PREVALENSI DAN FAKTOR RISIKO OBESITAS SENTRAL PADA PASIEN HIPERTENSI DI PUSKESMAS KECAMATAN KEMIRI MUKA, KOTA DEPOK, JAWA BARAT

Main Article Content

Dhamas Pratista
Ratu Ayu Dewi Sartika
Primasti Nuryandari Putri

Abstract

ABSTRACT


Non-communicable diseases (NCDs) such as hypertension and obesity have become major health challenges worldwide, including in Indonesia. This study aimed to determine the prevalence and risk factors of central obesity among hypertensive patients at Kemiri Muka Community Health Center in Depok, West Java. A cross-sectional design was employed. The study sample consisted of 156 hypertensive individuals aged 18 years and above who regularly received treatment or blood pressure checks at the health center. The results showed that a majority of the subjects (71.20%) had central obesity, with a higher prevalence among women (76.60%) compared to men (31.6%). The mean waist circumference was similar between both groups, at 86.55 ± 12.08 cm for men and 86.45 ± 9.94 cm for women. The mean systolic blood pressure was higher in men (159.50 ± 24.71 mmHg) than in women (148.93 ± 17.34 mmHg), while diastolic blood pressure was similar between the two groups. Logistic regression analysis revealed that central obesity in hypertensive patients in the Kemiri Muka area was influenced by gender (OR 7.88, 95% CI 2.56-24.26), moderate physical activity (OR 2.63, 95% CI 1.10-2.29), and excessive carbohydrate intake (OR 1.22, 95% CI 1.07-1.70). Preventive efforts, especially for women, are needed to prevent central obesity among hypertensive patients in Puskesmas Kecamatan Kemiri 
Muka, Depok City, West Java.


Keywords: prevalence, risk factors, hypertension, central obesity


ABSTRAK  


Penyakit tidak menular (PTM) seperti hipertensi dan obesitas telah menjadi tantangan kesehatan utama di seluruh dunia, termasuk di Indonesia. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor risiko obesitas sentral pada pasien hipertensi di Puskesmas Kecamatan Kemiri Muka, Kota Depok, Jawa Barat. Desain penelitian adalah cross-sectional. Sampel penelitian adalah hipertensi yang berusia lebih dari 18 tahun dan melakukan pengobatan atau pemeriksaan tekanan darah setiap bulan di Puskesmas Kemiri Muka dengan jumlah sampel sebanyak 156 orang. Hasil penelitian menunjukkan bahwa sebagian 
besar subjek (71,20%) mengalami obesitas sentral, dengan prevalensi lebih tinggi pada perempuan (76,60%) dibandingkan laki-laki (31,6%). Rerata lingkar perut serupa antara kedua kelompok, yakni 86,55 ± 12,08 cm pada laki-laki dan 86,45 ± 9,94 cm pada perempuan. Rerata sistolik lebih besar pada laki-laki 159,50±24,71 mmHg dibandingkan perempuan 148,93±17,34 mmHg. Sedangkan diastolik serupa antara kedua kelompok, yakni  88,92±13,01 mmHg pada laki-laki dan 88,64±11,32 mmHg pada perempuan. Hasil analisis regresi logistik menunjukkan bahwa obesitas sentral pada pasien hipertensi di Wilayah Puskesmas Kecamtan Kemiri Muka, Kota Depok dipengaruhi oleh jenis kelamin (OR 7,88 CI 95% 2,56-24,26), aktivitas fisik intensitas sedang (OR 2,63 CI 95% 1,10-2,29), dan asupan karbohidrat yang berlebih  (OR 1,22 CI 95% 1,07-1,70). Perlu adanya upaya preventif khususnya pada perempuan dalam mencegah terjadinya obesitas sentral pada kelompok pasien hipertensi di Wilayah Puskesmas Kemiri Muka, Kota Depok, Jawa Barat.


Kata kunci: prevalensi, faktor risiko, hipertensi, obesitas sentral 

Downloads

Download data is not yet available.

Article Details

Section
Articles

References

UNICEF. Landscape Analysis of Overweight and Obesity in Indonesia. Unicef Indones. 2022;1–138.

Arifin H, Chou KR, Ibrahim K, Fitri SUR, Pradipta RO, Rias YA, et al. Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research. J Multidiscip Healthc. 2022;15(September):2203–21.

World Health Organization (WHO). Global report on hypertension. Vol. 01, Universitas Nusantara PGRI Kediri. 2023. 1–7 p.

Shariq OA, Mckenzie TJ. Obesity-related hypertension: A review of pathophysiology, management, and the role of metabolic surgery. Gland Surg. 2020;9(1):80–93.

Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–37.

Badan Kebijakan Pembangunana Kesehatan (BKPK). Laporan Survei Kesehatan Indonesia.

Kementerian Kesehatan RI. 2023.

Dhawan D, Sharma S. Abdominal Obesity, Adipokines and Non-communicable Diseases. J Steroid Biochem Mol Biol [Internet]. 2020;203(July):105737. Available from: https://doi.org/10.1016/j.jsbmb.2020.105737

Fuchs FD, Whelton PK. High Blood Pressure and Cardiovascular Disease. Hypertension. 2020;75(2):285–92.

El Meouchy P, Wahoud M, Allam S, Chedid R, Karam W, Karam S. Hypertension Related to

Obesity: Pathogenesis, Characteristics and Factors for Control. Int J Mol Sci. 2022;23(20).

Kazi DS, Elkind MSV, Deutsch A, Dowd WN, Heidenreich P, Khavjou O, et al. Forecasting

the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association. Circulation. 2024;150(4):e89–101.

Kadek N, Pratiwi W, Komang Wiardani N, Putu P, Sugiani S. Kajian Pustaka Hubungan Pola Konsumsi Lemak dan Status Obesitas Sentral dengan Profil Lipid Pasien Penyakit Jantung

Koroner. J Nutr Sci. 2018;11(2):116–22.

Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation [Internet]. 2021 May 25;143(21):3–7. Available from: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000973

Maulin Halimatunnisa’, Lalu Hersika Asmawariza, Azwar Hadi, Vera Yulandasari, Erwin Wiksuarini, D. Mustamu Qamal Pa’ni, et al. Faktor Risiko Stroke di Rumah Sakit Umum Daerah Praya Tahun 2022. J Kesehat Qamarul Huda. 2023;11(1):371–81.

Isni K, Allafia DN, Oktavianti AU. Stimulasi Kepedulian Terhadap Pencegahan Hipertensi Melalui Edukasi Kesehatan Di Kampung Pungkur, Kabupaten Garut, Jawa Barat. SELAPARANG J Pengabdi Masy Berkemajuan. 2023;7(3):1544.

Rohayati, Wiarsih Wiwin NAY. “Frustrasi Versus Puas”: Pengalaman Keluarga dalam Merawat Anggota Keluarga Obesitas Rohayati. 2021;12(12):332–6. DOI: http://dx.doi.org/10.33846/sf12326

Li Y, Teng D, Shi X, Teng X, Teng W, Shan Z, et al. Changes in the prevalence of obesity and

hypertension and demographic risk factor profiles in China over 10 years: two national

cross-sectional surveys. Lancet Reg Heal - West Pacific [Internet]. 2021;15:100227.

Available from: https://doi.org/10.1016/j.lanwpc.2021.100227

Ostchega Y, Fryar CD, Nwankwo T, Nguyen DT. Hypertension Prevalence Among Adults Aged 18 and Over: United States, 2017-2018. NCHS Data Brief. 2020;(364):1–8.

Wong MCS, Huang J, Wang J, Chan PSF, Lok V, Chen X, et al. Global, regional and time trend prevalence of central obesity: a systematic review and meta-analysis of 13.2 million subjects. Eur J Epidemiol. 2020;35(7):673–83.

Malekzadeh MM, Etemadi A, Kamangar F, Khademi H, Golozar A, Islami F, et al. Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population. J Hypertens. 2013;31(7):1364–71.

Opoku AA, Abushama M, Konje JC. Obesity and menopause. Best Pract Res Clin Obstet

Gynaecol. 2023;88:102348.

Dewanti D, Syauqy A, Noer ER, Pramono ,Adriyan. Hubungan Pola Makan Dan Aktivitas Fisik Dengan Obesitas Sentral Pada Usia Lanjut Di Indonesia: Data Riset Kesehatan Dasar. Gizi Indones. 2022;45(2):79–90.

Park SE, Jang S, So WY, Kim J. Epidemiological Association of Current Smoking Status with Hypertension and Obesity among Adults Including the Elderly in Korea: Multivariate Analysis of a Nationwide CrossSectional Study Excluding Grades 2–3 Hypertension Cases. J Cardiovasc Dev Dis. 2024;11(7):212.

Austin GL, Ogden LG, Hill JO. Trends in carbohydrate, fat, and protein intakes and association with energy intake in normal weight, overweight, and obese individuals: 1971-2006. Am J Clin Nutr [Internet]. 2011;93(4):836–43. Available from: http://dx.doi.org/10.3945/ajcn.110.000141

Triyanti T, Ardila P. Asupan Lemak Sebagai Faktor Dominan Terhadap Obesitas Sentral Pada Wanita Dewasa. J Gizi dan Pangan Soedirman. 2020;3(2):133.

Syafira Anindya Dhika Maulani, Ratna Djuwita. Hubungan Aktivitas Fisik dengan Kejadian Obesitas Sentral pada Usia ≥ 40 Tahun di Indonesia (Analisis Data Indonesian Family Life Survey 5). J Vokasi Keperawatan. 2023;6(2):159–67.

Sinulingga BO. Jurnal Penelitian Sains. J Penelit Sains. 2020;22(1):9–15.

Wahyuningsih KA, Raksanagara A, Susanti Y, Arisanti N, Wiramihardja S, Setiawati EP. Perbandingan Obesitas General Dan Obesitas Sentral Terhadap Risiko Hipertensi Pada Usia Dewasa Di Wilayah Kecamatan Cisauk Kabupaten Tangerang Comparison of General and Central Obesity in Association With the Risk of Hypertension in the Adult in the Distr. Damianus J Med. 2022;21(3):45363.

Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019;28(1):40–5.

Sudikno S, Syarief H, Dwiriani CM, Riyadi H, Pradono J. HUBUNGAN OBESITAS SENTRAL DENGAN PROFIL LIPID PADA ORANG DEWASA UMUR 25-65 TAHUN DI KOTA BOGOR (Baseline Studi Penyakit Tidak Menular di Kota Bogor, Jawa Barat). Gizi Indones. 2017;39(2):81.

Kemenkes RI. Angka Kecukupan Gizi Mayarakat Indonesia. Permenkes Nomor 28 Tahun 2019. 2019;Nomor 65(879):2004–6.

WHO. Global Physical Activity Questionnaire (GPAQ) Analysis Guide. Geneva World Heal Organ [Internet]. 2012;1–22. Available from: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Global+Physical+Activity+Questionnaire+(GPAQ)+Analysis+Guide#1

Program State of New Hampshire Employee Assistance. Perceived Stress Scale Score Cut Off. 2020;2. Available from: https://www.das.nh.gov/wellness/docs/percieve

d stress scale.pdf

Kemenkes. Buku Pedoman Hipertensi 2024. Buku Pedoman Pengendali Hipertens di Fasilitas Kesehat Tingkat Pertama. 2023;1–71.

World Health Organization [WHO]. The AsiaPasific Perspective: Redefining Obesity and its

Treatment. 2000. p. 8–45.

Weng J, Mao Y, Xie Q, Sun K, Kong X. Gender differences in the association between healthy

eating index-2015 and hypertension in the US population: evidence from NHANES 1999

BMC Public Health [Internet]. 2024;24(1):1–11. Available from: https://doi.org/10.1186/s12889-023-17625-0

Tovée MJ, Cohen-Tovée EM. Body Fat Percent and Distribution. In: Shackelford TK, Weekes-Shackelford VA, editors. Encyclopedia of Evolutionary Psychological Science [Internet]. Cham: Springer International Publishing; 2021. p. 675–9. Available from: https://doi.org/10.1007/978-3-319-19650-3_86

Muscogiuri G, Verde L, Vetrani C, Barrea L, Savastano S, Colao A. Obesity: a gender-view. J Endocrinol Invest [Internet]. 2024;47(2):299306. Available from: https://doi.org/10.1007/s40618-023-02196-z

Power ML, Schulkin J. Sex differences in fat storage, fat metabolism, and the health risks from obesity: Possible evolutionary origins. Br J Nutr. 2008;99(5):931–40.

Guglielmi V, Dalle Grave R, Leonetti F, Solini A. Female obesity: clinical and psychological assessment toward the best treatment. Front Endocrinol (Lausanne). 2024;15(May):1–21.

Goodwin J. Endothelial Dysfunction and Vascular Remodeling in Hypertension BT - Pediatric Hypertension. In: Flynn JT, Ingelfinger JR, Brady TM, editors. Cham: Springer International Publishing; 2023. p. 195–215. Available from: https://doi.org/10.1007/978-3-031-06231-5_41

Drożdż D, Drożdż M, Wójcik M. Endothelial dysfunction as a factor leading to arterial hypertension. Pediatr Nephrol [Internet]. 2023;38(9):2973–85. Available from: https://doi.org/10.1007/s00467-022-05802-z

DeMarco VG, Aroor AR, Sowers JR. The pathophysiology of hypertension in patients with obesity. Nat Rev Endocrinol [Internet]. 2014 Jun 15;10(6):364–76. Available from: https://www.nature.com/articles/nrendo.2014.44

Dun Q, Xu W, Fu M, Wu N, Moore JB, Yu T, et al. Physical Activity, Obesity, and Hypertension

among Adults in a Rapidly Urbanised City. Int J Hypertens. 2021;2021.

Diaz KM, Shimbo D. Physical activity and the prevention of hypertension. Curr Hypertens

Rep. 2013;15(6):659–68.

Zhu Z, Yan W, Yu Q, Wu P, Bigambo FM, Chen J. Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis. Evidence-based Complement Altern Med. 2022;2022.

Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):19.

Wondmkun YT. Obesity, insulin resistance, and type 2 diabetes: Associations and therapeutic implications. Diabetes, Metab Syndr Obes. 2020;13:3611–6.

Hamer M, Endrighi R, Poole L. Physical activity, stress reduction, and mood: insight into immunological mechanisms. Methods Mol Biol. 2012;934:89–102.

Pescatello LS, Buchner DM, Jakicic JM, Powell KE, Kraus WE, Bloodgood B, et al. Physical Activity to Prevent and Treat Hypertension: A Systematic Review. Med Sci Sports Exerc. 2019;51(6):1314–23

World Health Organization (WHO). WHO Guidelines on physical activity and sedentary

behaviour [Internet]. Routledge Handbook of Youth Sport. 2016. 1–582 p. Available from: https://www.who.int/publications/i/item/978924 0015128

Ismail I, Keating SE, Baker MK, Johnson NA. A systematic review and meta-analysis of the

effect of aerobic vs. resistance exercise training on visceral fat. Obes Rev. 2012;13(1):68–91.

Zhao Z, Zhen S, Yan Y, Liu N, Ding D, Kong J. Association of dietary patterns with general

and central obesity among Chinese adults: a longitudinal population-based study. BMC

Public Health [Internet]. 2023;23(1):1–10. Available from: https://doi.org/10.1186/s12889023-16556-0

Aller EEJG, Abete I, Astrup A, Alfredo MJ, van Baak MA. Starches, sugars and obesity. Nutrients. 2011;3(3):341–69.

Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet [Internet]. 2019;393(10170):434–45. http://dx.doi.org/10.1016/S01406736(18)31809-9

Alwahsh SM, Gebhardt R. Dietary fructose as a risk factor for non-alcoholic fatty liver disease

(NAFLD). Arch 2017;91(4):1545–63. Toxicol https://doi.org/10.1007/s00204-016-1892-7

Antonio-Villa NE, Bello-Chavolla OY, VargasVázquez A, Mehta R, Fermín-Martínez CA, Martagón-Rosado AJ, et al. Increased visceral fat accumulation modifies the effect of insulin

resistance on arterial stiffness and hypertension risk. Nutr Metab Cardiovasc Dis. 2021;31(2):506–17.

Li M, Cui Z, Meng S, Li T, Kang T, Ye Q, et al. Associations between dietary glycemic index

and glycemic load values and cardiometabolic risk factors in adults: Findings from the China health and nutrition 2021;13(1):1–17. survey. Nutrients.

Kim HJ, Kwon H, Jeong SM, Hwang SE, Park JH. Effects of abdominal visceral fat compared

with those of subcutaneous fat on the association between PM 10 and hypertension in Korean men: A cross-sectional study. Sci Rep [Internet]. 2019;9(1):1–9. Available from: http://dx.doi.org/10.1038/s41598-019-42398-1

Ludwig DS, Hu FB, Tappy L, Brand-Miller J. Dietary carbohydrates: role of quality and quantity in chronic disease. BMJ [Internet]. 2018;361. Available from: https://www.bmj.com/content/361/bmj.k2340

Santos FL, Esteves SS, da Costa Pereira A, Yancy Jr WS, Nunes JPL. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes 2012;13(11):1048–66. Rev Available https://doi.org/10.1111/j.1467789X.2012.01021.x

Kemenkes. Tiga tahun GERMAS lessons learned. Kementerian Kesehatan RI. 2019. 1122 p.