Effect of Socio-demographic Factors and Obesity

on Blood Pressure among Adults Based on Health

Status in Gaza, Palestine: The UPM-Gaza Study

Mohammed Ellulu

Department of Nutrition and Dietetics,

Faculty of Medicine and Health Sciences

Background

• To identify risk factors of blood pressure due to

change of socio-demographic factors, obesity and

health status.

• Cross-sectional designed study of 482 participants

have chosen from Primary Health Care Centers in

Gaza Strip; Palestine.

• The study ethically approved by:

1. JKE-UPM: (FPSK_Mac (13)04).

2. Helsinki committee: (PHRC/HC/11/13).

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Nutrition (APCCN)

Distribution of sex by marital status

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95.4

73.9

4.6

26.1

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Male (No.: 174) Female (No.: 310)

Married Unmarried

Distribution of sex by education level

51.1

71.6

20.1

7.1

28.8 21.3

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Male (No.: 174) Female (No.: 310)

Low Moderate High

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Distribution of sex by health status

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17.8 23.9

26.4 19.4

29.4 18.7

26.4 38.1

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Male (No.: 174) Female (No.: 310)

Healthy HT T2DM HT+T2DM

Distribution of sex by obesity factors

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67.8

86.8 72.9

91.6

32.2

13.2 27.1

8.4

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Male (BMI) Female (BMI) Male (WC) Female (WC)

Obese Non-obese

Difference of BP due to change of sex

130

84.02

130

81.93

Systolic BP Diastolic BP

P value = 0.04

Male Female

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Difference of BP due to change of marital state

132

83.48

130

79.15

Systolic BP Diastolic BP

P value = 0.001

Married Unmarried

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133.83

81.39

132.77

82.62

136.33

85.99

Systolic BP Diastolic BP

P value = 0.013

Small Medium Large

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Difference of BP due to change of family size

Difference of BP due to change of education

135

83.75

122

80.02

120

81.14

Systolic BP Diastolic BP

P value = 0.011

Low Moderate High

P value = 0.001

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Difference of BP due to change of menopause

124

80

140

82.5

Systolic BP Diastolic BP

P value = 0.006

Pre-menopause Post-menopause

P value ˂ 0.001

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Difference of BP due to change of health state

118

78

139

88

125

80

140

86

Systolic BP Diastolic BP

P value ˂ 0.001

Healthy Hypertensive Diabetic Hypertensive-diabetic

P value ˂ 0.001

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Difference of BP due to change of obesity

134

84

118

76

Systolic BP Diastolic BP

P value ˂ 0.001

Obese Normal weight

P value ˂ 0.001

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Correlations of BP with subject’s characteristics

Factors

Systolic BP Diastolic BP

Spearman’s Coefficient Spearman’s Coefficient

Age (years) rs= 0.444 rs= 0.170

WC (cm) rs= 0.434 rs= 0.374

Weight (kg) rs= 0.323 rs= 0.362

All correlations were significant at the 0.01 level (2-tailed).

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Prediction of risk factors associated with the HT

Merging of SBP with DBP in one variable

SBP Total

Normal

(<130 mmHg)

High

(≥130 mmHg)

DBP

Normal (<85 mmHg) 180 107 287

High (≥85 mmHg) 26 169 195

Total

206

276

482

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Predication of risk factors associated with blood pressure (SBP≥130 & DBP≥85)

B S.E. Wald df Sig. Exp (B) 95%CI for Exp(B)

Lower Upper

Female -0.283 0.275 1.060 1 0.303 0.754 0.440 1.291

Age (years) 0.020 0.016 1.679 1 0.195 1.020 0.990 1.052

Married 0.163 0.318 0.262 1 0.609 1.177 0.631 2.196

Low education -0.076 0.314 0.058 1 0.810 0.927 0.501 1.716

High education -0.168 0.426 0.156 1 0.693 0.845 0.367 1.948

Medium family size -0.493 0.248 3.941 1 0.047* 0.611 0.376 0.994

Large family size -0.019 0.346 0.003 1 0.956 0.981 0.498 1.932

Obese 1.018 0.434 5.514 1 0.019* 2.768 1.183 6.475

WC (cm) 0.005 0.014 0.133 1 0.716 1.005 0.978 1.033

Weight (kg) 0.013 0.013 1.091 1 0.296 1.013 0.989 1.039

Hypertensive 1.613 0.416 15.048 1 0.001* 5.019 2.221 11.339

Diabetic 0.069 0.450 0.024 1 0.878 1.071 0.444 2.587

HT+DM 1.016 0.436 5.428 1 0.020* 2.762 1.175 6.492

Diseased father -0.369 0.237 2.417 1 0.120 0.692 0.434 1.101

Diseased mother 0.635 0.237 7.150 1 0.007* 1.886 1.185 3.003

Constant -4.929 1.142 18.639 1 0.000 0.007

Exp (B) = OR: Odds Ratio. (S.E.) = Standard Error

* Association is significant at the 0.05 level (2-tailed).

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Risk factors

No. Prediction of risk factors by Odds Ratio (OR)

1 If participants have or had mother diseased by HT and/or diabetes

OR= [1.8] (95% CI: 1.185 to 3.003)

2 If the participant is obese

OR= [2.7] (95% CI: 1.183 to 6.475)

3 If the participants live in large family (OR decreased by smaller families)

OR= [0.6] (95% CI: 1.285 to 8.466)

4 If participants diseased by HT or HT+Type-2 DM

OR= [5.0] (95% CI: 2.221 to 11.339) or [2.7] (95% CI: 1.175 to 6.492)

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