE201811673_SUPP1.PDF
BKPK Kemenkes. (2023). Fact Sheet Survei Kesehatan Indonesia (SKI) 2023. https://www.badankebijakan.kemkes.go.id/fact-sheet-survei-kesehatan-indonesia-ski-2023/
Buonacera, A., Stancanelli, B., & Malatino, L. (2017). Stroke and Hypertension: An Appraisal from Pathophysiology to Clinical Practice. Current Vascular Pharmacology, 17(1), 72–84. https://doi.org/10.2174/1570161115666171116151051
Duncan, M. S., Freiberg, M. S., Greevy, R. A., Kundu, S., Vasan, R. S., & Tindle, H. A. (2019). Association of Smoking Cessation With Subsequent Risk of Cardiovascular Disease. JAMA, 322(7), 642–650. https://doi.org/10.1001/JAMA.2019.10298
Filippini, T., Malavolti, M., Whelton, P. K., Naska, A., Orsini, N., & Vinceti, M. (2021). Blood Pressure Effects of Sodium Reduction. Circulation, 143(16), 1542–1567. https://doi.org/10.1161/CIRCULATIONAHA.120.050371
Gallant, F., Sylvestre, M. P., O’Loughlin, J., & Bélanger, M. (2022). Teenage Sport Trajectory Is Associated With Physical Activity, but Not Body Composition or Blood Pressure in Early Adulthood. Journal of Adolescent Health, 71(1), 119–126. https://doi.org/10.1016/J.JADOHEALTH.2022.02.014
Gallucci, G., Tartarone, A., Lerose, R., Lalinga, A. V., & Capobianco, A. M. (2020). Cardiovascular risk of smoking and benefits of smoking cessation. Journal of Thoracic Disease, 12(7), 3866. https://doi.org/10.21037/JTD.2020.02.47
Gibbs, B. B., Hivert, M. F., Jerome, G. J., Kraus, W. E., Rosenkranz, S. K., Schorr, E. N., Spartano, N. L., & Lobelo, F. (2021). Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association. Hypertension, 78(2), E26–E37. https://doi.org/10.1161/HYP.0000000000000196/ASSET/58429248-C05F-411C-82F5-AC8D0348200F/ASSETS/IMAGES/LARGE/HYP.0000000000000196.FIG01.JPG
Guo, C., Zhou, Q., Zhang, D., Qin, P., Li, Q., Tian, G., Liu, D., Chen, X., Liu, L., Liu, F., Cheng, C., Qie, R., Han, M., Huang, S., Wu, X., Zhao, Y., Ren, Y., Zhang, M., Liu, Y., & Hu, D. (2020). Association of total sedentary behaviour and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose–response meta-analysis. Diabetes, Obesity and Metabolism, 22(1), 79–90. https://doi.org/10.1111/DOM.13867
Hassana, N. E., Shebinib, S. M. El, El-Masrya, S. A., Ahmedb, N. H., Alia, M. M., El-Saeedc, G. S. M., & El-Lebedyd, D. (2019). Association between dietary sodium, calcium, saturated fat and blood pressure in obese Egyptian adolescents. Egyptian Pediatric Association Gazette 2019 67:1, 67(1), 1–6. https://doi.org/10.1186/S43054-019-0007-5
Hay, M., Barnes, C., Huentelman, M., Brinton, R., & Ryan, L. (2020). Hypertension and Age-Related Cognitive Impairment: Common Risk Factors and a Role for Precision Aging. Current Hypertension Reports, 22(10), 1–14. https://doi.org/10.1007/S11906-020-01090-W/FIGURES/3
Hird, T. R., Zomer, E., Owen, A. J., Magliano, D. J., Liew, D., & Ademi, Z. (2019). Productivity burden of hypertension in Australia: A life table modeling study. Hypertension, 73(4), 777–784. https://doi.org/10.1161/HYPERTENSIONAHA.118.12606/SUPPL_FILE/HYP_HYPE201812606_SUPP1.PDF
Jabbari, M., Eini-Zinab, H., Safaei, E., Poursoleiman, F., Amini, B., Babashahi, M., Barati, M., & Hekmatdoost, A. (2023). Determination of the level of evidence for the association between different food groups/items and dietary fiber intake and the risk of cardiovascular diseases and hypertension: An umbrella review. Nutrition Research, 111, 1–13. https://doi.org/10.1016/J.NUTRES.2022.12.011
Kokubo, Y., Padmanabhan, S., Iwashima, Y., Yamagishi, K., & Goto, A. (2019). Gene and environmental interactions according to the components of lifestyle modifications in hypertension guidelines. Environmental Health and Preventive Medicine, 24(1), 1–11. https://doi.org/10.1186/S12199-019-0771-2/TABLES/5
Kolahdooz, F., Nader, F., Jang, S. L., Daemi, M., Ezekowitz, J. A., Johnston, N., Cruickshank, K., & Sharma, S. (2020). Elevated Blood Pressure and Associations with Sodium Intake Among Multiethnic Youth in Edmonton, Canada: Findings from WHY ACT NOW. High Blood Pressure and Cardiovascular Prevention, 27(3), 239–249. https://doi.org/10.1007/S40292-020-00377-Y/METRICS
Lu, X., Gu, D., He, Z., Jia, Y., Li, J., Cao, J., Liu, F., Li, H., Chen, J., Hu, D., Shen, C., Zhao, Y., Liu, X., Yu, L., Huang, J., Lu, X., Gu, D., & Chen, S. (2023). Fruit and Vegetable Intake and the Risk of Arterial Hypertension In China: A Prospective Cohort Study. Chronic Diseases and Translational Medicine.
MacLeod, K. E., Ye, Z., Donald, B., & Wang, G. (2022). A Literature Review of Productivity Loss Associated with Hypertension in the United States. Population Health Management, 25(3), 297–308. https://doi.org/10.1089/POP.2021.0201/SUPPL_FILE/SUPPL_APPENDIXC.DOCX
Madsen, H., Sen, A., & Aune, D. (2023). Fruit and Vegetable Consumption and the Risk of Hypertension: A Systematic Review and Meta-Analysis of Prospective Studies. European Journal of Nutrition, 62, 1941–1955.
Mamdouh, H., Alnakhi, W. K., Hussain, H. Y., Ibrahim, G. M., Hussein, A., Mahmoud, I., Alawadi, F., Hassanein, M., Abdullatif, M., AlAbady, K., Farooq, S., & Sulaiman, N. (2022). Prevalence and associated risk factors of hypertension and pre-hypertension among the adult population: findings from the Dubai Household Survey, 2019. BMC Cardiovascular Disorders, 22(1), 1–9. https://doi.org/10.1186/S12872-022-02457-4/TABLES/4
Masenga, S. K., & Kirabo, A. (2023). Hypertensive heart disease: risk factors, complications and mechanisms. Frontiers in Cardiovascular Medicine, 10, 1205475. https://doi.org/10.3389/FCVM.2023.1205475/BIBTEX
Nepali, P., Suresh, S., Pikale, G., Jhaveri, S., Avanthika, C., Bansal, M., Islam, R., & Chanpura, A. (2022). Hypertension and the Role of Dietary Fiber. Current Problems in Cardiology, 47(7), 101203. https://doi.org/10.1016/J.CPCARDIOL.2022.101203
Nugent, J. T., Young, C., Funaro, M. C., Jiang, K., Saran, I., Ghazi, L., Wilson, F. P., & Greenberg, J. H. (2022). Prevalence of Secondary Hypertension in Otherwise Healthy Youths with a New Diagnosis of Hypertension: A Meta-Analysis. The Journal of Pediatrics, 244, 30-37.e10. https://doi.org/10.1016/J.JPEDS.2022.01.047
Onuh, J. O., & Qiu, H. (2020). New progress on the study of aortic stiffness in age-related hypertension. Journal of Hypertension, 38(10), 1871–1877. https://doi.org/10.1097/HJH.0000000000002452
Osei, A. D., Mirbolouk, M., Orimoloye, O. A., Dzaye, O., Uddin, S. M. I., Benjamin, E. J., Hall, M. E., DeFilippis, A. P., Stokes, A., Bhatnagar, A., Nasir, K., & Blaha, M. J. (2019). Association Between E-Cigarette Use and Cardiovascular Disease Among Never and Current Combustible-Cigarette Smokers. The American Journal of Medicine, 132(8), 949-954.e2. https://doi.org/10.1016/J.AMJMED.2019.02.016
Park, J. H., Moon, J. H., Kim, H. J., Kong, M. H., & Oh, Y. H. (2020). Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks. Korean Journal of Family Medicine, 41(6), 365. https://doi.org/10.4082/KJFM.20.0165
Pinckard, K., Baskin, K. K., & Stanford, K. I. (2019). Effects of Exercise to Improve Cardiovascular Health. Frontiers in Cardiovascular Medicine, 6, 458447. https://doi.org/10.3389/FCVM.2019.00069/BIBTEX
Rizzoni, D., Rizzoni, M., Nardin, M., Chiarini, G., Agabiti-Rosei, C., Aggiusti, C., Paini, A., Salvetti, M., & Muiesan, M. L. (2019). Vascular Aging and Disease of the Small Vessels. High Blood Pressure and Cardiovascular Prevention, 26(3), 183–189. https://doi.org/10.1007/S40292-019-00320-W/METRICS
Said, M. A., van de Vegte, Y. J., Zafar, M. M., van der Ende, M. Y., Raja, G. K., Verweij, N., & van der Harst, P. (2019). Contributions of Interactions Between Lifestyle and Genetics on Coronary Artery Disease Risk. Current Cardiology Reports, 21(9), 1–8. https://doi.org/10.1007/S11886-019-1177-X/FIGURES/1
Schutte, A. E., Venkateshmurthy, N. S., Mohan, S., & Prabhakaran, D. (2021). Hypertension in Low- and Middle-Income Countries. Circulation Research, 128(7), 808–826. https://doi.org/10.1161/CIRCRESAHA.120.318729
Simonetto, D. A., Liu, M., & Kamath, P. S. (2019). Portal Hypertension and Related Complications: Diagnosis and Management. Mayo Clinic Proceedings, 94(4), 714–726. https://doi.org/10.1016/J.MAYOCP.2018.12.020
Speer, H., D’cunha, N. M., Naumovski, N., & Mckune, A. J. (2021). Sex, Age, BMI, and C-Reactive Protein Impact the Odds of Developing Hypertension—Findings Based on Data From the Health and Retirement Study (HRS). American Journal of Hypertension, 34(10), 1057–1063. https://doi.org/10.1093/AJH/HPAB088
Suvila, K., Langén, V., Cheng, S., & Niiranen, T. J. (2020). Age of Hypertension Onset: Overview of Research and How to Apply in Practice. Current Hypertension Reports, 22(9), 1–8. https://doi.org/10.1007/S11906-020-01071-Z/TABLES/2
Tian, D., & Meng, J. (2019). Exercise for Prevention and Relief of Cardiovascular Disease: Prognoses, Mechanisms, and Approaches. Oxidative Medicine and Cellular Longevity, 2019(1), 3756750. https://doi.org/10.1155/2019/3756750
Tirtasari, S., & Kodim, N. (2019). Prevalensi dan karakteristik hipertensi pada usia dewasa muda di Indonesia. Tarumanagara Medical Journal, 1(2), 395–402. https://doi.org/10.24912/TMJ.V1I2.3851
Tran, D. B., Weber, C., & Lopez, R. A. (2019). Anatomy, Thorax, Heart Muscles. StatPearls. http://europepmc.org/books/NBK545195
Turana, Y., Tengkawan, J., Chia, Y. C., Nathaniel, M., Wang, J. G., Sukonthasarn, A., Chen, C. H., Minh, H. Van, Buranakitjaroen, P., Shin, J., Siddique, S., Nailes, J. M., Park, S., Teo, B. W., Sison, J., Soenarta, A. A., Hoshide, S., Tay, J. C., Sogunuru, G. P., … Kario, K. (2021). Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. The Journal of Clinical Hypertension, 23(3), 513–521. https://doi.org/10.1111/JCH.14099
WHO. (2020). WHO Guidelines on Physical Activity and Sedentary Behaviour. In World Health Organization. Geneva: World Health Organization.
WHO. (2023). Global report on hypertension: the race against a silent killer. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO. Https://Www.Who.Int/Publications/i/Item/9789240081062, 1–291. https://www.who.int/publications/i/item/9789240081062
Wierzejska, E., Giernaś, B., Lipiak, A., Karasiewicz, M., Cofta, M., & Staszewski, R. (2020). A global perspective on the costs of hypertension: a systematic review. Archives of Medical Science : AMS, 16(5), 1078. https://doi.org/10.5114/AOMS.2020.92689
Copyright (c) 2025 Renaningtyas Nityasani, Eny Qurniyawati, Vivin Asniyah Akasa, Nadia Rizqiyah Syafitri

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Media Gizi Kesmas by Unair is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author(s) to hold the copyright and to retain the publishing right of the article without restrictions.
2. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Share-Alike (CC BY-SA).
3. The Creative Commons Attribution-Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violations.
















