{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:10:27Z","timestamp":1791835827989,"version":"4.3.4"},"reference-count":47,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fogarty International Center of the National Institutes of Health","award":["U2RTW010088"],"award-info":[{"award-number":["U2RTW010088"]}]},{"DOI":"10.13039\/501100006378","name":"Universitas Indonesia","doi-asserted-by":"publisher","award":["NKB 579\/UN2.RST\/HKP.05.00\/2021"],"award-info":[{"award-number":["NKB 579\/UN2.RST\/HKP.05.00\/2021"]}],"id":[{"id":"10.13039\/501100006378","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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 \u201csilent killer\u201d among Indonesian farmers.<\/jats:p>","DOI":"10.3390\/ijerph19031152","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T22:40:20Z","timestamp":1642718420000},"page":"1152","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Determinants of Hypertension amongst Rice Farmers in West Java, Indonesia"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-7923","authenticated-orcid":false,"given":"Nurhayati Adnan","family":"Prihartono","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9371-1642","authenticated-orcid":false,"given":"Laila","family":"Fitria","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doni Hikmat","family":"Ramdhan","sequence":"additional","affiliation":[{"name":"Department of Occupational Health and Safety, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-0722","authenticated-orcid":false,"given":"Fitriyani","family":"Fitriyani","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1076-8534","authenticated-orcid":false,"given":"Sifa","family":"Fauzia","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1562-1945","authenticated-orcid":false,"given":"Susan","family":"Woskie","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Massachusetts Lowell, One University Ave, Lowell, MA 01854-2867, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S0140-6736(12)60861-7","article-title":"Hypertension in developing countries","volume":"380","author":"Ibrahim","year":"2012","journal-title":"Lancet"},{"key":"ref_2","first-page":"1284","article-title":"The global epidemiology of hypertension","volume":"23","author":"Mills","year":"2021","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.cjca.2014.02.020","article-title":"Hypertension in developing countries","volume":"30","author":"Tibazarwa","year":"2014","journal-title":"Can. J. Cardiol."},{"key":"ref_4","unstructured":"Ministry of Health of Republic of Indonesia (2019). Basic Health Research Year 2018."},{"key":"ref_5","unstructured":"Ministry of Health of Republic of Indonesia (2019). West Java Province Basic Health Research Year 2018."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5610725","DOI":"10.1155\/2018\/5610725","article-title":"The prevalence and social determinants of hypertension among adults in Indonesia: A cross-sectional population-based national survey","volume":"2018","author":"Peltzer","year":"2018","journal-title":"Int. J. Hypertens."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-017-2966-1","article-title":"Prevalence and associated factors of hypertension among adults in Ethiopia: A community based cross-sectional study","volume":"10","author":"Asresahegn","year":"2017","journal-title":"BMC Res. Notes"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5491838","DOI":"10.1155\/2017\/5491838","article-title":"Prevalence and associated risk factors of hypertension: A cross-sectional study in Urban Varanasi","volume":"2017","author":"Singh","year":"2017","journal-title":"Int. J. Hypertens."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"425","DOI":"10.5271\/sjweh.1170","article-title":"Shift work, occupational noise, physical workload with ensuing development of blood pressure and their joint effect on the risk of coronary heart disease","volume":"33","author":"Virkkunen","year":"2007","journal-title":"Scand J. Work Environ. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1161\/01.HYP.0000238327.41911.52","article-title":"Work hours and self-reported hypertension among working people in California","volume":"48","author":"Yang","year":"2006","journal-title":"Hypertension"},{"key":"ref_11","unstructured":"Nenonen, N., Saarela, K.L., Takala, J., and Manickam, K. (2014). Global Estimates of Occupational Accidents and Work-Related Illnesses 2014, Tampere University of Technology. Made for the ILO Report at XX World Congress in Frankfurt."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"776","DOI":"10.3390\/ijerph10030776","article-title":"Does farming have an effect on health status? A comparison study in west Greece","volume":"10","author":"Demos","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1440-1584.2012.01273.x","article-title":"Cardiovascular risk factors and psychological distress in Australian farming communities","volume":"20","author":"Brumby","year":"2012","journal-title":"Aust. J. Rural Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e142","DOI":"10.1097\/MD.0000000000000142","article-title":"Associations of blood pressure with common factors among lety-behind farmers in Rural China: A cross sectional study using quantile regression analysis","volume":"94","author":"Shen","year":"2015","journal-title":"Medicine"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Manus, M.B., Gerald, S., and Leonard, G.S.B.A.S. (2018). High prevalence of hypertension in an agricultural village in Madagascar. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201616"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e12249","DOI":"10.1002\/1348-9585.12249","article-title":"Association between occupations and selected non-communicable diseases: A matched case-control among Thai informal workers","volume":"63","author":"Tipayamongkholgul","year":"2021","journal-title":"J. Occup. Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kongtip, P., Nankongnab, N., Tipayamongkholgul, M., Bunngamchairat, A., Yimsabai, J., Pataitiemthong, A., and Woskie, S. (2018). A cross-sectional investigation of cardiovascular and metabolic biomarkers among conventional and organic farmers in Thailand. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15112590"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Fitria, L., Prihartono, N.A., Ramdhan, D.H., Wahyono, T.Y.M., Kongtip, P., and Woskie, S. (2020). Environmental and occupational risk factors associated with chronic kidney disease of unknown etiology in West Javanese rice farmers, Indonesia. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17124521"},{"key":"ref_19","unstructured":"National Heart Lung and Blood Institute (NHLBI) National Institute of Health (2021, October 06). The Seventh of Joint Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) 2003, Available online: https:\/\/www.nhlbi.nih.gov\/files\/docs\/guidelines\/jnc7full.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Caplin, B., Jakobsson, K., Glaser, J., Nitsch, D., Jha, V., Singh, A., Correa-Rotter, R., and Pearce, N. (2017). International collaboration for the epidemiology of eGFR in low and middle income populations\u2014rationale and core protocol for the disadvantaged populations eGFR Epidemiology Study (DEGREE). BMC Nephrol., 18.","DOI":"10.1186\/s12882-016-0417-1"},{"key":"ref_21","unstructured":"Central Bureau Statistic of Indonesia (2014). Population Income Classification."},{"key":"ref_22","unstructured":"World Health Organization (2021, October 06). The Asia-Pacific Perspective: Redefining Obesity and its Treatment, Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/206936\/0957708211_eng.pdf."},{"key":"ref_23","unstructured":"American Diabetes Association (2021, November 17). Diagnosis. Available online: https:\/\/www.diabetes.org\/a1c\/diagnosis."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Fitria, L., Prihartono, N.A., Ramdhan, D.H., and Woskie, S. (2020). Reply to \u201cComment on Fitria et al. \u2018Environmental and occupational risk factors associated with chronic kidney disease of unknown etiology in West Javanese rice farmers, Indonesia\u2019 Int. J. Environ. Res. Public Health, 2020, 17, 4521\u201d. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17197273"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1136\/oem.55.4.272","article-title":"Prevalence odds ratio or prevalence ratio in the analysis of cross-sectional data: What is to be done?","volume":"55","author":"Thompson","year":"1998","journal-title":"Occup. Environ. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Barros, A.J., and Hirakata, V.N. (2003). Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio. BMC Med. Res. Methodol., 3.","DOI":"10.1186\/1471-2288-3-21"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/HJH.0b013e32833310e0","article-title":"The association between smoking and hypertension in a population-based sample of Vietnamese men","volume":"28","author":"Thuy","year":"2010","journal-title":"J. Hypertens."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"245","DOI":"10.4330\/wjc.v6.i5.245","article-title":"Alcohol-induced hypertension: Mechanism and prevention","volume":"26","author":"Husain","year":"2014","journal-title":"World J. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/jrh.12001","article-title":"Alcohol consumption, obesity, and psychological distress in farming communities\u2014an Australian study","volume":"29","author":"Brumby","year":"2013","journal-title":"J. Rural Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.3892\/etm.2016.3667","article-title":"Obesity and hypertension (Review)","volume":"12","author":"Jiang","year":"2016","journal-title":"Exp. Ther. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.3109\/0886022X.2015.1052951","article-title":"Undiagnosed hypertension in a rural community in Sudan and association with some features of the metabolic syndrome: How serious is the situation?","volume":"37","author":"Bushara","year":"2015","journal-title":"Ren. Fail."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Boonruksa, P., Maturachon, T., and Kongtip, P. (2020). Heat stress, physiological response, and heat-related symptoms among Thai sugarcane workers. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17176363"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.envres.2015.07.007","article-title":"Heatstress, dehydration, and kidney function in sugarcane cutters in El Salvador--A cross-shift study of workers at risk of Mesoamerican nephropathy","volume":"142","author":"Wesseling","year":"2015","journal-title":"Environ. Res."},{"key":"ref_34","unstructured":"Silverthorn, D.U. (2019). Human Physiology: An Integrated Approach, Pearson Education. [8th ed.]."},{"key":"ref_35","unstructured":"Parsons, K. (2003). Human Thermal Environments: The Effects of Hot, Moderate and Cold Environments on Human Health, Comfort and Performance, CRC Press. [3rd ed.]."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/00004872-198512000-00001","article-title":"Vasopressin in circulatory control and hypertension","volume":"3","author":"Johnston","year":"1985","journal-title":"J. Hypertens."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/19338244.2012.701245","article-title":"Prevalence of systemic arterial hypertension, electrocardiogram abnormalities, and noise-induced hearing loss in agricultural workers","volume":"68","author":"Tomei","year":"2013","journal-title":"Arch. Environ. Occup. Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/ajh\/hpv093","article-title":"Pesticide exposure and cardiovascular hemodynamic parameters among male workers involved in mosquito control in East Coast of Malaysia","volume":"29","author":"Samsuddin","year":"2016","journal-title":"Am. J. Hypertens."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kongtip, P., Nankongnab, N., Kallayanatham, N., Pundee, R., Yimsabai, J., and Woskie, S. (2020). Longitudinal study of metabolic biomarkers among conventional and organic farmers in Thailand. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17114178"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Hung, D.Z., Yang, H.J., Li, Y.F., Lin, C.L., Chang, S.Y., Sung, F.C., and Tai, S.C.W. (2015). The long-term effects of organophosphates poisoning as a risk factor of CVDs: A nationwide population-based cohort study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0137632"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e012569","DOI":"10.1161\/JAHA.119.012569","article-title":"Association between occupational exposure to pesticides and cardiovascular disease incidence: The Kuakini Honolulu heart program","volume":"8","author":"Berg","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kongtip, P., Nankongnab, N., Pundee, R., Kallayanatham, N., Pengpumkiat, S., Chungcharoen, J., Phommalachai, C., Konthonbut, P., Choochouy, N., and Sowanthip, P. (2021). Acute changes in thyroid hormone levels among Thai pesticide sprayers. Toxics, 9.","DOI":"10.3390\/toxics9010016"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1210\/jc.2006-2208","article-title":"Association between blood pressure and serum thyroid-stimulating hormone concentration within the reference range: A population-based study","volume":"92","author":"Asvold","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Damalas, C., and Koutroubas, S. (2016). Farmers\u2019 exposure to pesticides: Toxicity types and ways of prevention. Toxics, 4.","DOI":"10.3390\/toxics4010001"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Wang, G.B., Lan, Y.B., Yuan, H.Z., Qi, H.X., Chen, P.C., Ouyang, F., and Han, Y.X. (2019). Comparison of spray deposition, control efficacy on wheat aphids and working efficiency in the wheat field of the unmanned aerial vehicle with boom sprayer and two conventional knapsack sprayers. Appl. Sci., 9.","DOI":"10.3390\/app9020218"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1080\/03601234.2011.589309","article-title":"Pesticide risk assessment: A study on inhalation and dermal exposure to 2,4-D and paraquat among Malaysian paddy farmers","volume":"46","author":"Baharuddin","year":"2011","journal-title":"J. Environ. Sci. Health Part B"},{"key":"ref_47","unstructured":"(2020, October 26). RAND Indonesian Family Life Survey (IFLS)|RAND. Available online: https:\/\/www.rand.org\/well-being\/social-and-behavioral-policy\/data\/FLS\/IFLS.html."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1152\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:04:47Z","timestamp":1760133887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,20]]},"references-count":47,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19031152"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19031152","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,20]]}}}