Prevalence and Determinants of Pre-hypertension among Undergraduate Nursing Students of Private Health Sciences College

Mohammad Al-Shloul


Hypertension is a major public health concern worldwide; while most studies describe hypertension in older adults, there is scarce data on prehypertension in young. The aim of highlighting this new category of "prehypertension" is to raise public awareness about the cardiovascular risk associated with blood pressure in this range and the importance of taking preventive action. Also, it is to determine the frequency of prehypertension among undergraduate nursing students and the association between demographic factors and psychological factors with prehypertension. A cross-sectional study was conducted in 2018 among undergraduate nursing students of private health colleges. A convenience sample of 282 students participated in this study. The Arabic version of Depression, Anxiety, and Stress Scale-21 elicited depression, anxiety, and stress levels. Blood pressures were measured twice using a sphygmomanometer, and the averages were taken. Data analyses used descriptive and inferential statistics. Out of the total number of 282 participants included in this study, 7.5% (19.6% male; 5.1% female) have a systolic pressure of ≥130 mmHg, and 6.7% (10.9% male; 5.9% female) have a diastolic pressure of ≥85 mmHg. Significant gender differences were detected regarding employment status, smoking, study year, depression, stress, and systolic pressure (p<.05). Results showed significant anthropometric differences in systolic and diastolic pressure (p<.001), higher in elevated than normal. The level of depression was significantly associated with systolic prehypertension, while the level of stress was significantly different for diastolic prehypertension (p<.05). The prevalence rate of prehypertension and hypertension was quite high in the present study. Early identification of pre-hypertensive individuals and early intervention by implementing a healthier lifestyle have been discovered to slow the development of hypertension.


Keywords: prehypertension, hypertension, body mass index, depression, anxiety, stress.


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MILLS K. T., BUNDY J. D., KELLY T. N., REED J. E., KEARNEY P. M., REYNOLDS K., CHEN J., and HE J. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation, 2016, 134(6), 441-450.

SINGH K., ARYA V., and NAVARATNARAJAH N. Chronic kidney disease and cardiovascular disease: a focus on primary care. Cardiovascular & Hematological Disorders Drug Targets, 2014, 14(3), 212-218.

ARTHUR M. Institute for health metrics and evaluation. Nursing Standard, 2014, 28(42), 32. /10.7748/ns.28.42.32.s33

EL BCHERAOUI C., MEMISH Z. A., TUFFAHA M., DAOUD F., ROBINSON M., JABER S., MIKHITARIAN S., AL SAEEDI M., ALMAZROA M., MOKDAD A., and Al RABEEAH A. Hypertension and its associated risk factors in the Kingdom of Saudi Arabia, 2013: a national survey. International Journal of Hypertension, 2014, 564679.

DOUMAS M., KATSIKI N., and MIKHAILIDIS D. P. Prehypertension, the risk of hypertension and events. In: Prehypertension and Cardiometabolic Syndrome, Springer, Cham, 2019, 37-55.

GYAMFI D., OBIRIKORANG C., ACHEAMPONG E., DANQUAH K. O., ASAMOAH E. A., LIMAN F. Z., and BATU E. N. Prevalence of prehypertension and hypertension and its related risk factors among undergraduate students in a Tertiary institution, Ghana. Alexandria Journal of Medicine, 2018, 54(4), 475-480.

CHITRAPU R. V., & THAKKALLAPALLI Z. M. Prehypertension among medical students and its association with cardiovascular risk factors. Journal of Dr. Nandamuri Taraka Rama Rao University of Health Sciences, 2015, 4(1), 8-12.

DEBBARMA A., BHATTACHARJYA H., MOHANTY A., and MOG C. Prevalence of prehypertension and its relationship with body mass index among the medical students of Agartala government medical college. International Journal of Research in Medical Sciences, 2015, 3(5), 1097-1101.

HASSAN S. K., SOLIMAN M., EL-SALAMONY O., EL-KHASHAB K., and El-SHIRBINY N. A. E.-K. Study of hypertension among Fayoum university students. PhD thesis, Fayoum University, Al Fayoum, 2014.

AL-HAQWI A. I., AL-NASIR M., AHMAD N., MASAUDI E., ALOTAIBI S. S., and HAMAD B. Obesity and overweight in a major family practice center, central region, Saudi Arabia. Saudi Journal of Obesity, 2015, 3(1), 12-17.

DENG W. W., WANG J., LIU M. M., WANG D., ZHAO Y., LIU Y.-Q., WANG H., and DONG G.-H. Body mass index compared with abdominal obesity indicators in relation to prehypertension and hypertension in adults: the CHPSNE study. American Journal of Hypertension, 2013, 26(1), 58-67.

GRAHAM N., & SMITH D. J. Comorbidity of depression and anxiety disorders in patients with hypertension. Journal of Hypertension, 2016, 34(3), 397-398.

MERMERELIS A., KYVELOU S. M., VELLINGA A., PAPAGEORGIOU C., STEFANADIS C., and DOUZENIS A. Association between anxiety and depression symptoms with resistant hypertension and central hemodynamics: A pilot study. Hellenic Journal of Cardiology, 2016, 57(3), 203-204.

VENTURA H. O., & LAVIE C. J. Impact of comorbidities in hypertension. Current Opinion in Cardiology, 2016, 31(4), 374-375.

ALSHLOUL M. N., BDAIR I. A., and ALALYANI M. M. Severity of depression, anxiety, and stress among undergraduate health science students in Abha, Saudi Arabia. Open Journal of Psychiatry & Allied Sciences, 2021, 1-8.

SHAMSUDDIN K., FADZIL F., ISMAIL W. S. W., SHAH S. A., OMAR K., MUHAMMAD N. A., JAFFAR A., ISMAIL A., and MAHADEVAN R. Correlates of depression, anxiety and stress among Malaysian university students. Asian Journal of Psychiatry, 2013, 6(4), 318-323.

MAMOONA M., & NAJMA N. Depression, anxiety, stress and demographic determinants of hypertension disease. Pakistan Journal of Medical Sciences, 2014, 30(6), 1293-1298.

NISHIMURA R. A., OTTO C. M., BONOW R. O., CARABELLO B. A., ERWIN J. P., FLEISHER L. A., JNEID H., MACK M. J., MCLEOD C. J., O’GARA P. T., RIGOLIN V. H., SUNDT T. M., and THOMPSON A. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 2017, 70(2), 252-289.

ALDIAB A., SHUBAIR M. M., AL-ZAHRANI J. M., ALDOSSARI K. K., AL-GHAMDI S., HOUSEH M., RAZZAK H. A., EL-METWALLY A., and JRADI H. Prevalence of hypertension and prehypertension and its associated cardioembolic risk factors; a population based cross-sectional study in Alkharj, Saudi Arabia. BioMedCentral Public Health, 2018, 18(1327), 1-9.

MOHD FAUZI M. F., MAT SARUAN N. A., MOHD YUSOFF H., and MOHD TAMIL A. Prevalence and Determinants of Pre-Hypertension among Undergraduate Preclinical Medical Students in Central Malaysia. International Islamic University Malaysia Medical Journal Malaysia, 2019, 18(3), 65-72.

ALHAWARI H. H., AL-SHELLEH S., ALHAWARI H. H., AL-SAUDI A., AL-MAJALI D. A., AL-FARIS L., and AL-RYALAT S. A. Blood pressure and its association with gender, body mass index, smoking, and family history among university students. International Journal of Hypertension, 2018, 4186496.

ALSHLOUL M. N., & KHAMAISEH A. M. Hypertension among Faculty Members of Health Sciences College at South Saudi Arabia: Prevalence and Risk Factors. International Journal of Science and Research, 2017, 6(1), 145-150.

KHADER Y., BATIEHA A., JADDOU H., RAWASHDEH S. I., EL-KHATEEB M., HYASSAT D., KHADER A., and AJLOUNI K. Hypertension in Jordan: prevalence, awareness, control, and its associated factors. International Journal of Hypertension, 2019, 3210617.

IBRAHIM M. M., & DAMASCENO A. Hypertension in developing countries. The Lancet, 2012, 380(9841), 611-619.

JAIN J., MATHUR H., APTE S., SINHA U., AGARWAL K., and CHANCHLANI R. Prevalence of prehypertension and hypertension and its correlation with anthropometric measurements in medical students of Central India. Journal of Evolution of Medical and Dental Sciences, 2014, 3(10), 2429-2433.

KAZEMI T., HAJIHOSSEINI M., MASHREGHIMOGHADAM H., AZDAKI N., and ZIAEE M. Prevalence and determinants of hypertension among Iranian adults, Birjand, Iran. International Journal of Preventive Medicine, 2017, 8(1), 36.

GUPTA R., DEEDWANIA P. C., ACHARI V., BHANSALI A., GUPTA B. K., GUPTA A., MAHANTA T. G., ASIRVATHAM A. J., GUPTA S., MAHESHWARI A., SABOO B., JALI M. V., SINGH J., GUPTHA S., and SHARMA K. K. Normotension, prehypertension, and hypertension in urban middle-class subjects in India: prevalence, awareness, treatment, and control. American Journal of Hypertension, 2013, 26(1), 83-94.

MADIKA A. L., & MOUNIER-VEHIER C. Tabac et pression artérielle: une relation complexe à mieux connaître. Smoking and blood pressure: A complex relationship. La Presse Médicale, 2017, 46(7-8), 697-702.

BALAMI A. D., SALMIAH M. S., and NOR AFIAH M.Z. Psychological determinants of prehypertension among first year undergraduate students in a public university in Malaysia. Malaysian Journal of Public Health Medicine, 2014, 14(2), 67-76.


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