EFFECTS OF PARENTAL ABSENCE ON THE BEHAVIOR OF SENIOR HIGH

SCHOOL STUDENTS OF SARRAT NATIONAL HIGH SCHOOL

A THESIS

Presented to
The Faculty of Senior High School
Sarrat, Ilocos Norte

In Partial Fulfillment of the Requirements

Stem 12

Researchers

Nathalia Eicellrose Bueno

Ashley Kate Eugenio
Dawn Angel Ramos

JUNE 2019
 CHAPTER I

THE PROBLEM AND ITS BACKGROUND

Introduction

Hypertension is one of the risk factors for cardiovascular diseases in the Philippines

and worldwide. According to the 8th National Nutrition Survey conducted In 2013, it was

estimated that 22.3% of Filipinos were considered hypertensive. It is inevitable, especially for

those who are genetically predisposed to such condition, that hypertension suddenly arises

when a person hits the age of 50. Although efforts of providing treatment for hypertension have

been progressing, the number of hypertensive cases is still very visible and the probable way

to lessen its deleterious future effects is to control this disease by diet and lifestyle modification

as well as medications.

Global burden of Disease estimated that in Philippines, the total percentage of death

due to cardiovascular diseases (CVD) below 70 years of age is 52% as compared to those who

live in developed nations where it is 23% only. The prevalence rate varies with the age, as the

younger age group of 18-24 years, it is only 4% and rises to 60 % after 65 years. Over the last

thirty years, there is considerable decline in morbidity and mortality in developed countries as

the consequence of treatment and control of hypertension proving it to be one of the major

modifiable risk factor. In the rural area of the Philippines, blood pressure control to the

suboptimal level remains challenging. Recent studies showed that there is a variable prevalence

at different regions and excessively low awareness among general public leading to poor

control of hypertension.

Moreover, several factors may contribute to lack of awareness and treatment of

hypertension in young adults. Young adults have traditionally been less integrated into the

healthcare system, as they are more likely to be uninsured and less likely to have a usual source
of care. Provider specialty and both provider and patient perceptions of risk based on patient

age, gender, race/ethnicity, or comorbidities may impact awareness and treatment as well. A

recent study of adults with regularly scheduled physician visits who met clinical criteria for

hypertension found that those who were ages 18–24 years vs. at least 60 years of age were

28 % less likely to have their hypertension diagnosed by their physician. Moreover, young

adults are less likely to receive information about lifestyle changes to address

hypertension. Often described as the “young invincible,” young adults may also not consider

themselves at risk for chronic diseases such as hypertension and cardiovascular disease (CVD).

Developing countries including the Philippines are suffering with the increasing burden

of hypertension and other cardiovascular diseases. Hypertension forces an excessive financial

burden on population and health systems, consuming scarce resources. There are limited data

on the prevalence of high blood pressure and its risk factors among the young, whereas this is

the population that could derive the most benefit from control measures.

In this premise, the researchers were motivated to conduct a research study on Risk

Factors of Hypertension among Young Adults from Sarrat, Ilocos Norte.

Theoretical framework

The Theory of Reasoned Action (Ajzen and Fishbein, 1980; Fishbein and Ajzen, 1975)

is among the most influential and widely applied theories on the link between attitudes and

behavior. It provides a simple, yet logical, conceptual framework for measuring the relationship

between beliefs, attitudes, subjective norms, intentions and behavior. According to this theory,

attitudes and subjective norms are developed from beliefs, behavioral intentions from attitudes

and subjective norms, and behavior from behavioral intentions. Behavioral intentions

constitute an intermediate variable between attitudes/subjective norms and behavior (Ajzen and

Fishbein, 1980; Fishbein and Ajzen, 1975).

As a range of behaviors (such as eating healthy or exercising) is not always perceived

to be under the full volitional control of a person, Ajzen (1985) extended the Theory of

Reasoned Action with a new variable to account for factors outside of a person’s full control,

perceived behavioral control. Thus, The Theory of Planned Behavior suggests that when an

individual has a favorable attitude towards a given behavior, perceives that significant others

want him or her to perform this behavior, and, in addition, feels capable of performing the

behavior he or she will have a higher intention to adopt this behavior. Hence, the overarching

idea of testing the theory in the field of healthy eating is delineating the main psychological

causes of these behaviors, as this knowledge will provide valuable information that can be used

for predicting and influencing behavior, for instance in terms of influencing attitudes or making

it easier to engage in healthy eating (e.g., by making healthy food available).

A number of studies have been conducted to investigate how well the Theory of

Planned Behavior predicts healthy eating behavior among young people. Chan and Tsang

(2011) found that perceived behavioral control, attitudes toward healthy eating and subjective

norms predicted 45 percent of the variance in behavioral intention. In a survey including

 children and adolescents aged 9-18, healthy eating behavior was also predicted by the

constructs included in the Theory of Planned Behavior, although sex differences in the

determinants were found (Fila and Smith, 2006). For boys, subjective norms and perceived

behavioral control explained 30 percent of the variance in behavior, while for girls barriers,

attitudes, self-efficacy and subjective norms predicted 45 percent of the model. Overall, the

most predictive barrier to healthy eating was the availability and taste of foods (Fila and Smith,

2006

Conceptual Framework

INPUT PROCESS OUTPUT

-Profile of the selected - Risk Factors of - Identify the risk factors

S
respondents as to: Hypertension among of hypertension.

*Age Young Adults from -A proposed program in

*Sex Sarrat, Ilocos Norte. the Municipality of

*Civil Status Sarrat that promotes

.
*Address healthy habits in

*Occupation reducing the risk of

having hypertension.

Figure 1- The schematic diagram of the study.

The main goal of this study was to find out the Risk Factors of Hypertension among

Young Adults from Sarrat, Ilocos Norte.

 The study starts with the relationship of Input variables which contains the profile of

the selected respondents as to: Age, Sex, Civil Status, Address, and Occupation.

While in the next assessment contains the survey, data gathering, data analysis, and data

interpretation regarding on The Risk Factors of Hypertension among Young Adults from

Sarrat, Ilocos Norte.

Finally, it is expected that the results and findings of the study contains the risk factors

of hypertension and proposed program in the Municipality of Sarrat that promotes healthy

habits in reducing the risk of having hypertension.

Statement of the Problem

This study aimed to assess Risk Factors of Hypertension among Young Adults from

Sarrat, Ilocos Norte.

Specifically, this study sought to answer the following questions;

1. What is the profile of the respondents as to their:

1.1 Age;

1.2 Sex;

1.3 Civil Status;

1.4 Address; and

1.5 Occupation;

2. What are the Risk Factors of Hypertension among Young Adults from Sarrat, Ilocos Norte?

3. What interventions can be best applied to reduce the risk of hypertension?

Scope and Delimitations

In general, this study attempted to analyze The Risk Factors of Hypertension among

Young Adults from Sarrat, Ilocos Norte. The scope of this study includes the socio-
demographic profile status of the respondents, the risk factors of hypertension and its

implications.

The information needed was gathered using the research-made questionnaire. The

respondents of the study were composed of forty-eight (48) respondents. Two (2) respondents

who is diagnosed with hypertension in each barangay. This study specifically focused in

describing the results of the analysis and interpretation of data pertaining to the following

topics:

- The Risk Factors of Hypertension among Young Adults from Sarrat, Ilocos Norte.

- Ways to minimize the risk of hypertension.

- The impact of healthy eating habits in reducing the risk of hypertension.

Significance of the Problem

The study is conducted in order to determine The Risk Factors of Hypertension

among Young Adults in Sarrat, Ilocos Norte.

The study seeks to find out what are the risks of hypertension within the community

and helps to prevent it.

The findings of this study will benefit the following:

The families within the community will gain more information and will be more

aware of the risk factors of hypertension within their area.

The nurses and doctors will be aware of the risk factors of hypertension and will be

able to help prevent it.

The findings will serve as an initial data to conceptualize a solution for hypertension.
Definition of Terms

For better clarification and understanding of the terms of this study, the following terms

are defined conceptually and operationally:

Hypertension- is another name for high blood pressure. It can lead to severe complications

and increases the risk of heart disease, stroke, and death. Blood pressure is the force exerted by

the blood against the walls of the blood vessels.

Young adult- is generally a person ranging in age from their late teens or early twenties to

their thirties, although definitions and opinions, such as Erik Erikson's stages of human

development, vary. The young adult stage in human development precedes middle adulthood.

Diagnose- recognize (something, such as a disease) by signs and symptoms

Risk- is the possibility of losing something of value. Values (such as physical health, social

status, emotional well-being, or financial wealth) can be gained or lost when taking risk

resulting from a given action or inaction, foreseen or unforeseen (planned or not planned).
 CHAPTER II

REVIEW OF RELATED LITERATURE

Hypertension

Hypertension or high blood pressure is a worldwide problem that effects approximately

15-20% of all adults (Wang et al., 2008). Hypertension known as silent killer as it showed no

symptom. Even though it is simple to diagnose and usually can be controlled by healthy diet,

regular exercise, medication prescribed by doctors or a combination of these, untreated

hypertension will cause serious condition (Campbell et al., 2002). Hypertension is associated

with cardiovascular disease, insulin resistance, obesity, carbohydrate tolerance,

hyperuricacidemia, and atherosclerosis (Yeh et al., 2009). Hypertension affects the structures

and functions of small muscular arteries, arterioles and other blood vessels and can cause

damage at variable rate to various target organs including kidney, brain and eye, related with

the end stage of renal disease and to be the cause of stroke (Hock et al., 1995; Lee et al., 2010;

Escobales et al., 2005). It is associated with the alterations in the blood vessels wall that

affecting the endothelium, the media and the adventitia, whereas alteration in the media leading

to remodeling of the vessel wall (Escobales et al., 2005). Patients with hypertension die

prematurely with the most common cause of death are heart disease, while strokes and renal

failure are frequently occurring, particularly in those with significant retinopathy (Jinglun et

al., 1995).

“21 percent of Filipino adults are hypertensive,” said Dr. Dante Morales, President of

the Philippine Society of Hypertension (PSH). Hypertension is considered as the biggest single

risk factor for deaths worldwide. According to the World Health Organization (WHO),

hypertension causes 7 million deaths every year while 1.5 billion people suffer due to its

complications. “Most of the time, hypertension has no symptoms,” said Dr. Morales. “This
makes the condition more dangerous. If remain untreated, the arteries and other vital organs in

the body will be damaged,” he added. Hypertension causes heart attack, stroke, heart failure,

aneurysm or renal failure. In the Philippines, heart attack is the most common cause of death

among Filipinos. “This may be attributed to continuous neglect on the danger of hypertension

and its complications,” said Dr. Morales.

A study conducted by PSH found out that the prevalence of hypertension in the country

is increasing. In 2003, data showed that 16 percent or approximately 7 million Filipino adults

20 years and above has hypertension. The incidence increased to 10 million or 21 percent of

Filipino adults 20 years and above in 2008. “Based on the data, we are expecting the incidence

to increase more in the next survey in 2013,” said Dr. Morales. He reminded the public to be

aware of the food they eat and encouraged them to have at least 30 minutes exercise a day to

reduce the risk of hypertension. “Because our lifestyle has direct impact on our health,” added

Dr. Morales. Living a healthy lifestyle plays an important role in treating hypertension. “If you

were diagnosed with high blood pressure, avoid smoking, minimize salt intake and alcohol

consumption and a regular exercise are among the key strategies which may avoid, delay or

reduce the need for medication,” stressed Dr. Morales.

Moreover, in Region I Acute Respiratory Infections remain to be the top cause of

morbidity. This is followed by diarrhea, hypertension, chicken pox and PTB. Table 2 shows

that majority of the leading cause of morbidity are communicable diseases. It is notable

however that non-communicable disease such as CVD, are becoming one of the top causes of

morbidity.

Now, a new assessment of 13,000-plus patients reveals that hypertension is more

common among Pilipino adults than previously believed. Even more, the risk for hypertension

was even greater for African Americans and white women. While this form of high blood
pressure is generally asymptomatic, it is important to monitor the issue to help prevent future

heart damage. Pop on over to MD Magazine to read more of this analysis.

In order to establish the diagnosis of hypertension, blood pressure measurement must

be repeated in a calm state over time. The precise interval between measurements over what

period of time is not clear. Regulating your blood pressure is a vital question and it can become

a real virtue. Hypertension is also called silent killer so if you are an older person and unable

to regulate your blood pressure so than it might be pretty harmful and sometime impossible. A

study of more than 2, 000 seniors published online in the Archives of Internal Medicine show

the surprising results.

Blood pressure affects the function of the kidneys, arteries, and the entire body. If not

regulated on time, it causes great damage to the arteries, and the other body organs, leading to

heart attack, kidney failure, heart failure, and numerous other health problems. This explains

why most doctors decide to treat hypertension with an aggressive approach, in order to bring

down high blood pressure .This is a list of 10 symptoms which indicate high blood pressure:

1 - Poor circulation

2 - Headache

3 - Lightheadedness or dizzy spells

4 - Difficulty breathing

5 - Pounding in the ears and neck

6 - Numbing sensation

7 - Nosebleed

9 - Impaired vision

10 - Blood in urine
 If you experience any of the above mentioned symptoms you need to consult your

doctor and get tested to determine the best course of action. You can use some natural

ingredients like Hawthorne, omega 3 fatty acids and potassium to lower your blood pressure

without medications, they are very effective. When you go see your doctor he’ll recommend

the best therapy for you. The DASH diet (Dietary Approaches to Stop Hypertension) is a really

effective way to preserve your health and lower high blood pressure naturally. Numerous

studies have shown that natural remedies can significantly reduce the need for hypertension

medications.

You can get your blood pressure back to normal by exercising in moderation, reduce

the intake of sodium and follow a healthy eating regimen. One recent clinical trial showed that

reducing the sodium intake can significantly lower high blood pressure, but still everything

points out to the fact that the DASH diet is the most effective method to eliminate hypertension.

DASH diet

1 - Low fat dairy products.

2 - Consuming more nuts, grains, fish and poultry.

3 - Fresh foods and vegetables.

4 - Avoiding high cholesterol and fatty foods.

The lucky ones can resolve their hypertension problems completely naturally, by

exercising, eating healthier and reducing the sodium intake. Others still need to take certain

medications to prevent bigger complications. You need to consult your doctor and see whether

a completely natural approach will suit you or you need to take another course of action. The

case may be, a healthier lifestyle can improve your overall health in general, so you should

consider making some changes regardless what your diagnosis. For this article, the purpose is

to show you how to control high blood pressure, since the methods vary in the fifth and the
eighth decade of life. Generally, health providers tend to chart blood pressure changes, and

start following their results since they’re 20.Getting an exact picture of the patient’s blood

pressure and charting what happens over time is what healthcare providers will want to do.

It all starts at age of 20. The Philippine Heart Association reveals young people to

screen their blood pressure at their regular healthcare visit. This happens once in every 2 years

and applies to those whose blood pressure is lower than 120/80 mm Hg .Yet, blood pressure

rises with heart beats and falls down between the beats. It is also affected by stress, sleep,

posture, and physical activity. Yet, despite all these changes, the blood pressure should be

lower than 120/80 mm Hg (which is less than 120 systolic and less than 80 diastolic). Sadly, 1

in 3 American adults suffers from high blood pressure. In this case, doctors read the blood

pressure over time, or may advise a monitoring at home, before they diagnose high blood

pressure.

Blood pressure is usually recorded in two numbers; systolic (pressure during a

heartbeat) over diastolic (pressure between heartbeats). For example, a measurement of 120/80

millimetres of mercury (mmHg) is read as 120 over 80. Normal blood pressure level should

fall below 120/80. People with blood pressure readings that fall between 120/80 and 139/89

are considered to have “pre-hypertension” and may go on to have high blood pressure if

preventative measures are not put in place.

Blood pressure rises as your body weight rises (and obesity is also a risk factor for

developing diabetes and high cholesterol, which in turn triggers heart diseases). A loss of as

little as 10 kg can help lower blood pressure.

Hypertension is not limited by age, gender, socioeconomic status or race is anybody

can have hypertension. It seems to be increasingly common in young adults within the age 20

to 39 years in Philippines
 Hypertension is an under-recognized disease in society. This, coupled with its

widespread prevalence, makes it mandatory for all members of society to participate in

measures to prevent and treat it adequately. Failing to do so not only increases the illness

burden of society but also results in an enormous increase in health care expenditure.

Young adults meeting hypertension diagnostic criteria have a lower prevalence of a

hypertension diagnosis than middle-aged and older adults. The purpose of this study was to

compare the rates of a new hypertension diagnosis for different age groups and identify

predictors of delays in the initial diagnosis among young adults who regularly use primary care.

Hypertension is one of the leading preventable causes of death in the Philippines. Blood

pressures from young adulthood predict the incidence of future cardiovascular events. Among

young adults (18–39 years), approximately 20% of men and 15% of women have diagnosed

hypertension, with an expected increase in prevalence due to high obesity rates.

According to the National Health and Nutrition Examination Survey (NHANES), rates

of hypertension control have improved in the Philippines(defined per NHANES as an average

SBP of <140 mmHg and diastolic pressure of <90 mmHg among patients with hypertension or

self-reported current use of blood pressure-lowering medication).However, young adults have

consistently low prevalence of hypertension control (38%) compared with middle-aged (40–

59 years) and older (≥60 years) adults whose prevalence of control is 54 and 53%, respectively.

This is concerning because young adults with uncontrolled hypertension are at risk for chronic

kidney disease and premature strokes, particularly in the presence of diabetes.

Unfortunately, prior studies report low hypertension diagnosis prevalence in young

adults meeting criteria for hypertension. Reasons for this disparity are largely unknown.

Limited studies identifying barriers to hypertension diagnosis in young adults have focused on

lower primary care use and the lack of a regular source of primary care as contributing factors.
However, a previous study demonstrated that young adult and middle-aged women (18–49

years) are less likely to be diagnosed with hypertension within an obstetrics/gynecology clinic

compared to internal medicine. Suggesting that, even with healthcare utilization, encounter

context may impact timely hypertension diagnosis. Studies in middle-aged and older primary

care patients also demonstrated that insufficient clinic time and competing comorbidities

contribute to diagnosis delays (clinical inertia). The purpose of our study was to determine the

rate of initial hypertension diagnosis and predictors that contribute to faster or slower rates of

diagnosis among younger and older adults with regular primary care who meet clinical

hypertension criteria.

Foreign Literature and Studies

Cardiovascular diseases (CVD) are the main sources of disease burden worldwide, and

constitute a major public health problem in many countries.1 High blood pressure (HBP) is an

established major risk factor for stroke and coronary heart disease.2 Studies have shown that

blood pressure (BP) in childhood and adolescence are crucial factors in developing

hypertension in adulthood.3

Several studies have reported high prevalence of factors such as abdominal obesity,

inflammation markers, metabolic syndrome, and clustered metabolic risk among the risk

factors for CVD. Between the cardiovascular risk factors, some article highlights increased BP

values among adolescents as being particularly noteworthy. Because the prevalence of obesity

has been increasing, we would expect to observe an increase in the prevalence of HBP, since

there is a strong association between obesity and hypertension. Freedman also found that the

prevalence of obesity increased but no increase in BP was observed.

In Portugal, the hypertension has a high prevalence exceeding 40% in the adult

population and although predominates in this age group, hypertension in children and
adolescents is not negligible. It becomes diversified on reports of several authors, which will

be discussed immediately in this review, depending mainly on the methodology used. Note that

when blood pressure is measured several times, the prevalence tends to decline because of the

average regression phenomenon.

Several studies also indicated that hypertension is a disease with high prevalence in the

elderly population, becoming a determining factor in the high rates of morbidity and mortality

of these individuals. It affects nearly 60% of the elderly and is often associated with other

diseases such as arteriosclerosis, diabetes mellitus and metabolic syndrome, conferring to this

group a high cardiovascular risk.

Regarding a population-based study developed in Brazil (individuals aged 20 to 69

years), the data showed a prevalence of hypertension of 23.6%, and that individuals with less

than four years of schooling were almost twice as more likely to present hypertension; the

female gender exhibited 17.0% more likely to have hypertension than male gender; concerning

the distribution of hypertension with age, a significant and positive tendency was found, that

is, the AH increases with age; in relation to skin color, it was verified that people classified as

non- Caucasians presented 25.0% more AH than the individuals of the base category

(Caucasians).

Another Brazilian study stated that this prevalence in African-native peoples is due to

the low socioeconomic level, to intake of a high-sodium/low potassium diet and to poor

maternal nutrition that leads to low weight of the child at birth, and this in turn is associated

with the risk of developing AH in adulthood.

In the study of hypertension validity, it was found that the prevalence of hypertension

based on blood pressure measurement was 43.4%, and individuals with more than nine years
of education were 29.0% less likely to report the disease when compared those with lower

education.

Inversely, a study done in community pharmacies in Portugal, revealed a prevalence of

hypertension in the sample of 54.8% and was significantly higher in men (61%), increased with

age (the average predominated in 56 years old) and was more frequent in individuals with lower

education.

Risk Factors

The cardiovascular risk factors can be classified into two types: modifiable and non-

modifiable. The first are those who in a perspective of prevention we can intervene and correct,

and include smoking, dyslipidaemia (high cholesterol), diabetes mellitus, obesity, physical

inactivity, excessive alcohol consumption, high sodium intake, among others. A healthy

lifestyle has a positive influence on all these risk factors. Already the non-modifiable risk

factors are not subject to intervention, and involve the personal and family history of

cardiovascular disease.

Some authors claim that the blood pressure of an individual is determined by the

interaction between environmental and genetic factors (heredity), which generally refer to the

modifiable and non-modifiable factors, respectively.

`As to hereditary factors, studies developed in the pre-molecular era have proved that these

factors contribute at least 20% to 50% of the variation of blood pressure in humans. In a study

by Costa et al., the data demonstrated an association between positive family histories (for a

minimum of one parent) with increased prevalence of hypertension.

As for environmental factors, they are equally important in determining blood pressure

throughout life. Some studies state vigorously, that one or more of these factors may
permanently change physiological factors, predisposing the individual to an increased risk of

cardiovascular disease.

Dietary Factors

Dietary factors include: sodium, potassium and obesity, which are the most frequently

cited as being important risk factors for AH in most studies. As for sodium, there is a well-

documented relationship between sodium intake and hypertension in humans. Some studies

have also shown that, associated with the genetic factor, sodium intake leads to a rapid increase

in blood pressure. Another study found a positive correlation between sodium intake and blood

pressure, after adjusting for age, gender, body mass index (BMI), potassium and alcohol intake.

However, high sodium intake is not sufficient for the development of hypertension, as

not all people with high sodium content in the diet develop it. This phenomenon is called

sodium sensitivity. This sensitivity is more evident in patients with severe hypertension, obese

patients, African-native peoples, and people with a family history of AH, in the elderly and

hyper-aldosterone’s (characterized by elevated levels of plasma and urinary aldosterone,

suppression of plasma renin activity, hypokalaemia and metabolic alkalosis.

Results of different authors suggested that low potassium intake in the diet can be an

important function in the genesis of hypertension. A study done in children and adolescents

from 5 to 17 years old [12], showed that the sodium/potassium relation in diet is more important

in determining blood pressure in childhood than sodium intake alone.

In adults, the analogy of obesity and hypertension can be detected early in childhood

and has most relevant clinical due to the relationship with silent diseases such as dyslipidaemia

and diabetes mellitus type II. Several studies found that, when comparing AH with people of

adequate weight, overweight individuals were twice as likely to hypertension, while in those

with obesity this increase was 3.5 times. And a study of obese individuals in the age group
between 7 and 14 years old showed no difference between the same ages, and concluded that

it is the range of 13 and 14 years who has a higher prevalence of hypertension, differing from

the other ages studied.

Other Factors

In a study by Costa et al. [3], it was found that smokers had a higher prevalence rate

than non-smokers, and individuals who ingested alcohol were more likely to exhibit AH than

those who did not consume; the individuals who reported having diabetes mellitus showed

higher prevalence of hypertension. The same is also observed in several studies [13,16], such

as Oliveira-Martins et al. [13], in which hypertension was also more common in professionally

inactive individuals, diabetics and among those with a previous personal and family of

cardiovascular diseases; and in a study of elderly women [16], heart disease and diabetes were

significant associated factors since their occurrences are more likely to exhibit high blood

pressure.

Concerning stress, this contributes to a large number of diseases, both of a psychic and

organic nature, such as hypertension. Thus, it was found in the literature some studies that have

demonstrated the valid relation between AH and stress. In a study conducted by Fonseca et al.

[7], it was verified that hypertensive patients exhibit significant increase in blood pressure

when submitted to experimental stress sessions; and as well as in Oliveira’s et al. study [16],

except that in this study was of lower magnitude. So, people who are exposed to stress have a

high prevalence of developing high blood pressure. The genetic factor also influences the stress

response, since the offspring of hypertensive individuals have a higher BP increase in response

to stress factors than non-offspring

Raised blood pressure is a major risk factor for chronic heart disease, stroke, and

coronary heart disease. Elevated BP is positively correlated to the risk of stroke and coronary
heart disease. Other than coronary heart disease and stroke, its complications include heart

failure, peripheral vascular disease, renal impairment, retinal hemorrhage, and visual

impairment.

Essential hypertension

95% of all hypertension cases were categorized as essential hypertension that also

known as primary hypertension or idiopathic hypertension (Carretero et al., 2000). It is a

heterogeneous disorder as different patients have different factors that cause high blood

pressure (Carretero et al., 2000). The cause of essential hypertension is still unknown but it is

considered as the sum of interaction between genetic and multiple environmental factors

(Büssemaker et al., 2010). Environmental factors including obesity, high alcohol intake, high

salt intake, insulin resistance, low potassium intake, aging, sedentary lifestyles, stress, and low

calcium intake contribute to the development of hypertension (Carretero et al., 2000). Inherited

blood pressure (Bp) known as blood pressure that are genetically determined, while

hypertensinogenic factors are factors that cause high blood pressure such as obesity, high

alcohol and salt intake (Carretero et al., 2000). Various of gene might involve in the

development of hypertension can cause inherited blood pressure and the influences of these

genes have been demonstrated by family studies that showed high blood pressure are associated

among siblings and between parents and children (Carretero et al., 2000). Obesity is known as

important risk factor for type 2 diabetes and cardiovascular disease (CVD) (He et al., 2009). It

is associated with an incidence of hypertension and known to be one of powerful risk factors

for non-communicable diseases (Florencio et al., 2004). Obesity also acknowledge as the main

hypertensinogenic factor compared to high alcohol intake, high salt intake, stress, sedentary

lifestyles, dyslipidemia, low potassium and low calcium intake (Carretero et al., 2000).

According to the study in Shanghai on Chinese adults age 40 years and above, subject with

obesity are significantly has higher risk of hypertension and type 2 diabetes (He et al., 2009).
Obesity can cause insulin resistance, adult-onset diabetes mellitus, left ventricular hypertrophy,

hyperlipidemia and atherosclerotic disease (Carretero et al., 2000). However, the mechanism

of obesity raises blood pressure (Bp) is not fully understood (Carretero et al., 2000)

In young adults, particularly women, renal artery stenosis caused by fibromuscular

dysplasia is one of the most common secondary etiologies. Fibromuscular dysplasia can be

detected by abdominal magnetic resonance imaging or computed tomography. These same

imaging modalities can be used to detect atherosclerotic renal artery stenosis, a major cause of

secondary hypertension in older adults. In middle-aged adults, aldosteronism is the most

common secondary cause of hypertension, and the recommended initial diagnostic test is an

aldosterone/renin ratio.

Secondary hypertension

Secondary hypertension can be caused by medical conditions such as renal

parenchymal disease, renal artery stenosis, hyperaldosteronism, or pheochromocytoma

(Grossman et al., 2012). Temporary high blood pressure also can cause by medications such as

corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), cold medicines and birth

control pills. Corticosteroids such as prednisone and prednisolone will lead to Cushing

syndrome in long-term use. Usage of nonsteroidal anti-inflammatory drugs (NSAIDs) increase

blood pressure as well as will interfere in anti-hypertensive treatment, and abolish its effect

(Grossman et al., 2012). NSAIDs interfere in some of the antihypertensive agents such as beta-

blockers, diuretics agents as well as angiotensin converting enzyme inhibitors (ACEI), except

for calcium antagonist and central-acting drugs (Grossman et al., 2012). NSAIDS such as

indomethacin, naproxen band piroxicam were the greatest that involves in the increasing of

blood pressure, while rofecoxib raise systolic blood pressure more than celecoxib (Grossman

et al., 2012).
 Cold medicines such as pseudoephedrine hydrochloride that used for upper respiratory

decongestant may elevate blood pressure in hypertensive patients (Grossman et al., 2012).

Intake of birth control pills contributes in the increasing of blood pressure particularly in

women above 35 years old that overweight and smokers. Increasing of arterial blood pressure

can be caused by several factors such as increased in vascular resistance and initial increase in

volume. Neurogenic and humoral stimuli stimulates vasoconstriction of blood vessel and cause

renal volume retention that lead to increasing of cardiac output, tissue blood flow and vascular

resistance that has cause increasing of arterial blood pressure. Increasing of blood volume also

lead to vascular resistance thus induced blood pressure.

Negligence in blood pressure monitoring among young adults is common. They usually

have a false sense of security about medical conditions like hypertension and are more likely

to ignore the symptoms and be less disciplined when it comes to prevention and cure.

In a Coronary Artery Risk Development in Young Adults (CARDIA) study conducted

in the United States, it was found that 20% of 18-30-year-olds were hypertensive due to an

increase in lifestyle risk factors.

About 90-95% of cases are primary hypertension, which refers to high blood pressure

with no medical cause. Secondary hypertension, which counts for the remaining 5-10% of

cases, is caused by medical conditions that affect the kidneys, arteries, heart or endocrine

system, and can be reversible once the underlying cause is removed. Causes of secondary

hypertension in young adults include kidney disease, anatomical abnormality of the aorta,

obstructive sleep apnea syndrome, chronic obstructive pulmonary disease, and hypo or

hyperthyroidism. Young adult females may also have hypertension due to taking oral

contraceptives
Genetics

A family history of hypertension increases the risk of having primary hypertension,

even in young adults. If there is no known underlying medical cause and no lifestyle risk

factors, genetics is probably the reason why.

Obesity

The increasing rate of obesity has also contributed to the increasing rate of hypertension

among young adults. According to World Health Organisation (WHO), obesity rates have more

than doubled since 1980 with 1 in 10 of the world’s adult population considered to be clinically

obese. In a survey published in the Journal of American College Surgery, overweight people

have a higher chance of developing hypertension than someone of a normal weight with the

risk increasing as their weight goes up.

Lack of physical activity

When you exercise, hormones are released that relax your blood vessels and lower your

blood pressure. A lack of physical activity increases the risk of being overweight which in turn

raises the risk of developing hypertension.

Dietary factors

A diet that is too high in sodium can elevate your blood pressure, narrow blood vessels

and cause fluid retention. Young people tend to consume more processed food with high levels

of sodium, and this increases hypertension incidence.

Hypertension in Young Adults

Hypertension (high blood pressure) is known as a medical condition that affects older

people and is an age-related health risk. Unfortunately, there's been a global increase in

children, adolescents and young adults suffering from it too.

 CHAPTER III

METHODOLOGY

This chapter presents the research design which includes the research design, locale of

the study, respondents, and data gathering procedure, instrumentation, and statistical treatment.

Research Design
This research that sought to determine The Risk Factors of Hypertension among Young

Adults from Sarrat, Ilocos Norte. It utilized a combination of qualitative and quantitative

research methods. It described and compared qualitatively the risk factors of hypertension

among young adults in both quantitative and qualitative methods. Description of the eating

habits of the respondents was done quantitatively, while attributive relationships were

established qualitatively.

Population and Sampling

Young adults from Sarrat, Ilocos Norte who were diagnosed by hypertension comprised

the population. Two (2) respondents in each barangay composed the sample. Samples were

selected purposively.

Locale of the Study

This research was conducted in the different barangays of Sarrat, Ilocos Norte.

Sarrat is a fourth class municipality in the province of Ilocos Norte, Philippines. It is

situated geographically just southeast of Laoag City, the capital of the province. Sarrat is

bounded by the cities and municipalities of Batac to the southwest, San Nicolas to the west,

Laoag to the northwest, Piddig to the northeast, Dingras to the east, the town of Marcos to the

southeast, and a small portion of Banna to the south. The town is traversed and divided into

two by the Padsan River, creating a north and south areas that are connected by the Sarrat
Bridge. It is politically subdivided into 24 barangays. According to the last census of May

2010, Sarrat has a population of 24,770 people in 5,339 households.

The town is known as the birthplace of Ferdinand Marcos, the 10th President of the

Philippines and for Sarrat Church, the largest church in the province and an important cultural

property of the Philippines.

Data Gathering Procedure

The researchers requested permission to conduct this study from the different barangays

of Sarrat, Ilocos Norte including Sarrat National High School which were observed are located.

Only those who were diagnosed with hypertension were observed. After the request had been

approved, the researchers visited the barangays and Sarrat National High School to be observed

to confer with the respondents.

After they finish fill outing, interviews were conducted with the respondents during

which time the researchers asked questions depending on what was observed. From the results

of the observations and interviews, the risks of hypertension among young adults were

determined.

Statistical Tools and Treatment of Data

All the data gathered for the Risk Factors of Hypertension among Young Adults from

Sarrat, Ilocos Norte were statistically treated with scoring methods such as percentage,

frequency and arithmetic mean. These were used to determine the profile of the respondents

and their honest answers, reactions and emotions pertaining to the problem.

Computation for the Weighted Mean:

WM=TWS/N

Where AM = Weighted Mean;

 TWS = Total Weighted Score; and

N = Number of Respondents

Computation for the Percentage:

P=F/N (100)

Where P = Percentage

F = Frequency

N = Number of Respondents