Determinants of Hypertension amongst Rice Farmers in West Java, Indonesia

The hypertension rate in Indonesia has increased significantly in the past five years, but there is limited information about the hypertension risk of farmers. Our study assesses the prevalence of hypertension in this population and examines the proportional risk of various work environment and lifestyle factors among farmers. A cross-sectional study was conducted in high and low heat stress agriculture areas of West Java, Indonesia. There were 354 male farmers aged 25 to 73 years old who participated in the study. We measured blood pressure and used a questionnaire on self-reported use of anti-hypertension drugs or diagnosis by a medical professional to define hypertension. We assessed occupational factors including farming methods, heat stress and pesticide use, and personal factors including obesity, food intake, smoking status, alcohol consumption. Multivariate analysis was used to evaluate factors potentially associated with prevalence of hypertension. Forty-six percent of farmers experience hypertension. Farming in a location with higher heat stress (WBGT) was significantly associated with increased risk of hypertension (adjusted prevalence ratio (aPR) 1.41, 95% confidence interval (CI) 1.01, 1.95). Farmers who used pesticide sprayers had an increased risk of hypertension (aPR 1.90, 95% CI 0.93, 3.87). No personal/lifestyle characteristics were significantly associated with hypertension, although ever smoking and ever consuming alcohol had an increased prevalence of hypertension. This study shows the importance of work environmental factors in the prevalence of hypertension and the necessity of public health education, identification and treatment of this "silent killer" among Indonesian farmers.