The association of depression and central obesity on hypertension in Indonesian provinces: a path analysis of the Indonesian baseline health research 2018 data

Purpose: This study aims to analyse the direct and indirect relationship between the prevalence of depression and hypertension through central obesity in the Indonesian population. Material and methods: This quantitative analytical observational study is based on secondary data with a cross-sectional design. The data is taken from the Indonesian Baseline Health Research of the Health Research and Development Agency in 2018, which is aggregated data from survey results on household members in 34 Indonesian provinces. We used path analysis and the Sobel test using AMOS 23.0 program to assess the direct and indirect relationship of depression and obesity to hypertension. Multiple linear regression analysis was used to determine the effect of confounding factors on hypertension. Results: The average prevalence (+/- SD) of depression, central obesity and hypertension in 2018 was 6.21% (+/- 2.30), 31.26% (+/- 4.80), and 31.07% (+/- 4.76). There was an indirect positive relationship between depression and hypertension through central obesity (p = 0.041). The direct effect of depression was associated with a 17% chance of being centrally obese (p = 0.009), and the direct effect of depression and central obesity was associated with a 32.7% chance of becoming hypertensive (p = 0.001). There is no significant direct relationship between depression and hypertension. The effect of confounding factors on hypertension was 21.9% (p = 0.007), lower than the effect of depression and central obesity. Conclusion: Central obesity might be an intermediate variable linking depression and hypertension.