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l J
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lt
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Science
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I
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S)
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
,
p
p
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6
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co
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Predic
tors
of bloo
d pressure
am
o
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adults:
the
ro
le o
f
lifes
tyle
a
nd bo
dy
com
po
sitio
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E
v
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a
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h
o
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v
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th
e
re
lativ
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c
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o
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s
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s
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th
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g
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m
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t
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g
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d
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d
y
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p
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siti
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re
m
o
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str
o
n
g
ly
a
ss
o
c
iate
d
with
b
lo
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d
p
re
ss
u
re
t
h
a
n
li
fe
st
y
le
b
e
h
a
v
io
rs.
In
c
o
rp
o
ra
ti
n
g
b
o
d
y
a
g
e
a
n
d
b
o
d
y
c
o
m
p
o
siti
o
n
a
ss
e
ss
m
e
n
ts
in
to
c
a
rd
io
v
a
sc
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lar
ris
k
sc
re
e
n
in
g
m
a
y
imp
r
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y
p
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n
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p
re
v
e
n
ti
o
n
a
n
d
e
a
rly
in
terv
e
n
ti
o
n
stra
teg
ies
.
K
ey
w
o
r
d
s
:
B
io
lo
g
ical
ag
in
g
B
o
d
y
co
m
p
o
s
itio
n
B
o
d
y
f
at
d
is
tr
ib
u
tio
n
L
if
esty
le
Sk
eleta
l m
u
s
cle
Sy
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Yu
n
u
s
E
lo
n
Facu
lty
o
f
Nu
r
s
in
g
,
Un
iv
er
s
ita
s
Ad
v
en
t I
n
d
o
n
esia
B
an
d
u
n
g
,
I
n
d
o
n
esia
E
m
ail:
y
u
n
u
s
.
elo
n
@
u
n
ai.
ed
u
1.
I
NT
RO
D
UCT
I
O
N
Hy
p
er
ten
s
io
n
r
em
ain
s
o
n
e
o
f
th
e
m
o
s
t
s
ig
n
if
ican
t
g
lo
b
al
p
u
b
lic
h
ea
lth
p
r
o
b
lem
s
a
n
d
is
a
lead
in
g
co
n
tr
ib
u
to
r
to
ca
r
d
io
v
ascu
lar
d
is
ea
s
e,
s
tr
o
k
e,
k
id
n
ey
f
ai
lu
r
e,
an
d
p
r
em
atu
r
e
m
o
r
tality
wo
r
ld
wid
e
[
1
]
.
Acc
o
r
d
in
g
to
th
e
W
o
r
ld
Hea
l
th
Or
g
an
izatio
n
,
ap
p
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o
x
im
ately
1
.
4
b
illi
o
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lts
ag
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3
0
–
7
9
y
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r
s
liv
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with
h
y
p
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ten
s
io
n
,
a
n
d
n
ea
r
ly
h
alf
ar
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u
n
awa
r
e
o
f
th
eir
c
o
n
d
iti
o
n
.
T
h
e
in
c
r
ea
s
in
g
p
r
ev
alen
c
e
o
f
elev
ated
b
lo
o
d
p
r
ess
u
r
e
h
as
b
ec
o
m
e
a
m
ajo
r
co
n
ce
r
n
,
p
ar
ticu
lar
ly
in
lo
w
-
an
d
m
id
d
le
-
in
c
o
m
e
c
o
u
n
tr
ie
s
wh
er
e
p
r
e
v
en
tiv
e
s
tr
ateg
ies
an
d
ea
r
ly
d
etec
tio
n
r
em
ain
lim
ited
.
Per
s
is
ten
t
h
y
p
er
ten
s
io
n
s
u
b
s
tan
tially
in
cr
ea
s
es
h
ea
lth
ca
r
e
b
u
r
d
e
n
an
d
n
eg
ativ
ely
a
f
f
ec
ts
q
u
ality
o
f
life
,
m
ak
in
g
id
en
ti
f
icatio
n
o
f
m
o
d
if
iab
le
d
eter
m
i
n
an
ts
an
im
p
o
r
ta
n
t
p
u
b
lic
h
ea
lth
p
r
io
r
ity
[
2
]
.
B
lo
o
d
p
r
ess
u
r
e
is
in
f
lu
e
n
ce
d
b
y
m
u
ltip
le
i
n
ter
r
elate
d
f
ac
t
o
r
s
,
in
clu
d
in
g
d
em
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
,
life
s
ty
le
b
eh
av
io
r
s
,
an
d
b
o
d
y
co
m
p
o
s
itio
n
.
L
if
esty
le
-
r
elate
d
f
ac
to
r
s
s
u
ch
as
p
h
y
s
ical
in
ac
tiv
ity
,
u
n
h
ea
lth
y
d
ietar
y
h
ab
its
,
s
m
o
k
in
g
,
alco
h
o
l
co
n
s
u
m
p
tio
n
,
in
ad
eq
u
ate
s
le
ep
,
an
d
s
ed
en
tar
y
b
eh
av
i
o
r
h
av
e
co
n
s
is
ten
tly
b
ee
n
ass
o
ciate
d
with
in
c
r
ea
s
ed
ca
r
d
i
o
v
ascu
lar
r
is
k
an
d
h
y
p
er
ten
s
io
n
[
3
]
,
[
4
]
.
T
h
e
I
n
d
o
n
esian
Min
is
tr
y
o
f
Hea
lth
em
p
h
asizes
th
at
h
ea
lth
y
life
s
ty
le
m
o
d
if
icatio
n
r
em
ai
n
s
o
n
e
o
f
t
h
e
m
o
s
t
ef
f
ec
tiv
e
a
p
p
r
o
ac
h
es
f
o
r
b
lo
o
d
p
r
ess
u
r
e
p
r
ev
en
tio
n
an
d
c
o
n
tr
o
l.
L
i
f
esty
le
in
ter
v
e
n
tio
n
s
in
clu
d
in
g
r
eg
u
lar
p
h
y
s
ical
ac
tiv
ity
,
b
alan
ce
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
6
6
9
-
677
670
n
u
tr
itio
n
,
s
m
o
k
in
g
ce
s
s
atio
n
,
an
d
weig
h
t
m
a
n
ag
em
en
t
s
ig
n
i
f
ican
tly
co
n
tr
ib
u
te
to
r
ed
u
ci
n
g
b
lo
o
d
p
r
ess
u
r
e
a
n
d
ca
r
d
io
v
ascu
lar
m
o
r
b
i
d
ity
[
5
]
.
I
n
r
ec
en
t
y
e
a
r
s
,
in
cr
ea
s
in
g
a
tten
tio
n
h
as
b
ee
n
d
ir
ec
te
d
to
war
d
th
e
r
o
le
o
f
b
o
d
y
co
m
p
o
s
itio
n
in
ca
r
d
io
v
ascu
lar
h
ea
lth
.
T
r
a
d
itio
n
al
o
b
esit
y
ass
ess
m
en
t
u
s
in
g
b
o
d
y
m
ass
in
d
ex
(
B
MI
)
m
ay
n
o
t
ad
eq
u
atel
y
r
ef
lect
b
o
d
y
f
at
d
is
tr
ib
u
tio
n
o
r
m
u
s
cle
c
o
m
p
o
s
itio
n
.
C
o
n
s
eq
u
en
tly
,
b
o
d
y
co
m
p
o
s
itio
n
in
d
icato
r
s
s
u
ch
as
v
is
ce
r
al
f
at,
s
k
eleta
l
m
u
s
cle
m
ass
,
b
o
d
y
f
at
p
er
ce
n
tag
e,
a
n
d
b
o
d
y
ag
e
h
av
e
em
e
r
g
ed
as
p
o
ten
tially
m
o
r
e
in
f
o
r
m
ativ
e
p
r
ed
icto
r
s
o
f
m
et
ab
o
lic
an
d
ca
r
d
io
v
ascu
lar
r
is
k
.
E
x
ce
s
s
v
is
ce
r
al
ad
ip
o
s
ity
h
as
b
ee
n
ass
o
ciate
d
with
s
y
s
tem
ic
i
n
f
lam
m
atio
n
,
in
s
u
lin
r
esis
tan
ce
,
en
d
o
th
elial
d
y
s
f
u
n
ctio
n
,
an
d
ac
tiv
atio
n
o
f
n
eu
r
o
h
o
r
m
o
n
al
p
ath
way
s
th
at
co
n
tr
ib
u
te
t
o
e
lev
ated
b
lo
o
d
p
r
ess
u
r
e.
C
o
n
v
er
s
ely
,
r
ed
u
ce
d
s
k
eleta
l
m
u
s
c
le
m
ass
h
as
b
ee
n
lin
k
ed
to
im
p
air
ed
m
eta
b
o
lic
r
eg
u
latio
n
an
d
p
o
o
r
er
ca
r
d
io
v
a
s
cu
l
ar
o
u
tco
m
es [
6
]
.
Sev
er
al
r
ec
en
t
s
tu
d
ies
h
a
v
e
in
v
esti
g
ated
th
e
r
elatio
n
s
h
ip
b
etwe
en
b
o
d
y
co
m
p
o
s
itio
n
a
n
d
b
lo
o
d
p
r
ess
u
r
e.
On
e
o
f
t
h
e
s
tu
d
ies
d
em
o
n
s
tr
ated
th
at
tr
u
n
k
f
at
m
as
s
was
o
n
e
o
f
th
e
s
tr
o
n
g
est
co
n
tr
ib
u
to
r
s
to
s
y
s
to
lic
an
d
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
am
o
n
g
y
o
u
n
g
an
d
m
id
d
le
-
ag
ed
ad
u
lts
,
wh
ile
m
u
s
cle
m
ass
also
in
d
ep
en
d
en
tly
co
n
tr
ib
u
ted
to
b
lo
o
d
p
r
ess
u
r
e
v
ar
iatio
n
[
6
]
.
L
ik
ewise,
o
th
e
r
r
esear
ch
r
ep
o
r
te
d
s
ig
n
if
ican
t a
s
s
o
ciatio
n
s
b
etwe
en
b
o
d
y
f
at
d
is
tr
ib
u
tio
n
,
lea
n
b
o
d
y
m
ass
,
an
d
b
lo
o
d
p
r
ess
u
r
e
lev
els,
em
p
h
asizin
g
th
e
im
p
o
r
t
an
ce
o
f
ev
al
u
atin
g
b
o
d
y
co
m
p
o
s
itio
n
b
e
y
o
n
d
co
n
v
en
tio
n
al
B
MI
m
ea
s
u
r
em
en
t
s
[
7
]
.
Fu
r
th
er
m
o
r
e,
a
n
o
th
er
f
o
u
n
d
t
h
at
lean
b
o
d
y
m
ass
was
p
o
s
itiv
ely
ass
o
ciate
d
with
b
lo
o
d
p
r
ess
u
r
e
am
o
n
g
ad
u
lts
,
an
d
th
at
th
e
r
elatio
n
s
h
ip
v
ar
ied
ac
co
r
d
i
n
g
to
ag
e
an
d
b
o
d
y
f
at
d
is
tr
ib
u
tio
n
[
8
]
.
Similar
ly
,
a
n
I
n
d
o
n
esian
co
m
m
u
n
ity
-
b
ased
s
tu
d
y
r
e
p
o
r
ted
th
at
b
o
d
y
m
ass
in
d
ex
was
s
ig
n
if
ican
tly
ass
o
ciate
d
with
b
o
th
s
y
s
to
lic
an
d
d
ia
s
to
lic
b
lo
o
d
p
r
ess
u
r
e,
wh
e
r
ea
s
s
ev
er
al
b
eh
av
io
r
al
f
ac
to
r
s
s
h
o
wed
in
co
n
s
is
ten
t
ass
o
ciatio
n
s
,
h
ig
h
lig
h
ti
n
g
th
e
n
ee
d
f
o
r
m
o
r
e
c
o
m
p
r
e
h
en
s
iv
e
b
o
d
y
c
o
m
p
o
s
itio
n
ass
es
s
m
en
ts
b
ey
o
n
d
c
o
n
v
e
n
tio
n
al
an
th
r
o
p
o
m
etr
ic
m
ea
s
u
r
em
en
ts
[
9
]
.
R
ec
en
t
ev
id
en
ce
h
as
also
h
ig
h
lig
h
ted
th
e
im
p
o
r
tan
ce
o
f
life
s
ty
le
f
ac
to
r
s
in
r
elatio
n
to
b
o
d
y
co
m
p
o
s
itio
n
a
n
d
ca
r
d
io
m
etab
o
lic
o
u
tco
m
es.
Stu
d
ies
r
e
p
o
r
t
ed
th
at
p
h
y
s
ical
ac
tiv
ity
an
d
s
ed
en
tar
y
b
eh
av
io
r
s
s
ig
n
if
ican
tly
in
f
l
u
en
ce
b
o
d
y
c
o
m
p
o
s
itio
n
p
ar
am
eter
s
an
d
ca
r
d
io
v
ascu
lar
h
ea
lth
o
u
tc
o
m
es.
A
s
tu
d
y
f
o
u
n
d
th
a
t
p
h
y
s
ical
ac
tiv
ity
,
a
g
e,
a
n
d
b
o
d
y
co
m
p
o
s
itio
n
wer
e
s
ig
n
if
ican
tly
ass
o
ciate
d
with
p
h
y
s
io
lo
g
ical
h
ea
lth
in
d
icato
r
s
m
ea
s
u
r
ed
th
r
o
u
g
h
b
io
elec
tr
ical
im
p
ed
an
ce
an
aly
s
is
[
1
0
]
-
[
1
2
]
.
Similar
ly
,
th
e
o
th
er
s
tu
d
y
d
em
o
n
s
tr
ated
th
at
s
ed
en
tar
y
life
s
ty
le
b
eh
av
io
r
s
wer
e
ass
o
ci
ated
with
u
n
f
av
o
r
a
b
le
b
o
d
y
c
o
m
p
o
s
itio
n
ch
an
g
es
an
d
m
etab
o
lic
d
is
tu
r
b
an
ce
s
[
1
3
]
.
T
h
ese
f
in
d
i
n
g
s
s
u
g
g
est
th
at
life
s
ty
le
an
d
b
o
d
y
co
m
p
o
s
itio
n
ar
e
clo
s
ely
in
ter
co
n
n
ec
ted
an
d
m
ay
jo
i
n
tly
co
n
tr
ib
u
te
to
b
l
o
o
d
p
r
ess
u
r
e
r
eg
u
latio
n
.
Alth
o
u
g
h
p
r
ev
io
u
s
s
tu
d
ies
h
av
e
p
r
o
v
id
e
d
v
alu
a
b
le
in
s
ig
h
ts
,
s
ev
er
al
im
p
o
r
ta
n
t
g
a
p
s
r
em
ain
u
n
r
eso
lv
ed
.
First,
m
an
y
s
tu
d
ie
s
h
av
e
f
o
cu
s
ed
p
r
im
ar
ily
o
n
B
MI
o
r
g
en
er
al
o
b
esit
y
in
d
icato
r
s
with
o
u
t
in
co
r
p
o
r
atin
g
co
m
p
r
eh
en
s
iv
e
b
o
d
y
co
m
p
o
s
itio
n
p
ar
am
ete
r
s
s
u
ch
as
v
is
ce
r
al
f
at,
s
k
eleta
l
m
u
s
cle
m
ass
,
an
d
b
o
d
y
a
g
e
m
ea
s
u
r
ed
th
r
o
u
g
h
b
i
o
elec
tr
ical
im
p
ed
an
ce
an
aly
s
is
[
1
4
]
-
[
1
7
]
.
Seco
n
d
,
m
a
n
y
p
r
ev
io
u
s
in
v
esti
g
atio
n
s
ev
alu
ated
life
s
ty
le
f
ac
to
r
s
o
r
b
o
d
y
c
o
m
p
o
s
itio
n
s
ep
ar
atel
y
,
wh
er
ea
s
f
ewe
r
s
tu
d
ies
h
av
e
s
im
u
ltan
eo
u
s
ly
ex
am
in
ed
t
h
eir
co
m
b
in
ed
co
n
tr
ib
u
tio
n
to
b
lo
o
d
p
r
ess
u
r
e
[
1
8
]
-
[
2
1
]
.
T
h
ir
d
,
ev
id
e
n
ce
f
r
o
m
ad
u
lt
co
m
m
u
n
ity
p
o
p
u
latio
n
s
in
I
n
d
o
n
esia
r
e
m
ain
s
lim
ited
,
p
ar
ticu
la
r
ly
r
eg
ar
d
in
g
th
e
i
n
teg
r
atio
n
o
f
l
if
esty
le
p
atter
n
s
an
d
d
etailed
b
o
d
y
co
m
p
o
s
itio
n
in
d
icato
r
s
in
b
lo
o
d
p
r
ess
u
r
e
r
e
s
ea
r
ch
.
I
n
ad
d
itio
n
,
m
o
s
t
p
r
e
v
io
u
s
s
tu
d
ies
wer
e
co
n
d
u
cte
d
in
h
o
s
p
ital
s
ettin
g
s
o
r
lar
g
e
u
r
b
an
p
o
p
u
latio
n
s
,
l
im
itin
g
th
e
u
n
d
er
s
tan
d
in
g
o
f
ca
r
d
io
v
ascu
lar
r
is
k
d
eter
m
in
an
ts
with
in
co
m
m
u
n
it
y
-
b
ased
ad
u
lt p
o
p
u
latio
n
s
.
T
h
er
ef
o
r
e,
th
is
s
tu
d
y
aim
s
to
a
n
aly
ze
th
e
d
eter
m
in
an
ts
o
f
b
lo
o
d
p
r
ess
u
r
e
a
m
o
n
g
ad
u
lts
b
y
e
x
am
in
in
g
th
e
r
o
le
o
f
life
s
ty
le
p
atter
n
s
an
d
b
o
d
y
c
o
m
p
o
s
itio
n
in
d
i
ca
to
r
s
,
in
clu
d
in
g
b
o
d
y
m
ass
in
d
ex
,
v
is
ce
r
al
f
at,
s
k
eleta
l
m
u
s
cle
m
ass
,
an
d
b
o
d
y
ag
e
m
ea
s
u
r
ed
u
s
in
g
OM
R
O
N
Kar
ad
a
Scan
b
io
elec
tr
ical
i
m
p
ed
an
ce
an
aly
s
is
.
Un
lik
e
p
r
e
v
io
u
s
s
tu
d
ies
t
h
at
f
o
cu
s
ed
o
n
ly
o
n
o
b
esit
y
in
d
icato
r
s
o
r
is
o
lated
lif
esty
le
f
ac
to
r
s
,
th
e
p
r
esen
t
s
tu
d
y
i
n
teg
r
ates
b
eh
a
v
io
r
al
an
d
p
h
y
s
io
lo
g
ical
m
ea
s
u
r
em
en
ts
s
im
u
ltan
eo
u
s
ly
wit
h
in
a
co
m
m
u
n
it
y
-
b
ased
ad
u
lt
p
o
p
u
latio
n
.
T
h
is
s
tu
d
y
is
ex
p
ec
ted
to
co
n
t
r
ib
u
te
to
th
e
g
r
o
win
g
b
o
d
y
o
f
ev
id
en
ce
r
eg
ar
d
i
n
g
m
o
d
if
iab
le
d
eter
m
in
a
n
ts
o
f
b
lo
o
d
p
r
ess
u
r
e
a
n
d
p
r
o
v
id
e
u
s
ef
u
l
in
f
o
r
m
atio
n
f
o
r
ea
r
ly
p
r
e
v
en
tio
n
s
tr
ateg
ies,
n
u
r
s
in
g
in
ter
v
e
n
tio
n
s
,
an
d
c
o
m
m
u
n
ity
h
ea
lth
p
r
o
m
o
tio
n
p
r
o
g
r
am
s
tar
g
etin
g
ca
r
d
io
v
ascu
lar
r
is
k
r
ed
u
ctio
n
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n a
nd
pa
rt
icipa
nts
T
h
is
co
m
m
u
n
ity
-
b
ased
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
y
was
co
n
d
u
cted
in
C
ih
an
ju
an
g
R
ah
ay
u
Villag
e,
I
n
d
o
n
esia,
b
etwe
en
No
v
em
b
er
2
0
2
4
an
d
Ma
r
ch
2
0
2
5
.
A
to
tal
o
f
1
6
7
ad
u
lts
ag
ed
≥
1
8
y
ea
r
s
wer
e
r
ec
r
u
ited
t
h
r
o
u
g
h
p
u
r
p
o
s
iv
e
s
am
p
lin
g
t
o
in
v
esti
g
ate
th
e
ass
o
ciatio
n
s
o
f
life
s
ty
le
f
ac
to
r
s
an
d
b
o
d
y
co
m
p
o
s
itio
n
with
b
lo
o
d
p
r
ess
u
r
e.
Par
ticip
an
ts
wer
e
elig
ib
le
if
th
ey
wer
e
p
er
m
an
e
n
t
r
esid
en
ts
an
d
p
r
o
v
id
e
d
in
f
o
r
m
e
d
co
n
s
en
t.
T
h
o
s
e
with
co
n
d
itio
n
s
th
at
c
o
u
ld
af
f
ec
t
b
o
d
y
co
m
p
o
s
itio
n
o
r
b
lo
o
d
p
r
ess
u
r
e
m
ea
s
u
r
em
en
ts
wer
e
ex
clu
d
ed
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
r
ed
icto
r
s
o
f b
lo
o
d
p
r
ess
u
r
e
a
mo
n
g
a
d
u
lts
:
th
e
r
o
le
o
f lifest
yle
a
n
d
b
o
d
y
c
o
mp
o
s
itio
n
(
E
ve
l
in
Ma
lin
ti
)
671
2
.
2
.
Da
t
a
c
o
llect
io
n
Data
wer
e
co
llected
u
s
in
g
s
ta
n
d
ar
d
ized
p
r
o
ce
d
u
r
es
b
y
tr
ain
ed
r
esear
ch
ass
is
tan
ts
.
Dem
o
g
r
ap
h
ic
an
d
life
s
ty
le
-
r
elate
d
in
f
o
r
m
atio
n
wer
e
o
b
tain
ed
u
s
in
g
a
s
tr
u
ctu
r
ed
q
u
esti
o
n
n
air
e.
T
h
e
life
s
ty
le
s
co
r
e
co
n
s
is
ted
o
f
s
ev
er
al
b
eh
av
io
r
al
co
m
p
o
n
en
t
s
,
in
clu
d
in
g
p
h
y
s
ical
ac
tiv
ity
,
d
ietar
y
h
ab
its
,
s
leep
/r
est
p
atter
n
s
,
an
d
s
m
o
k
in
g
b
eh
av
io
r
,
with
h
ig
h
er
s
co
r
es i
n
d
icatin
g
h
ea
lth
ie
r
life
s
ty
les.
B
o
d
y
co
m
p
o
s
itio
n
p
ar
am
eter
s
,
in
clu
d
in
g
B
MI
,
b
o
d
y
f
at
p
er
ce
n
tag
e,
s
k
eleta
l
m
u
s
cle
m
ass
,
an
d
b
o
d
y
ag
e,
wer
e
m
ea
s
u
r
e
d
u
s
in
g
th
e
Om
r
o
n
Kar
a
d
a
Scan
HB
F
-
3
7
5
b
io
elec
tr
ical
im
p
ed
a
n
ce
an
a
ly
s
is
(
B
I
A)
d
ev
ice.
Sy
s
to
lic
an
d
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
wer
e
m
ea
s
u
r
ed
u
n
d
er
s
tan
d
ar
d
ized
co
n
d
itio
n
s
ac
co
r
d
in
g
t
o
th
e
m
an
u
f
ac
tu
r
er
’
s
g
u
id
elin
es.
All
in
s
tr
u
m
en
ts
wer
e
ca
lib
r
ated
p
r
io
r
to
d
ata
co
llectio
n
to
en
s
u
r
e
m
ea
s
u
r
em
en
t
r
eliab
ilit
y
.
Data
wer
e
r
ec
o
r
d
ed
im
m
ed
iately
an
d
v
er
if
ied
to
m
ain
tain
ac
cu
r
ac
y
.
2
.
3
.
St
a
t
is
t
ica
l
a
na
ly
s
is
Data
wer
e
an
aly
ze
d
u
s
in
g
I
B
M
SP
S
S
Statis
tic
s
.
Descr
ip
tiv
e
s
tatis
tics
wer
e
u
s
ed
to
s
u
m
m
ar
ize
p
ar
ticip
an
t
ch
ar
ac
ter
is
tic
s
.
Var
iab
le
n
o
r
m
ality
was
ass
ess
e
d
u
s
in
g
th
e
Sh
ap
ir
o
–
W
ilk
test
.
B
ec
au
s
e
s
ev
er
al
v
ar
iab
les
wer
e
n
o
t
n
o
r
m
ally
d
is
tr
ib
u
ted
,
Sp
ea
r
m
an
’
s
r
an
k
co
r
r
elatio
n
an
al
y
s
is
was
p
er
f
o
r
m
ed
t
o
ex
am
in
e
ass
o
ciatio
n
s
b
etwe
en
s
tu
d
y
v
ar
iab
les.
Sep
ar
ate
m
u
ltip
le
lin
ea
r
r
eg
r
ess
io
n
m
o
d
els
wer
e
co
n
s
tr
u
cted
f
o
r
s
y
s
to
lic
an
d
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
o
u
tco
m
es
to
ev
alu
ate
th
e
p
r
e
d
ictiv
e
r
o
les
o
f
life
s
ty
l
e
s
co
r
e,
b
o
d
y
ag
e,
m
u
s
cle
m
ass
,
B
MI
,
an
d
b
o
d
y
f
at.
Mo
d
el
f
it
was
ass
ess
ed
u
s
in
g
R
²
an
d
ad
ju
s
ted
R
²
v
al
u
es,
wh
ile
s
tatis
tical
s
ig
n
if
ican
c
e
was
d
eter
m
in
ed
u
s
in
g
th
e
F
-
test
an
d
s
tan
d
ar
d
ized
b
eta
co
e
f
f
icien
ts
.
A
p
-
v
alu
e
<
0
.
0
5
was
co
n
s
id
er
ed
s
tatis
tically
s
ig
n
if
ican
t.
2
.
4
.
E
t
hica
l
c
o
ns
idera
t
io
ns
T
h
is
s
tu
d
y
was
co
n
d
u
cted
in
ac
co
r
d
an
ce
with
th
e
eth
ical
p
r
in
cip
les
o
f
th
e
Dec
lar
atio
n
o
f
Helsin
k
i
an
d
r
ec
eiv
ed
et
h
ical
ex
em
p
tio
n
ap
p
r
o
v
al
f
r
o
m
th
e
E
th
ics
C
o
m
m
ittee
o
f
th
e
Facu
lty
o
f
Nu
r
s
in
g
,
Un
iv
er
s
itas
Ad
v
en
t
I
n
d
o
n
esia
(
No
.
3
8
7
/K
E
PK
-
FIK
.
UNAI
/EC/
V/2
4
)
.
Pe
r
m
is
s
io
n
to
c
o
n
d
u
ct
th
e
s
tu
d
y
was
o
b
tain
ed
f
r
o
m
th
e
lo
ca
l
au
th
o
r
ities
o
f
C
ih
an
ju
an
g
R
ah
ay
u
Villag
e.
W
r
itten
in
f
o
r
m
e
d
co
n
s
en
t
was
o
b
tain
ed
f
r
o
m
all
p
ar
ticip
an
ts
p
r
io
r
to
d
ata
c
o
llectio
n
.
Par
ticip
atio
n
was
v
o
lu
n
ta
r
y
,
a
n
d
p
ar
ticip
an
t
co
n
f
id
e
n
tiality
an
d
an
o
n
y
m
ity
wer
e
s
tr
ictly
m
ai
n
tain
ed
th
r
o
u
g
h
o
u
t
th
e
s
tu
d
y
.
Par
ticip
an
ts
wer
e
in
f
o
r
m
e
d
o
f
th
eir
r
i
g
h
t
t
o
with
d
r
aw
f
r
o
m
th
e
s
tu
d
y
at
an
y
tim
e
with
o
u
t p
e
n
alty
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
T
ab
le
1
s
u
m
m
a
r
izes
th
e
d
em
o
g
r
a
p
h
ic,
life
s
ty
le,
b
o
d
y
co
m
p
o
s
itio
n
,
an
d
b
lo
o
d
p
r
ess
u
r
e
ch
ar
ac
ter
is
tics
o
f
th
e
p
ar
ticip
a
n
ts
.
T
h
e
m
ea
n
ag
e
was
4
3
.
7
7
y
ea
r
s
(
SD
=
1
2
.
0
0
)
,
with
a
m
e
an
life
s
ty
le
s
co
r
e
o
f
1
4
.
9
0
(
SD
=
3
.
8
7
)
.
T
h
e
m
ea
n
s
k
eleta
l
m
u
s
cle
m
ass
was
2
5
.
0
0
k
g
(
SD
=
5
.
8
9
)
,
wh
ile
th
e
m
ea
n
b
o
d
y
a
g
e
was
4
9
.
5
0
y
ea
r
s
(
SD
=
1
3
.
7
6
)
.
R
eg
ar
d
in
g
b
o
d
y
co
m
p
o
s
itio
n
,
t
h
e
m
ea
n
B
MI
was
2
7
.
2
6
k
g
/m
²
(
SD
=
6
.
5
4
)
a
n
d
th
e
m
ea
n
b
o
d
y
f
at
p
e
r
ce
n
tag
e
wa
s
3
1
.
4
6
%
(
SD
=
8
.
6
6
)
.
T
h
e
m
ea
n
s
y
s
to
lic
an
d
d
iast
o
lic
b
l
o
o
d
p
r
ess
u
r
es
wer
e
1
3
5
.
3
5
m
m
Hg
(
SD =
2
4
.
6
7
)
a
n
d
8
7
.
8
7
m
m
Hg
(
SD =
1
6
.
5
2
)
,
r
esp
ec
tiv
ely
.
Ov
er
all,
p
ar
ticip
an
ts
ex
h
ib
ite
d
an
elev
ated
ca
r
d
io
v
ascu
lar
r
is
k
p
r
o
f
ile,
ch
a
r
ac
ter
ized
b
y
o
v
er
weig
h
t
s
tatu
s
,
h
ig
h
b
o
d
y
f
at
p
e
r
ce
n
ta
g
e,
an
d
b
lo
o
d
p
r
ess
u
r
e
lev
els
co
n
s
is
ten
t
with
Stag
e
1
Hy
p
er
ten
s
io
n
.
T
h
e
f
in
d
in
g
th
at
m
ea
n
b
o
d
y
ag
e
ex
ce
ed
e
d
ch
r
o
n
o
lo
g
ical
ag
e
f
u
r
th
er
s
u
g
g
ests
th
e
p
r
esen
ce
o
f
ac
ce
ler
ated
p
h
y
s
io
lo
g
ical
ag
in
g
.
T
h
is
ac
ce
ler
ated
p
h
y
s
io
lo
g
ical
ag
in
g
m
ay
co
n
tr
i
b
u
te
to
in
cr
ea
s
ed
ca
r
d
io
m
et
ab
o
lic
r
is
k
in
th
is
co
m
m
u
n
ity
.
T
ab
le
1
.
Descr
ip
tiv
e
ch
a
r
ac
ter
is
tics
o
f
ag
e,
life
s
ty
le,
b
o
d
y
co
m
p
o
s
itio
n
,
an
d
b
lo
o
d
p
r
ess
u
r
e
am
o
n
g
p
a
r
ticip
an
ts
V
a
r
i
a
b
l
e
M
e
a
n
SD
M
i
n
M
a
x
I
n
t
e
r
p
r
e
t
a
t
i
o
n
A
g
e
4
3
.
7
7
12
30
78
La
t
e
a
d
u
l
t
h
o
o
d
Li
f
e
st
y
l
e
s
c
o
r
e
1
4
.
9
3
.
8
7
5
24
M
o
d
e
r
a
t
e
l
i
f
e
s
t
y
l
e
l
e
v
e
l
S
k
e
l
e
t
a
l
mu
s
c
l
e
m
a
ss
25
5
.
8
9
13
45
M
o
d
e
r
a
t
e
m
u
sc
l
e
m
a
ss
B
o
d
y
a
g
e
4
9
.
5
1
3
.
7
6
17
88
Ea
r
l
y
e
l
d
e
r
l
y
(
h
i
g
h
e
r
t
h
a
n
c
h
r
o
n
o
l
o
g
i
c
a
l
a
g
e
,
i
n
d
i
c
a
t
i
n
g
r
e
l
a
t
i
v
e
l
y
p
o
o
r
e
r
me
t
a
b
o
l
i
c
h
e
a
l
t
h
)
B
M
I
(
k
g
/
m²
)
2
7
.
2
6
6
.
5
4
17
55
O
v
e
r
w
e
i
g
h
t
To
t
a
l
b
o
d
y
f
a
t
(
%)
3
1
.
4
6
8
.
6
6
8
56
H
i
g
h
b
o
d
y
f
a
t
l
e
v
e
l
S
y
st
o
l
i
c
B
P
(
mm
H
g
)
1
3
5
.
3
5
2
4
.
6
7
90
2
2
5
S
t
a
g
e
1
H
y
p
e
r
t
e
n
s
i
o
n
D
i
a
st
o
l
i
c
B
P
(
mm
H
g
)
8
7
.
8
7
1
6
.
5
2
60
1
8
0
S
t
a
g
e
1
H
y
p
e
r
t
e
n
s
i
o
n
N
o
t
e
:
B
M
I
c
l
a
ssi
f
i
c
a
t
i
o
n
b
a
s
e
d
o
n
W
H
O
(
2
0
0
0
)
a
n
d
b
l
o
o
d
p
r
e
ss
u
r
e
c
l
a
ssi
f
i
c
a
t
i
o
n
b
a
se
d
o
n
A
C
C
/
A
H
A
H
y
p
e
r
t
e
n
s
i
o
n
G
u
i
d
e
l
i
n
e
(
2
0
1
7
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
6
6
9
-
677
672
T
ab
le
2
p
r
esen
ts
th
e
co
r
r
elati
o
n
s
b
etwe
en
life
s
ty
le
f
ac
to
r
s
,
b
o
d
y
co
m
p
o
s
itio
n
v
ar
ia
b
les,
an
d
b
lo
o
d
p
r
ess
u
r
e.
Ag
e
an
d
b
o
d
y
a
g
e
wer
e
s
ig
n
if
ican
tly
an
d
p
o
s
i
tiv
ely
co
r
r
elate
d
with
s
y
s
to
li
c
b
lo
o
d
p
r
ess
u
r
e,
in
d
icatin
g
th
at
in
cr
ea
s
in
g
ch
r
o
n
o
lo
g
ical
an
d
p
h
y
s
io
lo
g
i
ca
l
ag
e
m
ay
co
n
tr
ib
u
te
t
o
h
ig
h
er
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
lev
els.
B
o
d
y
ag
e
also
d
em
o
n
s
tr
ated
a
s
ig
n
if
ican
t
p
o
s
itiv
e
co
r
r
elatio
n
with
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e,
s
u
g
g
esti
n
g
th
at
ac
ce
ler
ated
p
h
y
s
io
lo
g
ical
ag
in
g
m
ay
b
e
ass
o
ciate
d
with
im
p
air
ed
ca
r
d
io
v
a
s
cu
lar
r
eg
u
latio
n
.
Am
o
n
g
th
e
b
o
d
y
co
m
p
o
s
itio
n
v
ar
iab
les,
B
MI
s
h
o
we
d
s
ig
n
if
ican
t
p
o
s
itiv
e
c
o
r
r
elatio
n
s
with
b
o
th
s
y
s
to
lic
an
d
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e,
wh
er
ea
s
to
tal
b
o
d
y
f
at
p
er
ce
n
tag
e
was sig
n
if
ican
tly
a
s
s
o
ciate
d
o
n
ly
with
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
No
t
ab
ly
,
B
MI
e
x
h
ib
ited
th
e
s
tr
o
n
g
est
co
r
r
elatio
n
with
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
(
r
=
0
.
3
5
8
,
p
<
0
.
0
0
1
)
,
f
o
llo
w
ed
b
y
b
o
d
y
ag
e
(
r
=
0
.
3
3
7
,
p
<
0
.
0
0
1
)
an
d
to
tal
b
o
d
y
f
at
p
e
r
ce
n
tag
e
(
r
=
0
.
3
0
8
,
p
<
0
.
0
0
1
)
.
T
h
ese
f
in
d
in
g
s
s
u
g
g
est
th
at
ex
ce
s
s
ad
ip
o
s
ity
m
ay
p
la
y
an
im
p
o
r
tan
t
r
o
le
in
b
lo
o
d
p
r
ess
u
r
e
r
eg
u
latio
n
,
p
a
r
ticu
lar
ly
i
n
r
elatio
n
to
d
ia
s
to
lic
b
l
o
o
d
p
r
ess
u
r
e.
I
n
co
n
tr
ast,
life
s
ty
le
s
co
r
e
a
n
d
s
k
eleta
l
m
u
s
cle
m
ass
wer
e
n
o
t
s
ig
n
if
ican
tly
a
s
s
o
ciate
d
with
eith
er
s
y
s
to
lic
o
r
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
Ov
er
all,
th
e
r
esu
lts
in
d
icate
th
at
p
h
y
s
io
lo
g
ical
ag
i
n
g
an
d
ad
ip
o
s
ity
-
r
elate
d
m
ea
s
u
r
es
ap
p
ea
r
to
b
e
m
o
r
e
s
tr
o
n
g
ly
ass
o
ciate
d
with
b
lo
o
d
p
r
ess
u
r
e
th
an
life
s
ty
le
b
eh
av
io
r
s
in
th
is
s
tu
d
y
p
o
p
u
latio
n
.
T
ab
le
2
.
C
o
r
r
elatio
n
s
o
f
life
s
ty
le
an
d
b
o
d
y
co
m
p
o
s
itio
n
v
ar
i
ab
les with
s
y
s
to
lic
an
d
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
(
n
=
1
6
7
)
P
r
e
d
i
c
t
o
r
S
B
P
r
(
p
-
v
a
l
u
e
)
D
B
P
r
(
p
-
v
a
l
u
e
)
Li
f
e
st
y
l
e
s
c
o
r
e
-
0
.
1
2
0
(
0
.
1
2
2
)
0
.
0
0
8
(
0
.
9
2
0
)
A
g
e
0
.
3
0
6
(
<
0
.
0
0
1
)
0
.
1
3
0
(
0
.
0
9
4
)
B
o
d
y
a
g
e
0
.
2
7
4
(
<
0
.
0
0
1
)
0
.
3
3
7
(
<
0
.
0
0
1
)
B
M
I
(
k
g
/
m²
)
0
.
1
8
2
(
0
.
0
1
8
)
0
.
3
5
8
(
<
0
.
0
0
1
)
To
t
a
l
b
o
d
y
f
a
t
(
%)
0
.
0
8
6
(
0
.
2
7
1
)
0
.
3
0
8
(
<
0
.
0
0
1
)
S
k
e
l
e
t
a
l
mu
s
c
l
e
m
a
ss (
k
g
)
-
0
.
0
8
9
(
0
.
2
5
3
)
-
0
.
1
0
6
(
0
.
1
7
3
)
N
o
t
e
:
r
=
S
p
e
a
r
m
a
n
'
s ra
n
k
c
o
r
r
e
l
a
t
i
o
n
c
o
e
f
f
i
c
i
e
n
t
;
p
-
v
a
l
u
e
s
a
r
e
s
h
o
w
n
i
n
p
a
r
e
n
t
h
e
ses.
S
B
P
=
s
y
s
t
o
l
i
c
b
l
o
o
d
p
r
e
ss
u
r
e
;
D
B
P
=
d
i
a
st
o
l
i
c
b
l
o
o
d
p
r
e
ss
u
r
e
;
B
M
I
=
b
o
d
y
mass
i
n
d
e
x
.
T
ab
le
3
p
r
esen
ts
th
e
m
u
ltip
l
e
lin
ea
r
r
eg
r
ess
io
n
m
o
d
el
p
r
ed
ictin
g
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
f
r
o
m
life
s
ty
le
s
co
r
e,
b
o
d
y
ag
e,
s
k
el
etal
m
u
s
cle
m
ass
,
B
MI
,
an
d
to
t
al
b
o
d
y
f
at
p
e
r
ce
n
tag
e.
T
h
e
o
v
er
all
m
o
d
el
was
s
tatis
t
ically
s
ig
n
if
ican
t
(
F
=
3
.
8
0
3
,
p
=
.
0
0
3
)
,
in
d
icatin
g
th
at
th
e
p
r
e
d
icto
r
s
co
llectiv
ely
ex
p
lain
ed
a
s
ig
n
if
ica
n
t
p
r
o
p
o
r
tio
n
o
f
v
ar
ia
b
ilit
y
in
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e.
T
h
e
m
o
d
el
ac
co
u
n
ted
f
o
r
1
0
.
6
%
o
f
th
e
v
a
r
ia
n
ce
in
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
(
R
²
=
.
1
0
6
)
,
with
a
n
ad
ju
s
ted
R
²
o
f
.
0
7
8
.
T
h
e
ef
f
ec
t
s
ize
(
C
o
h
en
’
s
f
²
=
.
1
1
9
)
in
d
icate
d
a
s
m
all
-
to
-
m
o
d
e
r
ate
p
r
ac
tical
ef
f
ec
t,
s
u
g
g
esti
n
g
th
at
t
h
e
m
o
d
el
p
r
o
v
id
es
a
m
ea
n
in
g
f
u
l,
alth
o
u
g
h
lim
ited
,
ex
p
lan
atio
n
o
f
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
v
ar
iatio
n
.
T
h
at,
B
=
u
n
s
tan
d
ar
d
ized
r
eg
r
ess
io
n
co
ef
f
icien
t;
SE
=
s
tan
d
ar
d
er
r
o
r
;
β
=
s
tan
d
ar
d
iz
ed
r
eg
r
ess
io
n
co
ef
f
icien
t;
t
=
t
-
v
alu
e;
p
=
s
ig
n
if
ican
ce
lev
el;
s
r
²
=
s
q
u
ar
ed
s
em
i
-
p
ar
tial
co
r
r
elatio
n
(
u
n
iq
u
e
v
ar
ian
ce
ex
p
lain
ed
b
y
ea
ch
p
r
ed
icto
r
)
.
D
ep
e
n
d
en
t
v
ar
iab
le:
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e.
Am
o
n
g
th
e
p
r
e
d
icto
r
s
,
b
o
d
y
ag
e
was
th
e
o
n
ly
v
ar
iab
le
s
ig
n
if
ican
tly
ass
o
ciate
d
with
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
(
B
=
0
.
5
5
7
,
SE
=
0
.
1
7
8
,
β
=
.
3
1
1
,
p
=
.
0
0
2
)
.
T
h
e
p
o
s
itiv
e
co
ef
f
icien
t
in
d
icate
s
th
at
in
d
iv
id
u
als
with
h
ig
h
er
b
o
d
y
a
g
e
ten
d
ed
to
h
av
e
h
ig
h
er
s
y
s
to
lic
b
l
o
o
d
p
r
ess
u
r
e.
L
if
esty
le
s
co
r
e
d
e
m
o
n
s
tr
ated
a
n
e
g
ativ
e
ass
o
ciatio
n
with
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
(
B
=
−
0
.
9
0
8
,
β
=
−.
1
4
2
)
,
alth
o
u
g
h
th
e
r
elatio
n
s
h
ip
d
id
n
o
t
r
ea
ch
s
tatis
t
ical
s
ig
n
if
ican
ce
(
p
=
.
0
6
9
)
.
L
ik
ewise,
s
k
e
letal
m
u
s
cle
m
ass
,
B
MI
,
an
d
to
tal
b
o
d
y
f
at
p
er
ce
n
tag
e
wer
e
n
o
t sig
n
if
ican
t p
r
ed
icto
r
s
.
B
ased
o
n
th
e
s
em
i
-
p
ar
tial
s
q
u
ar
ed
co
r
r
elatio
n
s
(
s
r
²)
,
b
o
d
y
ag
e
ex
p
lain
ed
th
e
lar
g
e
s
t
u
n
iq
u
e
p
r
o
p
o
r
tio
n
o
f
v
a
r
ian
ce
i
n
s
y
s
t
o
lic
b
lo
o
d
p
r
ess
u
r
e
(
5
.
7
%).
T
h
e
co
n
tr
ib
u
tio
n
s
o
f
life
s
ty
le
s
c
o
r
e,
s
k
eleta
l
m
u
s
cle
m
ass
,
B
MI
,
an
d
to
tal
b
o
d
y
f
at
p
er
ce
n
tag
e
wer
e
co
m
p
ar
ativ
el
y
s
m
all.
Ov
er
all,
th
ese
f
in
d
in
g
s
s
u
g
g
est th
at
b
o
d
y
ag
e
is
a
m
o
r
e
in
f
lu
en
tial
d
eter
m
in
an
t
o
f
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
th
a
n
life
s
ty
le
an
d
b
o
d
y
co
m
p
o
s
itio
n
v
a
r
iab
les
i
n
th
is
p
o
p
u
latio
n
.
T
ab
le
3
.
Mu
ltip
le
lin
ea
r
r
eg
r
ess
io
n
m
o
d
el
p
r
ed
ictin
g
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e
(
n
=
1
6
7
)
P
r
e
d
i
c
t
o
r
B
SE
β
t
p
sr
²
C
o
n
st
a
n
t
1
2
6
.
9
6
2
1
5
.
6
3
9
—
8
.
1
1
8
<
.
0
0
1
—
Li
f
e
st
y
l
e
s
c
o
r
e
−
0
.
9
0
8
0
.
4
9
5
−
0
.
1
4
2
−
1
.
8
3
3
.
0
6
9
.
0
2
0
B
o
d
y
a
g
e
0
.
5
5
7
0
.
1
7
8
.
3
1
1
3
.
1
2
3
.
0
0
2
*
.
0
5
7
S
k
e
l
e
t
a
l
mu
s
c
l
e
m
a
ss (
k
g
)
−
0
.
1
2
4
0
.
3
3
7
−
.
0
3
0
−
0
.
3
6
9
.
7
1
3
.
0
0
1
B
M
I
(
k
g
/
m²
)
0
.
3
1
9
0
.
3
4
8
.
0
8
4
.
9
1
6
.
3
6
1
.
0
0
5
To
t
a
l
b
o
d
y
f
a
t
(
%)
−
0
.
3
5
5
0
.
3
0
0
−
.
1
2
5
−
1
.
1
8
5
.
2
3
8
.
0
0
9
N
o
t
e
:
M
o
d
e
l
st
a
t
i
s
t
i
c
s:
R
=
.
3
2
5
,
R
² =
.
1
0
6
,
A
d
j
u
st
e
d
R
²
=
.
0
7
8
,
F
(
5
,
1
6
1
)
=
3
.
8
0
3
,
p
=
.
0
0
3
,
C
o
h
e
n
's f²
=
.
1
1
9
.
Ef
f
e
c
t
si
z
e
i
n
t
e
r
p
r
e
t
a
t
i
o
n
b
a
s
e
d
o
n
C
o
h
e
n
(
1
9
8
8
)
*
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
r
ed
icto
r
s
o
f b
lo
o
d
p
r
ess
u
r
e
a
mo
n
g
a
d
u
lts
:
th
e
r
o
le
o
f lifest
yle
a
n
d
b
o
d
y
c
o
mp
o
s
itio
n
(
E
ve
l
in
Ma
lin
ti
)
673
T
ab
le
4
p
r
esen
ts
th
e
m
u
ltip
le
lin
ea
r
r
e
g
r
ess
io
n
m
o
d
el
p
r
ed
ictin
g
d
iast
o
lic
b
lo
o
d
p
r
es
s
u
r
e
f
r
o
m
life
s
ty
le
s
co
r
e,
b
o
d
y
ag
e,
s
k
el
etal
m
u
s
cle
m
ass
,
B
MI
,
an
d
to
tal
b
o
d
y
f
at
p
e
r
ce
n
tag
e.
T
h
e
o
v
er
all
m
o
d
el
was
s
tatis
t
ically
s
ig
n
if
ican
t
(
F
=
5
.
4
2
0
,
p
<
.
0
0
1
)
,
in
d
icatin
g
th
at
th
e
p
r
e
d
icto
r
s
co
llectiv
ely
ex
p
lain
ed
a
s
ig
n
if
ica
n
t
p
r
o
p
o
r
tio
n
o
f
v
ar
iab
ilit
y
in
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
T
h
e
m
o
d
el
ac
co
u
n
ted
f
o
r
1
4
.
4
%
o
f
th
e
v
ar
ian
ce
in
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
(
R
²
=
.
1
4
4
)
,
with
an
ad
ju
s
ted
R
²
o
f
.
1
1
7
.
T
h
e
e
f
f
ec
t
s
ize
(
C
o
h
en
'
s
f
²
=
.
1
6
8
)
in
d
icate
d
a
m
o
d
er
ate
p
r
ac
tical
ef
f
ec
t,
s
u
g
g
esti
n
g
m
ea
n
in
g
f
u
l
e
x
p
lan
at
o
r
y
p
o
wer
o
f
th
e
m
o
d
el.
T
h
at,
B
=
u
n
s
tan
d
a
r
d
ized
r
eg
r
ess
io
n
co
e
f
f
icien
t;
SE
=
s
tan
d
ar
d
er
r
o
r
;
β
=
s
tan
d
a
r
d
ized
r
eg
r
ess
io
n
c
o
ef
f
icien
t;
t
=
t
-
v
alu
e;
p
=
s
ig
n
if
ican
ce
lev
el;
s
r
²
=
s
q
u
ar
ed
s
em
i
-
p
ar
tial
co
r
r
elatio
n
(
u
n
iq
u
e
v
ar
ian
ce
ex
p
lain
e
d
b
y
ea
ch
p
r
ed
icto
r
)
.
Dep
en
d
en
t
v
ar
iab
le:
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
Am
o
n
g
th
e
p
r
ed
icto
r
s
,
s
k
eleta
l
m
u
s
cle
m
ass
(
B
=
0
.
4
8
3
,
S
E
=
0
.
2
2
1
,
β
=
.
1
7
2
,
p
=
.
0
3
0
)
an
d
to
tal
b
o
d
y
f
at
p
er
ce
n
tag
e
(
B
=
0
.
4
7
3
,
SE
=
0
.
1
9
6
,
β
=
.
2
4
8
,
p
=
.
0
1
7
)
wer
e
s
ig
n
if
ica
n
t
p
o
s
itiv
e
p
r
ed
icto
r
s
o
f
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
T
h
e
s
e
f
in
d
in
g
s
in
d
icate
th
at
in
d
iv
id
u
als
with
h
ig
h
er
m
u
s
cle
m
ass
an
d
b
o
d
y
f
at
ten
d
ed
to
h
av
e
h
ig
h
er
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
lev
els.
I
n
co
n
tr
ast,
life
s
ty
le
s
co
r
e,
b
o
d
y
ag
e,
an
d
B
MI
wer
e
n
o
t
s
ig
n
if
ican
tly
ass
o
ciate
d
with
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e,
a
lth
o
u
g
h
b
o
d
y
ag
e
s
h
o
wed
a
p
o
s
itiv
e
tr
en
d
to
war
d
s
ig
n
if
ican
ce
(
p
=
.
0
6
7
)
.
B
ased
o
n
th
e
s
em
i
-
p
ar
tial
s
q
u
ar
ed
co
r
r
elatio
n
s
(
s
r
²)
,
to
tal
b
o
d
y
f
at
ex
p
lai
n
ed
th
e
lar
g
est
u
n
iq
u
e
p
r
o
p
o
r
tio
n
o
f
v
ar
ian
ce
in
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
(
3
.
6
%),
f
o
llo
wed
b
y
s
k
eleta
l
m
u
s
cl
e
m
ass
(
2
.
9
%).
T
h
e
r
em
ain
in
g
p
r
e
d
icto
r
s
co
n
tr
ib
u
ted
r
elativ
ely
s
m
all
p
r
o
p
o
r
t
io
n
s
o
f
u
n
iq
u
e
v
a
r
ian
ce
.
Ov
er
all,
th
e
f
in
d
in
g
s
s
u
g
g
est
th
at
b
o
d
y
c
o
m
p
o
s
iti
o
n
,
p
ar
ticu
la
r
ly
to
tal
b
o
d
y
f
at
an
d
s
k
eleta
l
m
u
s
cle
m
ass
,
is
m
o
r
e
s
tr
o
n
g
ly
ass
o
ciate
d
with
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
th
an
life
s
ty
le
s
co
r
e
o
r
B
MI
in
th
is
p
o
p
u
latio
n
.
T
ab
le
4
.
Mu
ltip
le
lin
ea
r
r
eg
r
ess
io
n
m
o
d
el
p
r
ed
ictin
g
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
(
n
=
1
6
7
)
P
r
e
d
i
c
t
o
r
B
SE
β
t
p
sr
²
C
o
n
st
a
n
t
5
4
.
9
7
3
1
0
.
2
4
8
—
5
.
3
6
4
<
.
0
0
1
—
Li
f
e
st
y
l
e
s
c
o
r
e
−
0
.
5
0
7
0
.
3
2
5
−
.
1
1
9
−
1
.
5
6
3
.
1
2
0
.
0
1
5
B
o
d
y
a
g
e
0
.
2
1
5
0
.
1
1
7
.
1
7
9
1
.
8
4
1
.
0
6
7
.
0
2
1
S
k
e
l
e
t
a
l
mu
s
c
l
e
m
a
ss (
k
g
)
0
.
4
8
3
0
.
2
2
1
.
1
7
2
2
.
1
8
6
.
0
3
0
*
.
0
2
9
B
M
I
(
k
g
/
m²
)
0
.
0
9
7
0
.
2
2
8
.
0
3
8
.
4
2
6
.
6
7
1
.
0
0
1
To
t
a
l
b
o
d
y
f
a
t
(
%)
0
.
4
7
3
0
.
1
9
6
.
2
4
8
2
.
4
0
8
.
0
1
7
*
.
0
3
6
N
o
t
e
:
M
o
d
e
l
st
a
t
i
s
t
i
c
s:
R
=
.
3
8
0
,
R
² =
.
1
4
4
,
A
d
j
u
st
e
d
R
²
=
.
1
1
7
,
F
(
5
,
1
6
1
)
=
5
.
4
2
0
,
p
<
.
0
0
1
,
C
o
h
e
n
's f²
=
.
1
6
8
.
Ef
f
e
c
t
si
z
e
i
n
t
e
r
p
r
e
t
a
t
i
o
n
b
a
s
e
d
o
n
C
o
h
e
n
(
1
9
8
8
)
*
.
3
.
2
.
Dis
cus
io
n
T
h
e
p
r
esen
t
s
tu
d
y
d
em
o
n
s
tr
at
ed
th
at
b
o
d
y
ag
e
was
th
e
s
tr
o
n
g
est
p
r
ed
icto
r
o
f
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e.
Sk
eleta
l
m
u
s
cle
m
ass
an
d
to
tal
b
o
d
y
f
at
p
er
ce
n
tag
e
we
r
e
s
ig
n
if
ican
t
p
r
e
d
icto
r
s
o
f
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
T
h
ese
f
in
d
i
n
g
s
s
u
g
g
est
th
at
p
h
y
s
io
lo
g
ical
a
g
in
g
an
d
b
o
d
y
c
o
m
p
o
s
itio
n
m
ay
co
n
tr
i
b
u
te
m
o
r
e
s
u
b
s
tan
tially
to
b
lo
o
d
p
r
ess
u
r
e
r
eg
u
latio
n
th
a
n
life
s
ty
le
b
eh
av
io
r
s
in
t
h
is
p
o
p
u
latio
n
.
On
e
o
f
th
e
m
o
s
t
n
o
tab
le
f
i
n
d
in
g
s
was
th
e
s
ig
n
if
ican
t
ass
o
ciatio
n
b
etwe
en
b
o
d
y
ag
e
a
n
d
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e.
Par
ticip
an
ts
with
h
ig
h
e
r
b
o
d
y
ag
e
ten
d
e
d
to
e
x
h
ib
it
h
ig
h
e
r
s
y
s
to
lic
b
l
o
o
d
p
r
ess
u
r
e
le
v
els,
s
u
p
p
o
r
tin
g
t
h
e
co
n
ce
p
t
th
at
p
h
y
s
io
lo
g
ical
ag
in
g
m
ay
b
etter
r
ef
lect
ca
r
d
io
v
ascu
lar
h
ea
lth
th
an
ch
r
o
n
o
lo
g
ical
ag
e
alo
n
e.
Ag
in
g
-
r
elate
d
v
ascu
lar
ch
an
g
es,
in
clu
d
in
g
a
r
ter
i
al
s
tiff
n
ess
,
en
d
o
th
elial
d
y
s
f
u
n
ctio
n
,
an
d
r
ed
u
ce
d
v
ascu
lar
co
m
p
lian
ce
,
h
a
v
e
b
e
en
id
en
ti
f
ied
as
k
ey
m
ec
h
an
is
m
s
u
n
d
er
ly
in
g
elev
ated
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e.
R
ec
en
t
ev
id
en
ce
f
u
r
th
er
in
d
icate
s
th
at
ac
ce
ler
ated
b
io
lo
g
ica
l
ag
in
g
is
s
tr
o
n
g
ly
ass
o
ciate
d
with
h
y
p
er
ten
s
io
n
,
ca
r
d
io
v
ascu
lar
d
is
ea
s
e,
an
d
m
o
r
tality
r
is
k
,
s
u
g
g
esti
n
g
th
at
b
io
lo
g
ical
ag
e
ca
p
tu
r
es
cu
m
u
lativ
e
p
h
y
s
io
lo
g
ical
d
eter
i
o
r
atio
n
th
a
t
m
ay
n
o
t
b
e
r
e
f
lecte
d
b
y
c
h
r
o
n
o
lo
g
ical
ag
e
alo
n
e
[
2
2
]
.
T
h
es
e
f
in
d
in
g
s
s
u
p
p
o
r
t
th
e
p
o
ten
tial
v
alu
e
o
f
b
o
d
y
ag
e
ass
es
s
m
en
t
as
an
ad
d
itio
n
al
in
d
icato
r
o
f
ca
r
d
io
v
as
cu
lar
r
is
k
in
ad
u
lt
p
o
p
u
latio
n
s
.
T
h
e
s
ig
n
if
ican
t
c
o
n
tr
ib
u
tio
n
o
f
to
tal
b
o
d
y
f
at
p
er
ce
n
ta
g
e
to
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
is
co
n
s
is
ten
t
with
cu
r
r
en
t
u
n
d
er
s
tan
d
in
g
o
f
ad
ip
o
s
ity
-
r
elate
d
ca
r
d
io
v
ascu
lar
d
y
s
f
u
n
ctio
n
.
E
x
ce
s
s
ad
ip
o
s
e
tis
s
u
e
f
u
n
ctio
n
s
as
an
ac
tiv
e
en
d
o
cr
in
e
o
r
g
a
n
th
at
p
r
o
m
o
tes
s
y
m
p
ath
et
ic
n
er
v
o
u
s
s
y
s
tem
ac
tiv
atio
n
,
r
en
in
–
an
g
io
ten
s
in
–
ald
o
s
ter
o
n
e
s
y
s
tem
s
tim
u
latio
n
,
ch
r
o
n
ic
in
f
lam
m
atio
n
,
a
n
d
i
n
s
u
lin
r
esis
tan
ce
.
T
h
ese
m
ec
h
an
is
m
s
co
llectiv
ely
in
cr
ea
s
e
p
er
ip
h
e
r
al
v
ascu
lar
r
esis
tan
ce
an
d
co
n
tr
ib
u
te
t
o
el
ev
ated
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
R
ec
en
t
ev
id
en
ce
in
d
icate
s
th
at
o
b
esit
y
-
r
elate
d
s
y
m
p
ath
etic
o
v
er
ac
tiv
ity
c
o
n
tr
ib
u
tes
to
s
u
s
tain
ed
v
aso
c
o
n
s
tr
ictio
n
,
s
o
d
iu
m
r
eten
tio
n
,
an
d
h
y
p
er
ten
s
io
n
,
th
er
eb
y
in
c
r
ea
s
in
g
ca
r
d
i
o
v
ascu
l
ar
r
is
k
[
2
3
]
.
Fu
r
th
er
m
o
r
e
,
ex
ce
s
s
ad
ip
o
s
ity
p
r
o
m
o
tes
ad
ip
o
cy
te
d
y
s
f
u
n
ctio
n
,
o
x
id
a
ti
v
e
s
tr
ess
,
an
d
s
y
s
tem
ic
in
f
lam
m
atio
n
th
at
im
p
air
en
d
o
th
elial
f
u
n
ctio
n
,
lead
in
g
to
a
b
n
o
r
m
alities
in
v
ascu
lar
r
eg
u
l
atio
n
an
d
in
c
r
ea
s
ed
b
lo
o
d
p
r
ess
u
r
e
[
2
4
]
.
R
ec
en
t
s
tu
d
ies
h
av
e
em
p
h
asized
t
h
at
b
o
d
y
f
at
m
ea
s
u
r
es
p
r
o
v
id
e
a
m
o
r
e
d
ir
ec
t
r
ep
r
esen
tatio
n
o
f
ca
r
d
io
m
etab
o
lic
r
is
k
th
an
tr
ad
itio
n
al
an
th
r
o
p
o
m
etr
ic
in
d
ices
b
ec
a
u
s
e
th
ey
r
ef
lect
th
e
b
io
lo
g
ical
co
n
s
eq
u
en
ce
s
o
f
ad
ip
o
s
ity
r
ath
er
t
h
an
b
o
d
y
s
ize
alo
n
e.
T
h
is
o
b
s
er
v
atio
n
is
s
u
p
p
o
r
ted
b
y
e
v
id
en
ce
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
6
6
9
-
677
674
s
h
o
win
g
th
at
in
d
i
v
id
u
als
with
n
o
r
m
al
B
MI
b
u
t
elev
ated
b
o
d
y
f
at
p
e
r
ce
n
tag
e
r
em
ain
at
s
i
g
n
if
ican
tly
g
r
ea
ter
r
is
k
f
o
r
h
y
p
er
ten
s
io
n
,
m
etab
o
l
ic
s
y
n
d
r
o
m
e,
d
y
s
lip
id
em
ia,
an
d
o
th
er
ca
r
d
io
m
etab
o
lic
d
is
o
r
d
er
s
[
2
5
]
,
[
2
6
]
.
T
h
e
f
in
d
in
g
th
at
b
o
d
y
f
at
e
x
p
lai
n
ed
th
e
lar
g
est
u
n
iq
u
e
v
ar
ia
n
ce
in
d
iast
o
lic
b
l
o
o
d
p
r
ess
u
r
e
r
ei
n
f
o
r
c
es
th
e
im
p
o
r
t
an
ce
o
f
ad
i
p
o
s
ity
ass
ess
m
en
t in
ca
r
d
i
o
v
ascu
lar
r
is
k
e
v
alu
atio
n
.
I
n
ter
esti
n
g
ly
,
s
k
eleta
l
m
u
s
cle
m
ass
wa
s
p
o
s
itiv
ely
a
s
s
o
ciate
d
with
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
Alth
o
u
g
h
s
k
eleta
l
m
u
s
cle
g
en
er
ally
s
u
p
p
o
r
ts
m
etab
o
lic
h
ea
l
th
,
g
r
ea
te
r
lean
m
ass
m
ay
in
cr
ea
s
e
b
lo
o
d
v
o
lu
m
e
an
d
ca
r
d
iac
o
u
tp
u
t,
p
o
te
n
tially
co
n
tr
ib
u
tin
g
to
h
ig
h
e
r
v
asc
u
lar
wo
r
k
lo
a
d
.
T
h
er
ef
o
r
e,
th
i
s
f
in
d
in
g
s
h
o
u
ld
b
e
in
ter
p
r
eted
with
in
t
h
e
b
r
o
ad
er
co
n
tex
t o
f
o
v
e
r
all
b
o
d
y
co
m
p
o
s
itio
n
r
ath
er
th
an
m
u
s
cle
m
ass
alo
n
e.
A
p
ar
ticu
lar
ly
im
p
o
r
tan
t
f
in
d
i
n
g
was
th
at
B
MI
was
n
o
t
a
s
ig
n
if
ican
t
p
r
e
d
icto
r
o
f
eith
er
s
y
s
to
lic
o
r
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e
af
ter
ad
ju
s
tm
en
t
f
o
r
b
o
d
y
ag
e
a
n
d
b
o
d
y
co
m
p
o
s
itio
n
v
ar
iab
l
es.
Alth
o
u
g
h
B
MI
s
h
o
wed
s
ig
n
if
ican
t
b
iv
a
r
iate
ass
o
ciatio
n
s
,
its
p
r
e
d
ictiv
e
v
alu
e
d
is
ap
p
ea
r
ed
in
th
e
m
u
ltiv
ar
iab
le
m
o
d
el,
s
u
g
g
esti
n
g
th
at
b
lo
o
d
p
r
ess
u
r
e
is
m
o
r
e
s
tr
o
n
g
ly
i
n
f
lu
en
ce
d
b
y
s
p
ec
if
ic
b
o
d
y
co
m
p
o
s
itio
n
ch
ar
ac
ter
is
tics
,
p
ar
ticu
lar
ly
ad
ip
o
s
ity
.
Un
lik
e
B
MI
,
wh
ich
ca
n
n
o
t
d
is
tin
g
u
is
h
f
at
m
ass
f
r
o
m
lean
m
ass
,
b
o
d
y
f
at
p
er
ce
n
ta
g
e
p
r
o
v
id
es a
m
o
r
e
d
ir
ec
t a
s
s
ess
m
en
t o
f
ca
r
d
io
m
etab
o
lic
r
is
k
.
T
h
is
in
ter
p
r
etatio
n
is
s
u
p
p
o
r
te
d
b
y
e
v
id
en
ce
s
h
o
win
g
th
at
in
d
iv
id
u
als
with
n
o
r
m
al
B
MI
b
u
t
elev
ated
b
o
d
y
f
at
r
em
ai
n
at
in
cr
ea
s
ed
r
is
k
o
f
h
y
p
er
ten
s
io
n
,
m
etab
o
lic
s
y
n
d
r
o
m
e,
d
y
s
lip
id
em
ia,
an
d
o
th
er
ca
r
d
io
m
etab
o
lic
ab
n
o
r
m
alitie
s
[
2
5
]
,
[
2
7
]
.
Fu
r
th
er
m
o
r
e,
n
o
r
m
al
-
weig
h
t
o
b
esit
y
h
as
b
ee
n
r
ec
o
g
n
ized
as
an
u
n
d
er
d
iag
n
o
s
ed
co
n
d
itio
n
ass
o
ciate
d
with
in
cr
ea
s
ed
ca
r
d
io
v
ascu
lar
r
is
k
,
h
ig
h
lig
h
tin
g
th
e
lim
itatio
n
s
o
f
B
MI
as
a
s
tan
d
alo
n
e
m
ea
s
u
r
e
o
f
ad
ip
o
s
ity
an
d
h
ea
lth
s
tatu
s
[
2
8
]
.
T
h
e
r
ef
o
r
e,
th
e
p
r
esen
t
f
i
n
d
in
g
s
s
u
p
p
o
r
t
th
e
g
r
o
win
g
r
ec
o
m
m
e
n
d
atio
n
t
o
co
m
p
lem
en
t
B
MI
with
b
o
d
y
co
m
p
o
s
itio
n
ass
ess
m
en
t
in
ca
r
d
io
v
ascu
lar
r
is
k
ev
alu
atio
n
.
C
o
n
tr
ar
y
to
ex
p
ec
tatio
n
s
,
life
s
ty
le
b
eh
av
io
r
s
wer
e
n
o
t
s
ig
n
if
ican
t
p
r
ed
icto
r
s
o
f
b
lo
o
d
p
r
ess
u
r
e
in
th
e
m
u
ltiv
ar
iab
le
an
aly
s
es.
W
h
ile
ex
ten
s
iv
e
ev
id
en
ce
s
u
p
p
o
r
ts
th
e
b
en
ef
icial
ef
f
ec
ts
o
f
p
h
y
s
ical
ac
tiv
ity
,
h
ea
lth
y
d
ietar
y
p
atter
n
s
,
ad
eq
u
ate
s
leep
,
an
d
s
m
o
k
in
g
av
o
id
a
n
ce
o
n
ca
r
d
io
v
ascu
lar
h
ea
lth
,
th
ese
ef
f
ec
ts
ar
e
lar
g
ely
m
ed
iated
th
r
o
u
g
h
p
h
y
s
io
lo
g
i
ca
l
p
ath
way
s
in
v
o
lv
in
g
ad
ip
o
s
ity
,
m
e
tab
o
lic
r
eg
u
latio
n
,
in
f
lam
m
atio
n
,
an
d
v
ascu
lar
f
u
n
ctio
n
[
2
9
]
,
[
3
0
]
.
C
o
n
s
eq
u
en
tly
,
wh
e
n
b
o
d
y
c
o
m
p
o
s
itio
n
an
d
b
o
d
y
a
g
e
wer
e
in
clu
d
ed
i
n
th
e
r
eg
r
ess
io
n
m
o
d
els,
th
e
d
ir
ec
t
ass
o
ciatio
n
b
etwe
en
life
s
t
y
le
s
co
r
e
an
d
b
lo
o
d
p
r
ess
u
r
e
m
ay
h
av
e
b
ee
n
atten
u
ated
.
Fu
r
th
e
r
m
o
r
e
,
th
e
cr
o
s
s
-
s
ec
tio
n
al
d
esig
n
an
d
u
s
e
o
f
a
c
o
m
p
o
s
ite
life
s
ty
le
s
c
o
r
e
m
ay
n
o
t
f
u
ll
y
ca
p
tu
r
e
th
e
c
u
m
u
lativ
e
im
p
ac
t o
f
lo
n
g
-
ter
m
b
eh
av
i
o
r
al
ex
p
o
s
u
r
es o
n
ca
r
d
io
v
ascu
lar
o
u
tco
m
es.
Fro
m
a
n
u
r
s
in
g
p
er
s
p
ec
tiv
e,
t
h
ese
f
in
d
in
g
s
h
i
g
h
lig
h
t
t
h
e
im
p
o
r
tan
ce
o
f
m
o
v
in
g
b
ey
o
n
d
co
n
v
en
tio
n
al
an
th
r
o
p
o
m
etr
ic
s
cr
ee
n
in
g
wh
en
ass
ess
in
g
ca
r
d
io
v
ascu
lar
r
is
k
.
I
n
co
r
p
o
r
atin
g
b
o
d
y
ag
e
a
n
d
b
o
d
y
co
m
p
o
s
itio
n
ass
ess
m
en
ts
in
to
r
o
u
tin
e
n
u
r
s
in
g
ev
al
u
atio
n
s
m
ay
f
ac
ilit
ate
ea
r
lier
id
en
tifi
ca
tio
n
o
f
ad
u
lts
at
in
cr
ea
s
ed
r
is
k
o
f
h
y
p
er
ten
s
io
n
wh
o
m
ig
h
t
n
o
t
b
e
d
etec
ted
th
r
o
u
g
h
B
MI
s
cr
ee
n
in
g
alo
n
e.
T
h
is
r
ec
o
m
m
en
d
atio
n
is
s
u
p
p
o
r
te
d
b
y
ev
id
en
ce
s
h
o
win
g
th
at
b
o
d
y
f
at
-
r
elate
d
m
ea
s
u
r
es
p
r
o
v
i
d
e
a
m
o
r
e
ac
c
u
r
ate
ass
es
s
m
en
t
o
f
ca
r
d
io
m
etab
o
li
c
r
is
k
th
an
B
MI
alo
n
e,
p
ar
ti
cu
lar
ly
am
o
n
g
in
d
iv
id
u
als
w
ith
n
o
r
m
al
-
we
ig
h
t
o
b
esit
y
[
3
1
]
,
[
3
2
]
.
As
n
o
n
-
in
v
asiv
e
b
o
d
y
c
o
m
p
o
s
itio
n
tech
n
o
lo
g
ies
b
ec
o
m
e
in
c
r
ea
s
in
g
ly
av
ailab
le
in
co
m
m
u
n
ity
an
d
p
r
im
ar
y
ca
r
e
s
ettin
g
s
,
n
u
r
s
es
m
ay
b
e
b
ett
er
p
o
s
itio
n
ed
to
im
p
lem
en
t
in
d
iv
id
u
alize
d
h
ea
lth
p
r
o
m
o
tio
n
,
life
s
ty
le
co
u
n
s
elin
g
,
an
d
p
r
e
v
en
tiv
e
in
ter
v
en
ti
o
n
s
aim
ed
at
r
ed
u
cin
g
ca
r
d
i
o
v
ascu
lar
r
is
k
an
d
im
p
r
o
v
in
g
lo
n
g
-
ter
m
h
ea
lth
o
u
tco
m
es.
Ov
er
all,
th
e
p
r
esen
t
f
in
d
in
g
s
s
u
g
g
est
th
at
p
h
y
s
io
lo
g
ical
ag
in
g
an
d
b
o
d
y
c
o
m
p
o
s
itio
n
ar
e
m
o
r
e
clo
s
ely
ass
o
ciate
d
with
b
lo
o
d
p
r
ess
u
r
e
r
e
g
u
latio
n
th
an
life
s
ty
le
b
eh
av
i
o
r
s
in
th
is
p
o
p
u
latio
n
.
T
h
ese
f
in
d
i
n
g
s
s
u
p
p
o
r
t
th
e
in
teg
r
atio
n
o
f
b
o
d
y
ag
e
an
d
b
o
d
y
co
m
p
o
s
itio
n
ass
es
s
m
en
t
in
to
ca
r
d
io
v
ascu
lar
r
is
k
ev
alu
atio
n
.
T
h
ey
also
p
r
o
v
id
e
a
d
d
itio
n
a
l
ev
id
en
ce
f
o
r
th
e
lim
itatio
n
s
o
f
r
ely
in
g
s
o
lely
o
n
B
MI
as
a
m
a
r
k
er
o
f
ca
r
d
io
m
etab
o
l
ic
h
ea
lth
.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
ex
a
m
in
ed
t
h
e
ass
o
ciatio
n
s
b
etwe
en
life
s
ty
le
b
e
h
av
io
r
s
,
b
o
d
y
ag
e,
b
o
d
y
c
o
m
p
o
s
itio
n
,
an
d
b
lo
o
d
p
r
ess
u
r
e
am
o
n
g
a
d
u
lts
.
T
h
e
f
in
d
in
g
s
in
d
icate
th
at
b
o
d
y
a
g
e
was
th
e
o
n
ly
s
ig
n
if
ican
t
p
r
ed
icto
r
o
f
s
y
s
to
lic
b
lo
o
d
p
r
ess
u
r
e,
wh
er
ea
s
s
k
eleta
l
m
u
s
cle
m
a
s
s
a
n
d
to
tal
b
o
d
y
f
at
wer
e
s
ig
n
i
f
ican
t
p
r
ed
icto
r
s
o
f
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e.
T
h
e
s
e
r
esu
lts
s
u
g
g
est
th
at
p
h
y
s
io
lo
g
ical
ag
in
g
a
n
d
b
o
d
y
co
m
p
o
s
itio
n
ar
e
m
o
r
e
s
tr
o
n
g
ly
ass
o
ciate
d
with
b
lo
o
d
p
r
ess
u
r
e
v
ar
iatio
n
th
an
life
s
ty
le
b
eh
av
io
r
s
in
th
e
s
tu
d
y
p
o
p
u
latio
n
.
Am
o
n
g
th
e
b
o
d
y
co
m
p
o
s
itio
n
in
d
icato
r
s
,
to
tal
b
o
d
y
f
at
d
em
o
n
s
tr
ated
th
e
g
r
ea
test
co
n
t
r
ib
u
tio
n
to
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e,
h
ig
h
l
ig
h
tin
g
th
e
im
p
o
r
tan
ce
o
f
ad
i
p
o
s
ity
as
a
ca
r
d
i
o
v
ascu
lar
r
is
k
f
ac
to
r
.
I
n
c
o
n
tr
ast,
B
MI
was
n
o
t
a
s
ig
n
if
ican
t
p
r
ed
icto
r
o
f
eith
er
s
y
s
to
lic
o
r
d
iast
o
lic
b
lo
o
d
p
r
ess
u
r
e,
s
u
g
g
e
s
tin
g
th
at
s
p
ec
if
ic
b
o
d
y
co
m
p
o
s
itio
n
m
ea
s
u
r
es
m
ay
p
r
o
v
id
e
m
o
r
e
m
ea
n
in
g
f
u
l
in
f
o
r
m
atio
n
th
a
n
co
n
v
en
ti
o
n
al
an
th
r
o
p
o
m
etr
ic
in
d
ices.
Ov
er
all,
th
e
f
in
d
in
g
s
em
p
h
asize
th
e
v
alu
e
o
f
in
co
r
p
o
r
atin
g
b
o
d
y
a
g
e
an
d
b
o
d
y
c
o
m
p
o
s
itio
n
ass
es
s
m
en
ts
in
to
ca
r
d
io
v
ascu
lar
r
is
k
ev
alu
atio
n
an
d
h
y
p
er
ten
s
io
n
p
r
e
v
en
tio
n
s
tr
ate
g
ies.
Alth
o
u
g
h
th
e
r
eg
r
ess
io
n
m
o
d
els
d
em
o
n
s
tr
at
ed
s
ig
n
if
ican
t
ex
p
lan
ato
r
y
p
o
wer
,
th
e
f
in
d
in
g
s
also
s
u
g
g
est
th
at
b
lo
o
d
p
r
ess
u
r
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
r
ed
icto
r
s
o
f b
lo
o
d
p
r
ess
u
r
e
a
mo
n
g
a
d
u
lts
:
th
e
r
o
le
o
f lifest
yle
a
n
d
b
o
d
y
c
o
mp
o
s
itio
n
(
E
ve
l
in
Ma
lin
ti
)
675
r
eg
u
lati
o
n
is
in
f
lu
en
ce
d
b
y
m
u
ltip
le
b
io
lo
g
ical,
b
eh
a
v
io
r
al,
an
d
en
v
ir
o
n
m
en
tal
f
ac
to
r
s
.
Fu
tu
r
e
s
tu
d
ies
s
h
o
u
ld
em
p
lo
y
l
o
n
g
itu
d
in
al
d
esig
n
s
a
n
d
lar
g
e
r
,
m
o
r
e
d
iv
er
s
e
p
o
p
u
l
atio
n
s
to
clar
if
y
ca
u
s
al
r
elatio
n
s
h
ip
s
an
d
f
u
r
th
e
r
in
v
esti
g
ate
th
e
in
ter
ac
tio
n
b
et
wee
n
life
s
ty
le
b
eh
av
io
r
s
,
b
o
d
y
co
m
p
o
s
itio
n
,
an
d
b
lo
o
d
p
r
ess
u
r
e
ac
r
o
s
s
th
e
ad
u
lt
life
s
p
an
.
ACK
NO
WL
E
DG
M
E
N
T
S
T
h
e
au
th
o
r
s
s
in
ce
r
ely
th
an
k
all
p
ar
ticip
an
ts
f
o
r
th
eir
in
v
o
lv
em
e
n
t
in
th
is
s
tu
d
y
.
W
e
also
ac
k
n
o
wled
g
e
th
e
s
u
p
p
o
r
t
a
n
d
co
o
p
er
atio
n
o
f
th
e
lo
ca
l
a
u
th
o
r
ities
an
d
co
m
m
u
n
ity
le
ad
er
s
in
C
ih
an
j
u
an
g
R
ah
ay
u
,
W
est J
av
a,
f
o
r
f
ac
ilit
atin
g
th
e
r
esear
ch
p
r
o
ce
s
s
.
F
UNDING
I
NF
O
R
M
A
T
I
O
N
T
h
e
au
th
o
r
s
d
ec
lar
e
th
at
th
is
s
tu
d
y
r
ec
eiv
ed
n
o
ex
ter
n
al
f
u
n
d
in
g
an
d
was c
o
n
d
u
cted
with
o
u
t
f
in
an
cial
s
u
p
p
o
r
t f
r
o
m
a
n
y
f
u
n
d
i
n
g
ag
e
n
cy
.
AUTHO
R
CO
NT
RI
B
UT
I
O
NS ST
A
T
E
M
E
N
T
T
h
is
jo
u
r
n
al
u
s
es
th
e
C
o
n
tr
ib
u
to
r
R
o
les
T
ax
o
n
o
m
y
(
C
R
ed
iT)
to
r
ec
o
g
n
ize
in
d
iv
id
u
al
au
th
o
r
co
n
tr
ib
u
tio
n
s
,
r
ed
u
ce
au
th
o
r
s
h
ip
d
is
p
u
tes,
an
d
f
ac
ilit
ate
co
llab
o
r
atio
n
.
Na
m
e
o
f
Aut
ho
r
C
M
So
Va
Fo
I
R
D
O
E
Vi
Su
P
Fu
E
v
elin
Ma
lin
ti
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
Yu
n
u
s
E
lo
n
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
Mo
r
i A
g
u
s
tin
a
b
r
Per
an
g
in
-
an
g
in
✓
✓
✓
✓
✓
C
:
C
o
n
c
e
p
t
u
a
l
i
z
a
t
i
o
n
M
:
M
e
t
h
o
d
o
l
o
g
y
So
:
So
f
t
w
a
r
e
Va
:
Va
l
i
d
a
t
i
o
n
Fo
:
Fo
r
mal
a
n
a
l
y
s
i
s
I
:
I
n
v
e
s
t
i
g
a
t
i
o
n
R
:
R
e
so
u
r
c
e
s
D
:
D
a
t
a
C
u
r
a
t
i
o
n
O
:
W
r
i
t
i
n
g
-
O
r
i
g
i
n
a
l
D
r
a
f
t
E
:
W
r
i
t
i
n
g
-
R
e
v
i
e
w
&
E
d
i
t
i
n
g
Vi
:
Vi
su
a
l
i
z
a
t
i
o
n
Su
:
Su
p
e
r
v
i
s
i
o
n
P
:
P
r
o
j
e
c
t
a
d
mi
n
i
st
r
a
t
i
o
n
Fu
:
Fu
n
d
i
n
g
a
c
q
u
i
si
t
i
o
n
CO
NF
L
I
C
T
O
F
I
N
T
E
R
E
S
T
ST
A
T
E
M
E
NT
T
h
e
au
th
o
r
s
d
ec
lar
e
th
at
th
er
e
ar
e
n
o
co
n
f
licts
o
f
in
ter
est
r
eg
ar
d
in
g
th
e
p
u
b
licatio
n
o
f
th
is
p
ap
er
.
T
h
e
au
th
o
r
s
af
f
ir
m
th
at
th
e
r
esear
ch
was c
o
n
d
u
cte
d
o
b
jectiv
ely
a
n
d
with
o
u
t a
n
y
u
n
d
u
e
in
f
lu
e
n
c
e.
I
NF
O
RM
E
D
CO
NS
E
N
T
W
r
itten
in
f
o
r
m
ed
c
o
n
s
en
t w
as o
b
tain
ed
f
r
o
m
all
p
ar
ticip
an
ts
p
r
io
r
t
o
th
eir
in
c
lu
s
io
n
in
th
e
s
tu
d
y
.
E
T
H
I
CAL AP
P
RO
V
AL
T
h
e
s
tu
d
y
r
ec
eiv
e
d
eth
ic
al
ap
p
r
o
v
al
f
r
o
m
t
h
e
E
th
ics
C
o
m
m
ittee
(
No
.
3
8
7
/KE
PK
-
FIK
.
UNAI
/EC/V
/2
4
;
Ma
y
1
5
,
2
0
2
4
)
.
Per
m
is
s
io
n
to
c
o
n
d
u
ct
th
e
s
tu
d
y
was
also
o
b
tai
n
ed
f
r
o
m
th
e
lo
ca
l
au
th
o
r
ities
o
f
C
ih
an
ju
a
n
g
R
ah
ay
u
.
DATA A
V
AI
L
AB
I
L
I
T
Y
T
h
e
d
ata
th
at
s
u
p
p
o
r
t
th
e
f
i
n
d
in
g
s
o
f
th
is
s
tu
d
y
ar
e
av
aila
b
le
f
r
o
m
th
e
c
o
r
r
esp
o
n
d
in
g
a
u
th
o
r
u
p
o
n
r
ea
s
o
n
ab
le
r
eq
u
est.
T
h
e
d
ata
a
r
e
n
o
t p
u
b
licly
av
aila
b
le
d
u
e
t
o
p
r
iv
ac
y
an
d
eth
ical
r
estrictio
n
s
.
RE
F
E
R
E
NC
E
S
[
1
]
Z.
C
h
e
r
a
g
h
i
,
B
.
A
z
m
i
-
N
a
e
i
,
P
.
C
h
e
r
a
g
h
i
,
a
n
d
A
.
D
o
o
st
i
-
I
r
a
n
i
,
“
Th
e
g
l
o
b
a
l
p
r
e
v
a
l
e
n
c
e
o
f
u
n
c
o
n
t
r
o
l
l
e
d
h
y
p
e
r
t
e
n
s
i
o
n
:
a
s
y
st
e
ma
t
i
c
r
e
v
i
e
w
a
n
d
m
e
t
a
-
a
n
a
l
y
si
s
,
”
BM
C
P
u
b
l
i
c
H
e
a
l
t
h
,
v
o
l
.
2
5
,
n
o
.
1
,
p
.
4
2
5
9
,
D
e
c
.
2
0
2
5
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
2
8
8
9
-
0
2
5
-
2
5
5
5
3
-
4.
[
2
]
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
(
W
H
O
)
,
“
H
y
p
e
r
t
e
n
si
o
n
,
”
W
H
O
.
A
c
c
e
ss
e
d
:
D
e
c
.
0
1
,
2
0
2
5
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
w
h
o
.
i
n
t
/
n
e
w
s
-
r
o
o
m
/
f
a
c
t
-
sh
e
e
t
s
/
d
e
t
a
i
l
/
h
y
p
e
r
t
e
n
si
o
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
6
6
9
-
677
676
[
3
]
H
.
K
a
s
e
g
e
r
e
t
a
l
.
,
“
M
u
l
t
i
d
i
me
n
si
o
n
a
l
l
i
f
e
st
y
l
e
d
e
t
e
r
mi
n
a
n
t
s
o
f
h
y
p
e
r
t
e
n
si
o
n
i
n
I
n
d
o
n
e
s
i
a
:
a
s
y
st
e
ma
t
i
c
r
e
v
i
e
w
w
i
t
h
i
mp
l
i
c
a
t
i
o
n
s
f
o
r
p
o
p
u
l
a
t
i
o
n
l
e
v
e
l
p
r
e
v
e
n
t
i
o
n
,
”
Me
d
i
a
P
u
b
l
i
k
a
si
Pro
m
o
s
i
K
e
se
h
a
t
a
n
I
n
d
o
n
e
s
i
a
(
MP
PK
I
)
,
v
o
l
.
9
,
n
o
.
5
,
p
p
.
1
0
8
4
–
1
0
9
9
,
M
a
y
2
0
2
6
,
d
o
i
:
1
0
.
5
6
3
3
8
/
mp
p
k
i
.
v
9
i
5
.
9
2
7
9
.
[
4
]
M
.
A
.
A
g
u
i
r
r
e
-
Q
u
e
z
a
d
a
,
M
.
P
.
A
r
a
n
d
a
-
R
a
m
í
r
e
z
,
M
.
d
e
l
C
a
r
me
n
-
G
a
r
c
í
a
,
a
n
d
G
.
R
e
i
v
á
n
-
O
r
t
i
z
,
“
A
sso
c
i
a
t
i
o
n
o
f
b
l
o
o
d
p
r
e
ss
u
r
e
w
i
t
h
met
a
b
o
l
i
c
f
a
c
t
o
r
s,
st
r
e
ss
l
e
v
e
l
s,
p
h
y
s
i
c
a
l
a
c
t
i
v
i
t
y
,
a
n
d
n
u
t
r
i
e
n
t
i
n
t
a
k
e
i
n
o
v
e
r
w
e
i
g
h
t
o
r
o
b
e
s
e
Ec
u
a
d
o
r
i
a
n
u
n
i
v
e
r
si
t
y
st
u
d
e
n
t
s
:
a
st
u
d
y
b
a
se
d
o
n
m
e
d
i
a
t
i
o
n
a
n
a
l
y
s
i
s,
”
N
u
t
r
i
e
n
t
s
,
v
o
l
.
1
8
,
n
o
.
2
,
p
.
2
0
1
,
Ja
n
.
2
0
2
6
,
d
o
i
:
1
0
.
3
3
9
0
/
n
u
1
8
0
2
0
2
0
1
.
[
5
]
K
e
m
e
n
t
e
r
i
a
n
K
e
s
e
h
a
t
a
n
R
I
,
“
K
e
n
a
l
i
d
a
n
k
e
n
d
a
l
i
k
a
n
h
i
p
e
r
t
e
n
si
:
s
i
s
i
l
e
n
t
k
i
l
l
e
r
,
”
K
E
M
EN
K
ES
R
I
.
A
c
c
e
ss
e
d
:
N
o
v
.
0
1
,
2
0
2
5
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
/
k
e
s
l
a
n
.
k
e
mk
e
s
.
g
o
.
i
d
/
v
i
e
w
_
a
r
t
i
k
e
l
/
4
1
1
9
/
k
e
n
a
l
i
-
d
a
n
-
k
e
n
d
a
l
i
k
a
n
-
h
i
p
e
r
t
e
n
s
i
-
si
-
s
i
l
e
n
t
-
k
i
l
l
e
r
.
[
6
]
S
.
Z
h
a
o
e
t
a
l
.
,
“
T
h
e
i
m
p
a
c
t
o
f
b
o
d
y
c
o
m
p
o
si
t
i
o
n
a
n
d
f
a
t
d
i
st
r
i
b
u
t
i
o
n
o
n
b
l
o
o
d
p
r
e
ss
u
r
e
i
n
y
o
u
n
g
a
n
d
m
i
d
d
l
e
-
a
g
e
d
a
d
u
l
t
s,
”
Fro
n
t
i
e
rs
i
n
N
u
t
ri
t
i
o
n
,
v
o
l
.
9
,
S
e
p
.
2
0
2
2
,
d
o
i
:
1
0
.
3
3
8
9
/
f
n
u
t
.
2
0
2
2
.
9
7
9
0
4
2
.
[
7
]
L.
B
a
i
,
J.
Z
h
o
u
,
L.
T
o
n
g
,
a
n
d
W
.
D
i
n
g
,
“
A
sso
c
i
a
t
i
o
n
b
e
t
w
e
e
n
b
o
d
y
c
o
m
p
o
s
i
t
i
o
n
a
n
d
b
l
o
o
d
p
r
e
ss
u
r
e
i
n
n
o
r
m
a
l
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m
e
n
t,
a
n
d
e
v
id
e
n
c
e
-
b
a
se
d
n
u
rsin
g
c
a
re
a
ime
d
a
t
imp
ro
v
i
n
g
p
a
ti
e
n
t
o
u
tc
o
m
e
s.
S
h
e
h
a
s
c
o
n
tri
b
u
ted
t
o
se
v
e
ra
l
a
c
a
d
e
m
ic
a
n
d
re
se
a
rc
h
a
c
ti
v
it
ies
in
n
u
rsin
g
e
d
u
c
a
ti
o
n
a
n
d
c
li
n
ica
l
p
ra
c
ti
c
e
.
S
h
e
c
a
n
b
e
c
o
n
ta
c
ted
a
t
e
m
a
il
:
e
v
e
li
n
.
m
a
li
n
ti
@u
n
a
i.
e
d
u
.
Yun
u
s
Elo
n
is
a
lec
tu
re
r
a
t
th
e
F
a
c
u
lt
y
o
f
Nu
rsi
n
g
,
U
n
iv
e
rsitas
Ad
v
e
n
t
I
n
d
o
n
e
sia
,
Ba
n
d
u
n
g
,
Wes
t
Ja
v
a
,
In
d
o
n
e
sia
.
He
tea
c
h
e
s
M
e
d
ica
l
–
S
u
rg
ica
l
Nu
rsin
g
a
n
d
is ac
ti
v
e
l
y
in
v
o
l
v
e
d
in
re
se
a
rc
h
o
n
li
fe
sty
le
b
e
h
a
v
io
rs,
b
o
d
y
c
o
m
p
o
siti
o
n
,
h
y
p
e
rten
si
o
n
,
a
n
d
c
o
m
m
u
n
it
y
h
e
a
lt
h
.
His
re
se
a
rc
h
fo
c
u
se
s
o
n
u
n
d
e
rsta
n
d
i
n
g
t
h
e
i
n
tera
c
ti
o
n
b
e
twe
e
n
p
h
y
si
o
lo
g
ica
l
fa
c
to
rs
a
n
d
li
fe
sty
le
p
a
tt
e
rn
s
in
sh
a
p
in
g
c
a
rd
io
v
a
sc
u
l
a
r
risk
a
n
d
h
e
a
lt
h
y
a
g
in
g
a
m
o
n
g
a
d
u
lt
p
o
p
u
lati
o
n
s.
He
h
a
s
p
a
rti
c
ip
a
ted
i
n
se
v
e
ra
l
c
o
m
m
u
n
it
y
-
b
a
se
d
h
e
a
lt
h
stu
d
ies
a
n
d
c
o
n
tri
b
u
tes
to
th
e
d
e
v
e
l
o
p
m
e
n
t
o
f
e
v
id
e
n
c
e
-
b
a
se
d
n
u
rsin
g
p
ra
c
ti
c
e
a
n
d
h
e
a
lt
h
p
ro
m
o
ti
o
n
stra
teg
ies
.
H
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
y
u
n
u
s.e
lo
n
@u
n
a
i.
e
d
u
.
Mo
r
i
A
g
u
stin
a
b
r
Per
a
n
g
in
-
a
n
g
in
is
a
lec
tu
re
r
a
t
t
h
e
F
a
c
u
lt
y
o
f
Nu
rsin
g
,
Un
iv
e
rsitas
Ad
v
e
n
t
In
d
o
n
e
sia
,
W
e
st
Ja
v
a
,
In
d
o
n
e
sia
.
S
h
e
tea
c
h
e
s
Nu
rsin
g
M
a
n
a
g
e
m
e
n
t
a
n
d
P
a
ll
iativ
e
Nu
rsin
g
Ca
re
a
n
d
is
a
c
ti
v
e
ly
in
v
o
l
v
e
d
i
n
re
se
a
rc
h
a
c
ti
v
it
ies
re
late
d
to
P
a
ll
iativ
e
Nu
rsin
g
a
n
d
Nu
rsin
g
M
a
n
a
g
e
m
e
n
t
.
He
r
re
se
a
rc
h
fo
c
u
se
s
o
n
imp
ro
v
i
n
g
q
u
a
li
t
y
o
f
li
fe
p
a
ti
e
n
ts
a
n
d
t
h
e
ir
fa
m
il
ies
a
s
c
a
re
g
iv
e
r
in
c
h
ro
n
ic
d
ise
a
se
,
imp
ro
v
in
g
k
n
o
wle
d
g
e
a
n
d
s
k
il
ls
o
f
n
u
rse
s
a
n
d
n
u
rsin
g
stu
d
e
n
ts
re
late
d
to
p
a
ll
iativ
e
c
a
re
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
m
o
ri.
p
e
ra
n
g
in
a
n
g
i
n
@u
n
a
i
.
e
d
u
.
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