INTRODUCTION:

Hypertension is serious hypo-kinetic problem of modern times; it is a long term medical problem. Hypertension is measured as high blood pressure (HBP), in which the blood pressure in the arteries is constantly elevated. HBP is a major risk factor for coronary artery disease, stroke, heart failure atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease and dementia^1,2,3,4. Blood pressure is measured by two numbers; one represents systolic pressure and other represents diastolic pressure. The systolic measure is the amount of arterial pressure when the ventricles contract and the diastolic measure is when the ventricles relax. The degree of arterial pressure in a young adult would be 120 (systolic) over 80 (diastolic). A blood pressure level that is over 140 (systolic pressure) and does not fall below 90 (diastolic pressure) is usually considered high (American Heart Association, 2017). High blood pressure indicates that there is resistance to the flow of blood through the cardiovascular system, which can lead to cardiovascular disease (CVD). CVD caused 2.3 million deaths in India in the year 1990; this is projected to double by the year 2020. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease death in India. There are 31.5 million hypertensive individuals in rural and 34 million in urban populations⁵. Unlike other diseases, there are usually no symptoms to signal high blood pressure. The individual experiences no personal distress. In severe cases, some people complain of headaches, tiredness, insomnia occasional dizzy spells, symptoms are often easy to ignore but most persons suffering from hypertension receive no warning symptoms.

Several studies have indicated that awareness regarding onset of problem is poor among population in a study it was reported that one third of the adults tested, had high blood pressure and only half of them were aware of it. Hypertension exerts a substantial public health burden on cardiovascular health status and healthcare systems in India^6,7.

Psychological factors play a role in the development of HBP. The classical psychoanalytic interpretation is that suppressed anger is the cause of the hypertension. Many researches support this hypothesis^8,9,10. Although some evidence relating to expressed anger with hypertension is also available¹¹.

It has been observed in a study that prevalence of hypertension was predominantly more in male patients as compared female. The average age (57 years) of the population clearly indicates the elderly population was affected more. It was alarming that 30 % of the total study population was identified as the first time hypertensive in the overall population. 26.7% of the study population was found to be mild hypertensive, around 23.3% of the study population was isolated systolic hypertensive and rest of the population was moderate and severe hypertension¹².

Some evidence suggests that lifestyle factors play an important role in the prevention and control of non-communicable diseases like hypertension. Lifestyle factors can be defined as an aggregation of personal decisions, over which the individual has control and which cause, illness. These factors include lack of physical activity, sleep problem, nutrition, stress, smoking and tobacco, alcohol and substance abuse. Literature reveals that patients of hypertension undergo with the various type of problem related to life style and maladaptive behaviour. Hence the present study was undertaken to find out anthropometric and psychological determinants of HBP.

OBJECTIVE:

Present empirical piece of research is to examine the role of anthropometric variables (Body mass index, age, weight, height and waist hip ratio), psychological variables (hypo-kinetic problems awareness, personal and environmental barrier) and physical activity level in discriminating high blood pressure and healthy group of teachers.

HYPOTHESIS:

The anthropometric and psychological variables taken in the present study will discriminate the blood pressure group of subjects from normal group of subjects.

METHOD:

The study sample was composed of 520 (male, 254 & female 266) teachers from different colleges & university of C.G., aged between 30 to 60 years. Anthropometric variables, body mass index, age, weight, height and waist hip ratios, psychological variables, hypo-kinetic problems awareness, personal and environmental barrier and physical activity level were selected. (The study was approved by Ethical Committee of Pt. RSU Raipur C.G. prior to the start of data collection.) A written consent was taken from each of the participants. The obtained data was organized and statistically analyzed with the help of spss 16 version. To find out the discriminating predictors discriminant analysis was used and results are reported.

RESULTS:

Discriminant analysis

Results of discriminant analysis are presented in table 1.1, 1.2, 1.3.

Table 1.1: Discriminating predictors of hypertension from normal health group

Function	Eigen value	Canonical correlation	Wilks' Lambda	Chi-square	Sig.
1	.057^a	.232	.946	19.165	.058

First 1 canonical discriminant functions were used in the analysis.

Table 1.1 shows that the various factors which are taken in present study collectively contribute 5.7 present of their variance to discriminant the two groups.

Table1.2: High blood pressure and normal health predictors

	Wilks’ Lambda	F –Ratio
Body mass index	1.00	.130
Personal barrier	.992	2.660*
Environmental barrier	.999	.260
Age	.979	7.684**
Weight	.999	.457
Height	.997	1.151
Hip	.998	.634
Waist	.997	1.034
Waist: hip ratio	.987	4.572**
Physical activity	.997	.994
Hypo-kinetic activity awareness	1.00	.044

Significant Level (** P < .01) & (* P < .05)

Table 1.2 shows that personal barriers, age, and waist hip ratio were the factors which differentiated the two groups. High blood pressure group showed higher personal barrier and higher waist hip ratio and higher age, indicating more the personal barriers, age and waist hip ratio more is the risk of high blood pressure among teachers.

Table 1.3: The hypertension predictors in structure matrix

	Function
	1
Age	.620
Waist: hip ratio	.478
Personal barrier	.365
Height	-.240
Waist	-.227
Physical activity	.223
Hip	-.178
Weight	-.151
Environmental barrier	-.114
Body mass index	.081
Hypo-kinetic activity aware	.047

Table 1.3 reveals that age waist hip ratio and personal barrier, contribute 62.0, 47.8 and 36.5 per cent of variance, respectively in discriminating the hypertension group of teachers from normal health group of teachers. The result showed positive relationship with age, waist: hip ratio and personal barrier to activity with high blood pressure.

DISCUSSION:

The result indicated that the independent variables, age, waist hip ratio and personal barrier to participate in physical activity, emerged out to be significant discriminating predictors which contribute in discriminating the groups. The nature of the teacher’s job involves high level of mental activity, and less physical activity, leading to sedentary life style, making them prone to the risk of developing life style diseases ^13,14,15. Studies have reported that age, central obesity, BMI sedentary life style, alcohol intake etc to be risk factors for hypertension¹⁶. It is also observed that hypertensive subjects have higher prevalence of elevated total cholesterol, high body mass index, diabetes and sedentary lifestyle than normotensive subjects¹⁷. A large WHR is a simple measure of central obesity and is associated with high blood pressure, even with BMI in the normal range. The score from the WHR predicts the risk of developing several conditions associated with excess abdominal fat.

Increase in blood pressure with age is mostly associated with structural changes in the arteries and especially with large artery stiffness. In the elderly, the most powerful predictor of risk is increased pulse pressure due to decreased diastolic and increased systolic blood pressure.

In fact, the evidence of the several benefits provided by physical activity either on cardiovascular and internal diseases or on psychosocial disorders is well known and exhaustively described in scientific literature. Physical activity would ameliorate anxiety by becoming a sort of distraction from its symptoms, a healthy life-style may improve social contacts in patients and, therefore, the feedback from their environment. Positive effects of physical activity on people who experienced normal or increased anxiety levels have been reported in several randomized trials 18, 19, 20.

Several studies indicate that anxiety symptoms high in people suffering from chronic illnesses, such as CVDs, high oxidative stress is related to Primary Congenital Glaucoma disease 21. Maladaptive behaviour can be reduced by life style changes like physical exercise 22,23. Evidence of clinically relevant lowering of BP in hypertensive subjects engaged in physical training is larger and several meta-analyses are in agreement with the results of beneficial effect of physical activity on resting BP 24,25,26,27,28. Barriers to exercise are similar in all the populations, development of motivational environment for physical activities is desirable. Aging effects can be delayed and it can be made graceful with regular participation in exercise program, WHR which indicates central obesity can be prevented by being physically active. Quality of life (QOL) is an important aspect of a complete outcomes evaluation 29. Authors have recommended diligent exercise, controlled daily diet, adherence to medication use, and lifestyles change to hypertensive patients, who underwent routine checkups at Community Health Centers especially those suffering from chronic diseases 30.

The present study revealed determinants of hypertension among teachers, these determinants provide base line for developing intervention programs to prevent the problem of hypertension. The concept of Exercise as health tool should be promoted for prevention of hypertension, along with motivational talks, and workshop on benefits of physical activity specifically for preventing hypertension. Awareness related to life style diseases, practicing the appropriate action helpful to prevent the disease are needed31. More innovative and creative research questions and designs are still required, to study diverse groups, populations and conditions.

CONFLICT OF INTEREST:

The authors declare no conflict of interest.

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Received on 16.02.2019 Modified on 17.03.2019

Research J. Pharm. and Tech. 2019; 12(6):2995-2998.

DOI: 10.5958/0974-360X.2019.00506.7