Physical Activity and Body Mass Index Among Hypertensive Patients Attending Outpatient Clinic at a Tertiary Hospital in Kelantan, Malaysia
Keywords:Physical activity, Body mass index, Hypertension
Introduction: Hypertension is one of the predisposing factors for increased morbidity and mortality rate in Malaysia as it significantly contributes to the risk of non-communicable diseases such as heart disease, stroke, and kidney injuries. Non-pharmacological intervention such as physical activity (PA) helps to reduce the progression of hypertension severity and body mass index (BMI) among hypertensive patients. Limited studies were conducted among hypertensive patients at outpatient clinics in the east-coast region of Malaysia.
Objective: To determine the level of PA and BMI of hypertensive patients attending outpatient clinics.
Methods: This is a cross-sectional study using purposive sampling. The study was conducted among 73 hypertensive patients who attended the outpatient clinic at a tertiary hospital in Kelantan state, the Northern East of Malaysia. Data was collected using a self -reported questionnaires for BMI and hypertension and the short form of the International Physical Activity Questionnaire (IPAQ) was used to measure the level of PA.
Results: The findings show that most of the respondents above 50 years old are moderately active (54.8%, n=40) and nearly half (45.2%, n=33) were overweight. There is no significant association between the level of PA and BMI (p=0.854). A significant association was only found between the respondents’ marital status and their BMI (p=0.034). Conclusion: The majority of the respondents in the study were moderately active in performing physical activity and within the category of overweight. PA and BMI are not significantly associated in the study. The non-significance findings could be due to the small sample size in this study and other contributing factors such as co-morbidities, lifestyle variables including dietary habits, and sedentary behaviour that were not investigated in the study. Overall, the study underlined the importance of physical activity and body mass index in achieving public health recommendations.
Conclusion: Overall, the study underlined the importance of physical activity and body mass index in achieving public health recommendations.
World Health Organization. Hypertension. World Health Organization. 2021.
Department of Statistics Malaysia. Statistics on Causes of Death, Malaysia. Department of Statistics Malaysia. 2021.
Chan YY, Sahril N, Rezali MS, Kuang Kuay L, Baharudin A, Abd Razak MA, et al. Self-reported modifiable risk factors of cardiovascular disease among older adults in Malaysia: a cross-sectional study of prevalence and clustering. Int J Environ Res Public Health. 2021; 18(15): 7941.
National Health and Morbidity Survey. Non-communicable diseases, healthcare demand, and health literacy. National Institutes of Health (NIH), Ministry of Health Malaysia. 2019.
Mahmood S, Shah KU, Khan TM, Nawaz S, Rashid H, Baqar SWA, et al. Non-pharmacological management of hypertension: in the light of current research. Irish J Med Sci. 2019; 188(2): 437–52.
Carey RM, Whelton PK. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Ann Intern Med. 2018; 168(5): 351–8.
Rego MLM, Cabral DAR, Costa EC, Fontes EB. Physical exercise for individuals with hypertension: it is time to emphasize its benefits on the brain and cognition. Clinical Medicine Insights: Cardiology. 2019; 13:1-10.
Zhang C, Zhang Y, Lin H, Liu S, Xie J, Tang Y, Huang H, Zhang W. Blood pressure control in hypertensive patients and its relation with exercise and exercise-related behaviors: A case-control study. Medicine (Baltimore). 2020 Feb;99(8): e19269. doi: 10.1097/MD.0000000000019269. PMID: 32080136; PMCID: PMC7034707.
Dun Q, Xu W, Fu M, Wu N, Moore JB, Yu T, Li X, Du Y, Zhang B, Wang Q, Duan Y, Meng Z, Tian S, Zou Y. Physical Activity, Obesity, and Hypertension among Adults in a Rapidly Urbanised City. Int J Hypertens. 2021; 2021:9982562. doi: 10.1155/2021/9982562. PMID: 34422409; PMCID: PMC8376427.
Mokti K, Syed Abdul Rahime SS. Relationship of age, body mass index (BMI), physical activity, salt intake, and stress with high blood pressure among rural dwellers in Kudat, Sabah. Bali Medical Journal. 2022; 11(1): 360-367.
Landi F, Calvani R, Picca A, Tosato M, Martone AM, Ortolani E, et al. Body mass index is strongly associated with hypertension: Results from the longevity check-up 7+ study. Nutrients. 2018; 10(12): 1976.
Doustjalali SR, Sabet NS, Eb R, Vs S, Ahs M, Si A, et al. Correlation between body mass index (BMI) and blood pressure among malaysian adults age 40-60. P J M H S. 2021; 15(3): 823-828.
Li W, Wang D, Wu C, Shi O, Zhou Y, Lu, Z. The effect of body mass index and physical activity on hypertension among Chinese middle-aged and older population. Scientific Reports, 2017.
National Health and Morbidity Survey. Healthcare demand. National Health and Morbidity Survey. 2015.
International Physical Activity Questionnaire. Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ) – Short and Long Form [Internet]. IPAQ Scoring Protocol. 2005 [cited 2014 Mar 15]. Available from: https://sites.google.com/site/theipaq/scoring-protocol.
Rampal L, Rampal S, Azhar MZ, Rahman AR. Prevalence, awareness, treatment and control of hypertension in Malaysia: a national study of 16,440 subjects. Public Health.2008; 122(1): 11–8.
Zaki NAM, Ambak R, Othman F, Wong NI, Man CS, Morad MFA, et al. The prevalence of hypertension among Malaysian adults and its associated risk factors: data from Malaysian Community Salt Study (MyCoSS). J Heal Popul Nutr. 2021; 40(1): 1–6.
Blacher J, Safar ME. Large-artery stiffness, hypertension and cardiovascular risk in older patients. Nat Clin Pract Cardiovasc Med. 2005; 2(9): 450–5.
Chantarat T, McGovern PM, Enns EA, Hardeman RR. Predicting the onset of hypertension for workers: does including work characteristics improve risk predictive accuracy? Journal of Human Hypertension. 2022. 1-7.
Ekerdt DJ, Sparrow D, Glynn RJ, Bossé R. Change in blood pressure and total cholesterol with retirement. Am J Epidemiol. 1984; 120(1): 64-71.
Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, et al. Factors associated with the severity of hypertension among Malaysian adults. PLoSOne.2019;14(1): e0207472.
Gallucci G, Tartarone A, Lerose R, Lalinga AV, Capobianco AM. Cardiovascular risk of smoking and benefits of smoking cessation. J Thorac 2020; 12(7): 3866-3876. doi: 10.21037/jtd.2020.02.47.PMID: 32802468; PMCID: PMC7399440.
Huai P, Xun H, Reilly KH, Wang Y, Ma w, Xi B. Physical activity and risk of hypertension: a meta-analysis of prospective cohort studies. Hypertension. 2013; 62(6); 1021-1026.
Joseph G, Marott JL, Torp-Pedersen C, Biering-Sørensen T, Nielsen G, Christensen A E, et al. Dose-response association between level of physical activity and mortality in normal, elevated, and high blood pressure. Hypertension. 2019; 74(6): 1307–15.
Ministry of Health Malaysia. Clinical Practice Guidelines on Management of Hypertension. Ministry of Health Malaysia. 2018.
Rogers MW, Probst MM, Gruber JJ, Berger R, Boone Jr JB. Differential effects of execise training intensity on blood pressure and cardiovascular response to stress borderline. J hypertens. 1996; 14:1369–75.
Ebrahim S, Smith GD. Lowering blood pressure: a systematic review of sustained effects of non-pharmacological interventions. J Public Health (Bangkok). 1998;20(4):441–8.
Centers for Disease Control and Prevention. Healthy weight, nutrition, and physical activity. Centers for Disease Control and Prevention. 2022.
Aniza I, Hayati K, Juhaida MN, Ahmad Taufik J, Idayu Badilla I, Khalib L. Obesity Related hypertension-gender specific analysis among adults in Tanjung Karang, Selangor, Malaysia. Malaysian J Public Heal Med. 2015;15(1).
Teh CH, Chan YY, Lim KH, Kee CC, Lim KK, Yeo PS, et al. Association of physical activity with blood pressure and blood glucose among Malaysian adults: a population-based study. BMC Public Health. 2015; 15:1205. Available from: https://pubmed.ncbi.nlm.nih.gov/26630916
Islam FMA. Factors Associated with Physical Activity among People with Hypertension in a Rural Area in Bangladesh: Baseline Data from a Cluster Randomized Control Trial. Int J Environ Res Public Health. 2021;18(14):7365.
Pirassol da Silva B, Moreira Tosi M, Quevedo dos Santos N, Vicentini de Oliveira D, Fidelix YL, Andrade do Nascimento Júnior JR, et al. Level of physical activity of hypertensive elderly citizens and its association with sociodemographic data and health conditions. Rev Pesqui em Fisioter. 2022;12: e4398..
Teachman J. Body weight, marital status, and changes in marital status. J Fam Issues. 2016;37(1):74–96.
Chung S, Domino ME, Stearns SC. The effect of retirement on weight. J Gerontol B Psychol Sci Soc Sci. 2009; 64(5): 656-65. doi: 10.1093/geronb/gbn044. Epub 2009 Apr 7. PMID: 19357073.
Gleason-Comstock J, Streate A, Ager J, Goodman A, Brody A, Kivell L, et al. Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol. BMC Emergency Medicine. 2015; 15(38): 1-9.