Hypertension is one of the most commonly encountered problems in primary health care and a major risk factor for other lethal diseases. Obesity, another arising problem in developing and developed countries, is another major risk factor for metabolic disease. However, studies about both diseases and their intercorrelation in rural areas are still limited. Therefore, we conducted this study to investigate the correlation between body mass index (BMI) and blood pressure in a rural area. This study was an observational, cross-sectional study performed in outpatients at Community Health Care of Ngronggot, a rural area in East Java for one month with inclusion criteria aged 18 years old, systole blood pressure (SBP) ≥140 and/or diastole blood pressure (DBP) ≥90, or a history of anti-hypertensive treatment. Information including age, gender, SBP, DBP, mean arterial pressure (MAP), body weight, and height was collected and calculated for its distribution and correlation using the Spearman rank-order correlation test. There were 201 subjects in this study, 65.7% of which were female, while 34.3% of which are male, and the median age was 59 years old. We also found that more than 60% of our participants were overweight and obese. The results of the Spearman test showed that BMI significantly correlated with SBP (p=0.029), DBP (p=0.016), and MAP (p=0.008). In conclusion, BMI had a positive correlation with blood pressure, and obesity was prevalent in our rural area population.
Small intestinal bacterial overgrowth (SIBO) is a condition that is characterized by an increased number of bacteria in the small intestine or an existence of bacteria type that generally should not be in the small intestine. In SIBO, the number of bacteria found in culture was more than 105 CFU (Colony-Forming unit) per ml. The fundamental problem in which SIBO occurred was the disruption in defensive mechanisms to prevent bacteria from overgrowing, including gastric acid juice, intestine motility, competent immune function, and intact anatomy. Disruption of this defensive mechanism will lead to SIBO, which furthermore will result in not only mild complications, such as abdominal complaints, but also severe complications, such as maldigestion/malabsorption, nutrient deficiency, or even systemic infection and acidosis. The manifestations of SIBO were often unclear so that it is hard to distinguish with other diseases, which much lead to misdiagnosis or underdiagnosis. Diagnosis of SIBO should be conducted very meticulously regarding underlying diseases that resulted in gastrointestinal defensive mechanism disturbance and malassimilation syndrome. Additional examinations for SIBO currently were jejunal aspiration and breath test, but both of them had their limitations in sensitivity and specificity. Therapeutical management consisted of treating the underlying diseases, eradicating bacteria with the antibiotic, particularly rifaximin, and improving nutritional deficiency.
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