Rural-urban comparison in prevalence of hypertension and its factors among adolescents of Sarawak, Malaysia: A cross-sectional study

Objectives: This paper reports a study of the prevalence of pre-hypertension and hypertension, and its associated factors among secondary school students in Sarawak. Methods: It was a cross-sectional study using questionnaire, anthropometric and blood pressure measurement. Results: A total of 2461 secondary school children participated. The prevalence of pre-hypertension was 13.2%, stage 1 hypertension was 12.4% and stage 2 hypertension was 4.6%. The prevalence of overweight and obesity was 24.3%, elevated waist circumference was 13.5, and overfat and obese was 6.7%. Based on the urban model, factors that were associated with pre-hypertension were age, male, parent with history of hypertension, overweight and obese. At the hypertension level, only male, overweight and obese were found to be associated. A higher odds ratio was found for elevated waist circumference of 4.42 (95% CI:1.75, 11.11) to be associated with hypertension. In rural model, factors found to be associated with pre-hypertension were age, male, ethnic group (Chinese), overweight and obese, elevated waist circumference. For pre- hypertension level, variables that were consistently to be associated with hypertension were male, ethnic group (Iban and Chinese), overweight and obese, elevated waist circumference, and parent with history of hypertension, overfat and obese. Conclusions: The prevalence of pre hypertension and hypertension was found to be different between urban and rural area, gender and obesity were found to be associated with elevated blood pressure. There is a need to emphasize earlier detection and intervention among younger generation on hypertension.