Determinants of Hypertension amongst Rice Farmers in West Java, Indonesia

Abstract

The hypertension rate in Indonesia has increased significantly in the past five years, but there is limited information about the hypertension risk of farmers. Our study assesses the prevalence of hypertension in this population and examines the proportional risk of various work environment and lifestyle factors among farmers. A cross-sectional study was conducted in high and low heat stress agriculture areas of West Java, Indonesia. There were 354 male farmers aged 25 to 73 years old who participated in the study. We measured blood pressure and used a questionnaire on self-reported use of anti-hypertension drugs or diagnosis by a medical professional to define hypertension. We assessed occupational factors including farming methods, heat stress and pesticide use, and personal factors including obesity, food intake, smoking status, alcohol consumption. Multivariate analysis was used to evaluate factors potentially associated with prevalence of hypertension. Forty-six percent of farmers experience hypertension. Farming in a location with higher heat stress (WBGT) was significantly associated with increased risk of hypertension (adjusted prevalence ratio (aPR) 1.41, 95% confidence interval (CI) 1.01, 1.95). Farmers who used pesticide sprayers had an increased risk of hypertension (aPR 1.90, 95% CI 0.93, 3.87). No personal/lifestyle characteristics were significantly associated with hypertension, although ever smoking and ever consuming alcohol had an increased prevalence of hypertension. This study shows the importance of work environmental factors in the prevalence of hypertension and the necessity of public health education, identification and treatment of this “silent killer” among Indonesian farmers.

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“…Undiagnosed hypertension occurs when those who have hypertension have not been informed of the condition by a health professional [4][5][6]. It is a silent but deadly condition that can lead to serious health consequences, including heart disease, stroke, kidney disease, and cognitive impairment [1].…”

“…Factors associated with undiagnosed hypertension in previous studies include lifestyle factors such as eating habits, physical activity, alcohol consumption, and smoking [4][5][6][7][8]. Additionally, access to health care and the availability of health insurance in the context of social economic status have also been linked to undiagnosed hypertension [10][11][12][13].…”

“…Additionally, access to health care and the availability of health insurance in the context of social economic status have also been linked to undiagnosed hypertension [10][11][12][13]. Some of the other associated factors include age, sex, educational level, and household income [4][5][6][7][8]10]. Most studies on undiagnosed hypertension have been conducted in high-income countries like Croatia [4], the United Kingdom [5], the United States [8], and France [10], although some studies have been done in low-middle income countries, including Indonesia [6], Fiji [7], Ethiopia [11], Nepal [12], and Peru [13].…”

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“…As many as 333 million people with hypertension in developed countries and 639 in developing countries, one of which is Indonesia. The case of hypertension is still a very big challenge in Indonesia (Prihartono et al, 2022).…”

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“…Hypertension is defined as having a systolic blood pressure greater than 140 mmHg and a diastolic blood pressure greater than 90 mmHg (WHO, 2020). Prihartono et al (2022) reported that prevalence of hypertension has increased significantly in Indonesia over the last five years, with 46% of farmers in West Java experiencing hypertension. In Indonesia, 3322 people (56.2%) were found to have undiagnosed hypertension (Mahwati et al, 2022).…”