The modifiable and non-modifiable risk factors of hypertension in the adult population of Kelantan: Structural equation modeling approach

Introduction: Hypertension is a silent disease that can lead to serious complications such as heart failure, acute coronary syndrome, renal failure, and stroke if not treated early. This study is to elucidate a model of modifiable and non-modifiable risk factors for hypertension and this model could give a clearer picture regarding the relation of each risk factor towards hypertension based on the adult population in Kelantan, Malaysia. Methodology: Statistical analysis was performed by using AMOS software through Structural Equation Modelling (SEM). Unlike current methods that focus only on identifying direct associations between hypertension diseases but our method introduces the effects of multiple risk factors simultaneously in a single model involving modifiable and non-modifiable risk factors. Results: The risk factors listed below are considered to have a direct statistically significant effect on hypertension: age (0.122, p = 0.001), fibrinogen (0.091, p = 0.003), Body mass index (0.138, p = 0.001), Triglycerides (0.069, p = 0.028) and Diabetes status (0.133, p = 0.001). Family history of heart attack had no significant effect on hypertension in this study (0.016, p = 0.608). The final model demonstrated good model fit where GFI, AGFI, NFI, CFI and TLI value are 0.9 and above. Conclusion: The SEM analysis aids in a better understanding of hypertension risk factors and a higher level of confidence in controlling hypertensive patients' risk factors.