Hypertension is a non-communicable disease that still requires attention because it poses a significant health risk. Hypertension or high blood pressure is defined as a condition where the systolic value is more than 140 mmHg and the diastolic is more than 90 mmHg on two measurements within about five minutes in a relaxed condition. The blood pressure mentioned above is permanent, disrupting the intake of nutrients and oxygen that should not be blocked and distributed generally to the body’s necessary tissues. Data from the Health Profiles of East Java Province in 2018 shows that the prevalence of hypertension in Surabaya is 31.13%, lower than the previous year, which was recorded at 45.32%. However, promotive and preventive efforts are still needed because the prevalence is higher than the national prevalence.
The global target is to reduce the prevalence of hypertension by 25% by 2025. Common symptoms in patients are dizziness, nosebleeds, frequent headaches, and shortness of breath. Two types of hypertension were identified, namely secondary hypertension, which means an increase in systemic blood pressure whose cause has not yet been detected. In contrast, essential or primary hypertension can cause an increased risk of kidney, heart, and brain events. Hypertension can cause severe damage to many organs, especially the heart. The increase in pressure causes the arteries to harden, causing a sudden reduction in blood flow and oxygen flow to the core—including chest pain, also known as angina, heart attack, heart failure, and an irregular heartbeat. In rare cases, this can lead to sudden death due to rupture or blockage of an artery that supplies blood and oxygen to the brain. Hypertension can act as a risk factor for cardiovascular diseases, such as stroke, coronary artery disease, and heart failure, affecting 26% of the adult population.
WHO estimates that 1.13 billion people worldwide suffer from hypertension, two-thirds of whom live in low- and middle-income countries. One in four men and one in five women tend to suffer from hypertension. Many determinants are known risk factors for hypertension—including sodium intake, alcohol, obesity, genetics, age, lifestyle, and working conditions. Although the treatment of hypertension using antihypertensive drugs is available, the effectiveness and side effects of these drugs are still questionable. The CDC report shows that 75 million people worldwide suffer from hypertension. In other words, only 54% of people worldwide have normal blood pressure.
The prevalence of hypertension in East Java based on the Basic Health Research conducted by the Indonesian Ministry of Health showed 8.01% for hypertension based on a doctor’s diagnosis. This value indicates an increase compared to the 2013 Basic Health Research results, with a rise of 9.9%. The clinical manifestations of hypertension are headaches, nosebleeds, heavy neck, ringing in the ears, difficulty sleeping, frequent dizziness, and blurred vision. In addition, several determinants of hypertension in Indonesia have been identified, including age, male gender, low education level, smoking, regular caffeine consumption of more than one serving per day, alcohol consumption, lack of physical activity, and obesity.
Preventive efforts have an important role in preventing cardiovascular disease, which can be done by early detection, namely screening, to minimize complications. Health screening in the era of health coverage is classified into two, namely screening for primary prevention/historical health screening and screening for secondary prevention (limited to people with chronic disease and cancer detection). Health screening has been used for decades as an easy-to-use and inexpensive instrument to prevent premature death. Valid screening instruments must be developed to be easy to use and identify risk factors. Validity can reveal the suitability of an instrument to find cases. This study aims to conduct early detection of hypertension cases in adults and the elderly at the Mulyorejo Public Health Center, Surabaya, Indonesia. The survey was conducted from 12 to 15 November 2019, targeting adult and elderly patients who visited the public health center. A structured questionnaire was used as a research instrument, while an examination using a digital sphygmomanometer was used as the gold standard. Family history, smoking habits, physical activity, vegetable consumption, and fruit consumption were independent variables. Data were analyzed using the chi-square test. Sampling was carried out by accident, and 100 people participated in this study. 10% of them were classified and checked as group hypertension based on examination with a sphygmomanometer, while based on a questionnaire, as many as 16%. The results of the calculation of validity showed a sensitivity value of 70%, specificity of 87.8%, a positive predictive value of 38.8%, and a negative predictive value of 96.34%. There was no significant relationship between the independent variables and hypertension, family history (p=0.48 ; OR=1.64 ; 95% CI= 0.42<OR<6.29), smoking habits (p=0.21; OR=2.96; 95% CI= 0.52< OR<16.7), physical activity (p=0.46 ; OR=1.71 ; 95% CI= 0.4<OR<7.29), vegetable consumption (p=0.94 ; OR=0.95 ; 95% CI= 0.25<OR<3.62), consumption fruit (p=0.89 ; OR= 1.09 ; 95% CI= 0.29<OR<4.03), salt consumption (p=0.66; OR=1.33; 95% CI= 0.25<OR<6.98). No independent variables are associated with the incidence of hypertension in this study. In this case, the efforts of health workers to conduct massive health checks are needed so that there are no undetected cases of hypertension.
Authors: Dr. Budi Utomo, dr., M.Kes; Shifa Fauziyah, S.Si., M.Ked.Trop; Teguh Hari Sucipto, S.Si., M.Si
Detailed information about this scientific article can be found at: https://e-journal.unair.ac.id/IJPH/article/view/17718
Source: news.unair.ac.id
Picture Source: Alodokter
