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. 2022 Dec 30;22(1):334.
doi: 10.1186/s12902-022-01244-8.

Identifying factors associated with of blood pressure using Structural Equation Modeling: evidence from a large Kurdish cohort study in Iran

Farid Najafi  1 , Mehdi Moradinazar  1 , Shahab Rezayan  1 , Reza Azarpazhooh  2 , Parastoo Jamshidi  3
Affiliations

Identifying factors associated with of blood pressure using Structural Equation Modeling: evidence from a large Kurdish cohort study in Iran

Farid Najafi et al. BMC Endocr Disord. .

Abstract

Background: Identifying the risk factors leading to hypertension can help explain why some populations are at a greater risk for developing hypertension than others. The present study seeks to identify the association between the risk factors of hypertension in 35- to 65-year-old participants in western Iran.

Methods: This cross-sectional study was conducted on 9705 adults from baseline data of Ravansar Non-Communicable Disease (RaNCD) cohort study, in the west region of Iran. Each of the latent variables were confirmed by confirmatory factor analysis. Using Structural Equation Modeling (SEM), we assessed the direct and indirect effects of factors associated with blood pressure.

Results: Socioeconomic status (SES), physical activity, mean of serum lipids, obesity, diabetes and family history of hypertension had a diverse impact on the blood pressure, directly and (or) indirectly. The standardized total effect of SES, physical activity, mean of serum lipids, and obesity were -0.09 vs. -0.14, -0.04 vs. -0.04, 0.13 vs. 0.13 and 0.24 vs. 0.15 in men and women, respectively. Diabetes had a direct relationship with the blood pressure in women (0.03).

Conclusion: With regard to control of high blood pressure, public health interventions must target obesity, lifestyle and other risk related to nutritional status such as hyperlipidemia and hyperglycemia in Iranian population and among those with higher SES.

Keywords: Blood pressure; Diabetes; Obesity; Physical activity; Risk factors; Structural Equation Modeling.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The conceptual model diagram for association between risk factors and blood pressure. SES socioeconomic status, SBP systolic blood pressure, DBP diastolic Blood pressure, WC waist circumference, BMI body mass index, WHR waist to hip ratio, LDL low-density lipoproteins, TC total cholesterol, HDL High-density lipoprotein, HTNfamily Family history of hypertension, HTNdrug antihypertensive drugs
Fig. 2
Fig. 2
Structural equation models for assessing direct and indirect effects of different risk factors on blood pressure, for males, by standardized path coefficient and goodness of fit indices. "e" represent the errors. SBP systolic blood pressure; DBP diastolic blood pressure; WHR waist to hip ratio; BMI body mass index; SES socioeconomic status, WC waist circumference, LDL low-density lipoproteins, TC total cholesterol, HDL High-density lipoprotein, HTNfamily Family history of hypertension, HTNdrug antihypertensive drugs
Fig. 3
Fig. 3
Structural equation models for assessing direct and indirect effects of different risk factors on blood pressure, for females, by standardized path coefficient and goodness of fit indices. "e" represent the errors. SBP systolic blood pressure; DBP diastolic blood pressure; WHR waist to hip ratio; BMI body mass index; SES socioeconomic status, WC waist circumference, LDL low-density lipoproteins, TC total cholesterol, HDL High-density lipoprotein, HTNfamily Family history of hypertension, HTNdrug antihypertensive drugs
See this image and copyright information in PMC

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