Smoking as a Major Risk for Elderly Hypertension in The Covid-19 pandemic: A case-control Study

International Journal of Research and Scientific Innovation (IJRSI) | Volume IX, Issue II, February 2022 | ISSN 2321–2705

Smoking as a Major Risk for Elderly Hypertension in The Covid-19 pandemic: A case-control Study

Cucu Herawati¹, Septi Wulandari1, Suzana Indragiri¹, Nuniek Tri Wahyuni¹, Dewi Mutiah¹, Didik Sumanto²,
¹Sekolah Tinggi Ilmu Kesehatan Cirebon, Cirebon, Indonesia
²Department of Epidemiology, Universitas Muhammadiyah Semarang, Indonesia

Abstract
Introduction: Hypertension is a non-communicable disease that is an important public health problem in the world because its prevalence continues to increase and is the third biggest risk of premature death. Lifestyle is the most important risk factor that can cause hypertension, including physical activity, diet, smoking behavior, rest patterns. The purpose of the study was to determine the effect of lifestyle on the incidence of hypertension in the elderly during the Covid-19 pandemic era.
Materials and Methods: The research design uses a quantitative case-control design approach. A sample of 88 respondents consisted of 48 cases and 40 controls. Sampling method using accidental sampling technique, the instrument used is a questionnaire, data collection method using interviews, data analysis using chi-square test and multivariate logistic regression.
Result: The results showed that there was a significant effect between physical activity (p-value 0.047), diet (p-value 0.012), smoking behavior with the incidence of hypertension (p-value 0.001), and there was no effect of rest patterns with the incidence of hypertension (p-value 0.001). p-value 0.334). Multivariate analysis found that smoking was the most influential factor with the incidence of hypertension (OR=6,647), meaning that respondents who had smoking behavior had a 7 times greater risk of suffering from hypertension than respondents who did not smoke.
Conclusion:
There is a significant influence between physical activity, diet, and smoking behavior with the incidence of hypertension and there is no effect of rest patterns with the incidence of hypertension. Smoking behavior is the most influential factor in the incidence of hypertension.

Keywords: Physical Activity, Diet, rest pattern, Smoking, Hypertension.

Introduction
Non-communicable diseases are the leading cause of death in the world. Three of the ten leading causes of death are caused by non-communicable diseases such as stroke, hypertension, and heart disease(1)’(2). Hypertension tends to be higher than coronary heart disease, chronic kidney failure, stroke due to uncontrolled hypertension can cause complications in coronary heart disease, chronic kidney failure, and stroke(3). Hypertension affects more than 26% of the adult population worldwide(4). One-quarter of the world’s adult population is estimated to have hypertension, with the worldwide prevalence projected to increase to 60% by 2025(5). Hypertension is a major health problem because 70% is the cause of death in the world(6). Non-communicable diseases are generally chronic so that they can lower the immune system and are very susceptible to infections including COVID-19virus infection(7). COVID-19disease contributed to 0.4 million deaths(8). Hypertension is a contributing factor to the severity of COVID-19(6).

The results of Riskesdas 2018 showed that the prevalence of hypertension rose from 27.8% to 34.1%. The prevalence of hypertension will increase with increasing age(2). The districts or cities with the highest coverage of health services for people with hypertension are Cimahi (122.3%), Cirebon (107.0%), and Tasikmalaya (100.0%)(9).

The increase in the prevalence of non-communicable diseases is related to lifestyle, including smoking, consumption of alcoholic beverages, physical activity, consumption of fruits and vegetables(2). Several factors cause hypertension such as excessive salt consumption, alcohol consumption, physical activity, diet, rest, smoking, and obesity. High salt intake and stress are risk factors for hypertension in the elderly(10). Individual lifestyle behavior and health status affect the risk of being infected with COVID-19(11). Hypertension is one of the most common co-morbidities of COVID-19 is closely related to lifestyle including diet, smoking behavior, physical activity, and stress. Unhealthy smoking behavior can cause uncontrolled hypertension(12). People with comorbidities are one of the groups most vulnerable to being exposed to the Covid-19 virus(13). The results of the study according to Poniyah showed that there was a relationship between physical activity, diet, and the incidence of hypertension in the elderly(14). The results of research on Nor’alia, et al lifestyle associated with the incidence of hypertension are diet, physical activity, and stress(15). Based on the results of previous studies that smoking is closely associated with a higher risk of hypertension in the long term(16).

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