Structural equation modeling: exploring relationships of body mass index, waist circumference, and hypertension in elderly

Waist circumference (WC) measurements in the elderly are uncommon and erratic. Furthermore, its correlation to hypertension has received less attention in Indonesia. This study attempted to investigate direct and indirect risk factors for high blood pressure in the elderly using structural equation modeling (SEM). A cross-sectional study was conducted in Surakarta, Central Java, Indonesia. The 297 elderly aged ≥60 is eager to take part. The path model of factors associated with blood pressure was analyzed using Stata 13. Male (b=-0.43; 95% CI=-5.67 to 4.81; p=0.872), age (b=0.52; 95% CI=0.12 to 0.93; p=0.012), and WC (b=0.35; 95% CI=0.17 to 0.53; p0.001) directly affected systolic blood pressure (SBP). Male (b=1.83; 95% CI=-1.17 to 4.82; p=0.231), age (b=-0.03; 95% CI=-0.26 to 0.20; p=0.790), BMI (b=0.40; 95% CI=-0.03 to 0.83; p=0.067), and WC (b=0.04; 95% CI=-0.09 to 0.16; p=0.571) directly affected diastolic blood pressure (DBP). Increasing age, body mass index (BMI), and waist circumference (WC) are the important variables that influence blood pressure in older people. This study supports the evidence that body composition and weight control are necessary to prevent and control blood pressure in the elderly.