Farapti Farapti, Chusnul Fadilla, Hari Basuki Notobroto, Saidatul Afzan Abdul Aziz

THE ASSOCIATION BETWEEN OBESITY AND HYPERTENSION AMONG ELDERLY RESIDING IN A NURSING HOME: IS GENDER IMPORTANT?

Introduction

The association between obesity and hypertension among elderly residing in a nursing home: is gender important?. Investigate obesity and hypertension in elderly nursing home residents. Gender is crucial: women show stronger links between obesity measures and systolic BP.

Abstract

Introduction: Elderly exhibit an increased for health complications, including obesity and hypertension (HT).. Obesity has been demonstrated to increase the risk of HT and the mechanism is also often influenced by gender. Aims: The study aimed to analyze the association between obesity and hypertension among elderly in nursing home stratified by gender. Methods: A cross-sectional study was conducted on a sample of 54 elderly subjects in nursing home. A sphygmomanometer was used to assess blood pressure (BIA) and a Bioelectrical Impedance Analysis (BIA) to determine nutritional status includingbody mass index (BMI), body fat (BF), visceral fat (VF), and subcutaneous fat (SF). Analysis of data was performed using an independent t-test and Pearson correlation test. Results: Mean age of respondents was 71.28 ± 8.21, dominated by women (75.9%), and 27.8% had hypertension. Dietary intake indicate excess sodium intake, while potassium, calcium, magnesium, vitamin D, vegetables, and fruits intake remain low. All indicators of nutritional status assessment differ significantly by gender except BMI. However, the present study found that BMI is the only variable associated with systolic BP (p=0.023). Stratified by gender, it was found that BW, BMI, and VF in women were related to systolic BP (p=0.022; p=0.015; p=0.040; respectively), and no such relationship was observed in men. Conclusion: It is proven that obesity and hypertension were more prevalent among elderly women. It is imperative to check nutritional statusfor preventive action for other diseases, including hypertension.

Review

This study addresses a highly relevant and important topic concerning the association between obesity and hypertension in a vulnerable population – elderly residents in nursing homes – with a commendable focus on potential gender differences. The aims are clearly stated, seeking to analyze this association stratified by gender, which is a pertinent area of inquiry given established physiological differences. The use of Bioelectrical Impedance Analysis (BIA) for a comprehensive assessment of nutritional status, including body fat and visceral fat, goes beyond simple BMI and represents a strength in methodological detail for body composition assessment. The recognition of dietary intake issues, such as excess sodium and low essential nutrient intake, also points to a holistic perspective on risk factors, though its direct integration into the core association analysis could be further elaborated. However, a significant limitation that critically impacts the interpretation and generalizability of the findings is the remarkably small sample size of 54 elderly subjects. When stratified by gender, as attempted by the authors, this sample size becomes particularly problematic. With women comprising 75.9% of the sample (~41 women), this leaves only a very small number of men (~13 men), rendering any gender-stratified analyses on "no relationship observed in men" highly susceptible to Type II error and statistically underpowered. This severely undermines the ability to draw robust conclusions regarding the importance of gender. Additionally, a clear typo in the methods stating "A sphygmomanometer was used to assess blood pressure (BIA)" needs immediate correction, as BIA is for body composition, not blood pressure measurement. The cross-sectional design, while suitable for initial exploration, also inherently limits the ability to infer causality. Despite these limitations, the study offers preliminary insights, particularly the finding that BMI was associated with systolic BP in the overall sample, and that BW, BMI, and visceral fat showed relationships with systolic BP specifically in women. These results, while needing replication in larger cohorts, highlight the potential role of different adiposity markers and the continued need to investigate gender-specific risk profiles in elderly populations. For future iterations, a substantially larger and more balanced sample size across genders would be crucial to robustly evaluate the "is gender important?" question. Furthermore, a clearer integration or discussion of the observed dietary intake patterns in relation to the main obesity-hypertension association would enhance the paper's overall coherence and practical implications for nursing home care. As presented, the study serves as an interesting preliminary exploration, but its conclusions, particularly regarding gender, must be interpreted with extreme caution due to the pronounced sample size constraint.

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