Physical activity and hypertension from a national perspective: a pedagogical strategy based on data from the 2018 National Risk Factor Survey (ENFR)
Main Article Content
Abstract
This study was conceived as a pedagogical strategy to integrate real epidemiological data into Animal Physiology classes at the School of Natural Sciences and Museum, National University of La Plata, with the aim of promoting meaningful and situated teaching. The objective was to analyze the association between physical activity level and arterial hypertension in Argentine youth aged 18 to 24 years, based on data from the 2018 National Risk Factor Survey (ENFR). A cross-sectional study was conducted with descriptive, bivariate, and logistic regression analyses. The prevalence of hypertension was 21.6%. No significant association was found with physical activity level, but there was association with obesity (OR = 2.00), diabetes (OR = 1.88), smoking (OR = 1.37), and lower educational level. The analysis stratified by sex revealed differences in the associated factors. In women, obesity (OR = 1.91) and smoking (OR = 1.38) were significantly associated with hypertension, while education was a non-significant protective trend. In males, significant associations were observed with obesity (OR = 2.02), diabetes (OR = 2.45), smoking (OR = 1.35), and lower education (OR = 0.85) were significantly associated. Using these findings in the classroom enables students to develop a critical understanding of population health and to approach social determinants of health in Argentina from an integrated perspective.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This magazine is available in open access under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (http://creativecommons.org/licenses/by-nc-sa/4.0/).
References
Bundy, J. D., Mills, K. T., Chen, J., Li, C., Greenland, P. y He, J. (2018). Estimation of lifetime risk of developing hypertension by sex and ethnicity: The Lifetime Risk Pooling Project. Journal of the American Heart Association, 7(17), e008884. https://doi.org/10.1161/JAHA.118.008884 DOI: https://doi.org/10.1161/JAHA.118.008884
Chow, C. K., Teo, K. K., Rangarajan, S., Islam, S., Gupta, R., Avezum, A., Bahonar, A., Chifamba, J., Dagenais, G., Diaz, R., Kazmi, K., Lanas, F., Wei, L., Lopez-Jaramillo, P., Ismail, N., Lear, S. A., Yusuf, R., Yusufali, A., McKee, M., … Yusuf, S. (2013). Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA, 310(9), 959–968. https://doi.org/10.1001/jama.2013.184182 DOI: https://doi.org/10.1001/jama.2013.184182
Cutler, J. A., Sorlie, P. D., Wolz, M., Thom, T., Fields, L. E. y Roccella, E. J. (2008). Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension, 52(5), 818–827. https://doi.org/10.1161/HYPERTENSIONAHA.108.113357 DOI: https://doi.org/10.1161/HYPERTENSIONAHA.108.113357
Díaz, K. M. y Shimbo, D. (2013). Physical activity and the prevention of hypertension. Current Hypertension Reports, 15(6), 659–668. https://doi.org/10.1007/s11906-013-0358-1 DOI: https://doi.org/10.1007/s11906-013-0386-8
Forouzanfar, M. H., Liu, P., Roth, G. A., Ng, M., Biryukov, S., Marczak, L., Alexander, L., Estep, K., Hassen Abate, K., Akinyemiju, T. F., Alvis-Guzman, N., Azzopardi, P., Banerjee, A., Barac, A., Bärnighausen, T., Basu, S., Bekele, T., Bennett, D. A., … Murray, C. J. L. (2017). Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990–2015. JAMA, 317(2), 165–182. https://doi.org/10.1001/jama.2016.19043 DOI: https://doi.org/10.1001/jama.2016.19043
GBD 2021 Risk Factors Collaborators. (2023). Global burden of 87 risk factors in 204 countries and territories, 1990–2021: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 105–134. https://doi.org/10.1016/S0140-6736(23)01184-2
Ji, H., Kim, A., Ebinger, J. E., Niiranen, T. J., Claggett, B. L., Bairey Merz, C. N., McCabe, J., Lacey, J., Lo, J. C., Cheng, S. y Shah, S. J. (2020). Sex differences in blood pressure trajectories over the life course. JAMA Cardiology, 5(3), 255–262. https://doi.org/10.1001/jamacardio.2019.5306 DOI: https://doi.org/10.1001/jamacardio.2019.5306
Kelly, A. S., Barlow, S. E., Rao, G., Inge, T. H., Hayman, L. L., Steinberger, J., Urbina, E. M., Ewing, L. J., Daniels, S. R. y Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. (2013). Severe obesity in children and adolescents: Identification, associated health risks, and treatment approaches. Circulation, 128(15), 1689–1712. https://doi.org/10.1161/CIRCULATIONAHA.113.001443 DOI: https://doi.org/10.1161/CIR.0b013e3182a5cfb3
Lear, S. A., Hu, W., Rangarajan, S., Gasevic, D., Leong, D., Iqbal, R., Casanova, A., Swaminathan, S., Anjana, R. M., Kumar, R., Rosengren, A., Wei, L., Yang, W., Chuangshi, W., Liu, H., Nair, S., Diaz, R., Swidon, H., Gupta, R., … Yusuf, S. (2017). The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income, middle-income, and low-income countries: The PURE study. The Lancet, 390(10113), 2643–2654. https://doi.org/10.1016/S0140-6736(17)31634-3 DOI: https://doi.org/10.1016/S0140-6736(17)31634-3
Maceira, A., Jait, A., Díaz, A., González, D., Álvarez, C. y Pereyra, A. (2020). Hipertensión arterial en Argentina: Situación actual y perspectivas. Revista Argentina de Cardiología, 88(2), 143–151.
Marmot, M., Allen, J., Bell, R., Bloomer, E. y Goldblatt, P. (2012). WHO European review of social determinants of health and the health divide. The Lancet, 380(9846), 1011–1029. https://doi.org/10.1016/S0140-6736(12)61228-8 DOI: https://doi.org/10.1016/S0140-6736(12)61228-8
Ministerio de Salud de la Nación Argentina. (2019). 4ª Encuesta Nacional de Factores de Riesgo 2018. Secretaría de Gobierno de Salud.
Muñoz-Rivas, M. J., Orozco-Beltrán, D., Recio-Rodríguez, J. I., Mena-Martín, F. J., Gil-Guillén, V., Sánchez-García, A., Cordero, A., Somoza, I. y Pérez-Francisco, D. (2021). Gender differences in cardiovascular health in the Spanish population: A 2019 nationwide cross-sectional study. Revista Española de Cardiología (English Edition), 74(6), 529–537. https://doi.org/10.1016/j.rec.2020.04.008 DOI: https://doi.org/10.1016/j.rec.2020.04.008
O’Donnell, M. J., Chin, S. L., Rangarajan, S., Xavier, D., Liu, L., Zhang, H., Rao-Melacini, P., Zhang, X., Pais, P., Agapay, S., Lopez-Jaramillo, P., Damasceno, A., Langhorne, P., McQueen, M. J., Rosengren, A., Dehghan, M., Hankey, G. J., Dans, A. L., Elsayed, A., … Yusuf, S. (2016). Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): A case-control study. The Lancet, 388(10046), 761–775. https://doi.org/10.1016/S0140-6736(16)30506-2 DOI: https://doi.org/10.1016/S0140-6736(16)30506-2
Pescatello, L. S., MacDonald, H. V., Ash, G. I., Lamberti, L. M., Farquhar, W. B. y Arena, R. (2015). Assessing the existing professional exercise recommendations for hypertension: A review and future directions. Current Hypertension Reports, 17(11), Article 87. https://doi.org/10.1007/s11906-015-0600-y DOI: https://doi.org/10.1007/s11906-015-0600-y
Primatesta, P., Falaschetti, E., Gupta, S., Marmot, M. G. y Poulter, N. R. (2001). Association between smoking and blood pressure: Evidence from the Health Survey for England. Hypertension, 37(2), 187–193. https://doi.org/10.1161/01.HYP.37.2.187 DOI: https://doi.org/10.1161/01.HYP.37.2.187
Prince, S. A., Adamo, K. B., Hamel, M. E., Hardt, J., Connor Gorber, S. y Tremblay, M. (2008). A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 5, 56. https://doi.org/10.1186/1479-5868-5-56 DOI: https://doi.org/10.1186/1479-5868-5-56
R Core Team. (2023). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/
Sarki, A. M., Nduka, C. U., Stranges, S., Kandala, N.-B. y Uthman, O. A. (2015). Prevalence of hypertension in low- and middle-income countries: A systematic review and meta-analysis. Medicine (Baltimore), 94(50), e1959. https://doi.org/10.1097/MD.0000000000001959 DOI: https://doi.org/10.1097/MD.0000000000001959
Williams, B., Mancia, G., Spiering, W., Rosei, E. A., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Laurent, S., … Schmieder, R. E. (2018). 2018 ESC/ESH guidelines for the management of arterial hypertension. European Heart Journal, 39(33), 3021–3104. https://doi.org/10.1093/eurheartj/ehy339 DOI: https://doi.org/10.1093/eurheartj/ehy339
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
World Health Organization. (2023a). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension
World Health Organization. (2023b). WHO report on the global tobacco epidemic, 2023: Protect people from tobacco smoke. https://www.who.int/publications/i/item/9789240074270
Yano, Y. (2020). Visit-to-visit blood pressure variability in young adulthood and cardiovascular disease risk in later life. Hypertension, 75(6), 1419–1425. https://doi.org/10.1161/HYPERTENSIONAHA.120.15286 DOI: https://doi.org/10.1161/HYPERTENSIONAHA.120.15286
Yano, Y., Reis, J. P., Colangelo, L. A., Shimbo, D., Viera, A. J. y Allen, N. B. (2018). Association of blood pressure classification in young adults using the 2017 ACC/AHA blood pressure guideline with cardiovascular events later in life. JAMA, 320(17), 1774–1782. https://doi.org/10.1001/jama.2018.13551 DOI: https://doi.org/10.1001/jama.2018.13551