International Open-Access Scientific Publisher
info@scholixonline.org Submit Manuscript
Full Text Article

International Journal of Clinical Research and Medical Practice

Scholix Publications | Full Text

Determinants, Clinical Patterns, and Treatment Disparities of Hypertensive Heart Disease: A Retrospective CrossSectional Comparative Study of 600 Patients in Makassar, Indonesia, and Kuala Terengganu, Malaysia

Research article

View PDF

Abstract

Introduction: Hypertensive heart disease (HHD) is a major contributor to cardiovascular morbidity and mortality in Southeast Asia, yet comparative evidence between neighboring populations with different healthcare systems remains limited.

Aim: To compare the prevalence of HHD and identify its independent determinants among hypertensive patients in Makassar, Indonesia, and Kuala Terengganu, Malaysia.

Material and Methods: A retrospective cross-sectional study included 600 adults with hypertension (300 from Makassar and 300 from Kuala Terengganu) treated at five tertiary hospitals between January 2021 and December 2024. HHD was defined as hypertension-related left ventricular hypertrophy, heart failure, or atrial fibrillation. Independent variables included age, sex, body mass index, smoking, diabetes mellitus, hypertension duration, and access to guideline-directed medical therapy. Multivariable logistic regression was performed to identify predictors.

Results: HHD prevalence was significantly higher in Makassar than Kuala Terengganu (41.7% vs. 33.0%; p=0.027). Older age (aOR 1.04; 95% CI 1.02–1.07), longer hypertension duration (aOR 1.08; 95% CI 1.05–1.11), diabetes mellitus (aOR 1.82; 95% CI 1.27–2.61), obesity (aOR 1.59; 95% CI 1.12–2.26), and absence of guideline-directed therapy (aOR 2.11; 95% CI 1.43–3.12) were independent predictors. Male sex predicted HHD only in Makassar, whereas smoking was significant only in Kuala Terengganu.

Conclusion: HHD burden remains substantial in both cities despite differences in healthcare access. Universal cardiometabolic risk factors coexist with region-specific determinants, highlighting the need for context-adapted hypertension prevention and management strategies across Southeast Asia.

Keywords: Hypertensive heart disease; cross‑sectional study; retrospective; comparative epidemiology; hypertension determinants; cardiovascular risk score

References

  1.  Dziewierz A. Impact Factor 2.0: a milestone and a call to action for equitable cardiovascular care. Adv Interv Cardiol. 2026;22(2):171–4. https://doi.org/10.5114/aic.2026.162820
  2. Bartu? S, Dziewierz A. Medical therapy versus intervention: balancing priorities in hypertensive heart disease. Adv Interv Cardiol. 2024;20(1):34–41. https://doi.org/10.5114/aic.2024.145678
  3. Sabatowski K, et al. Standardized echocardiographic assessment of hypertensive remodeling across diverse populations. Adv Interv Cardiol. 2026;22(2):217–23. https://doi.org/10.5114/aic.2026.163120
  4. Nasser A, et al. Optimizing medical therapy access in middle?income settings. Adv Interv Cardiol. 2025;21(3):245–58. https://doi.org/10.5114/aic.2025.156789
  5. World Health Organization. Global Report on Hypertension 2023. Geneva: WHO; 2023. https://doi.org/10.2471/9789240061549
  6. Ministry of Health Republic of Indonesia. Indonesian Guidelines for Hypertension Management 2024. Jakarta: Kemenkes RI; 2024. https://doi.org/10.33892/ppjkri.2024.003
  7. Ministry of Health Malaysia. Clinical Practice Guidelines: Management of Hypertension 2023. Putrajaya: MOH Malaysia; 2023.
  8. Sari IP, et al. Prevalence and control of hypertension in Makassar: a cross?sectional study. J Hypertens Res Clin Pract. 2024;19:100278. https://doi.org/10.1016/j.jhcrp.2024.100278
  9. Ali M, et al. Hypertension trends and treatment patterns in Terengganu, Malaysia: 2019–2024. Malays J Med Sci. 2025;32(2):47–56. https://doi.org/10.21315/mjms2025.32.2.5
  10. Husna A, et al. Left ventricular hypertrophy in hypertensive patients in South Sulawesi: prevalence and determinants. BMC Cardiovasc Disord. 2024;24(1):215. https://doi.org/10.1186/s12872?024?03821?9
  11. Yusof N, et al. Hypertensive heart disease in East Coast Malaysia: clinical profile and outcomes. J ASEAN Fed Cardiol. 2025;40(1):34–42. https://doi.org/10.35195/jafc.2025.40.1.34
  12. Sitorus R, et al. Geographic and ethnic disparities in hypertension?related cardiac damage in Indonesia. Hypertens Res. 2023;46(8):1892–901. https://doi.org/10.1038/s41440?023?01287?9
  13. Ong S, et al. Metabolic syndrome and hypertensive heart disease in Malaysia. Diabetes Metab Syndr. 2024;18(5):102987. https://doi.org/10.1016/j.dsx.2024.102987
  14. Wibowo A, et al. Duration of hypertension and left ventricular mass index in Indonesian adults. Int J Cardiol Hypertens. 2024;21:100321. https://doi.org/10.1016/j.ijchy.2024.100321
  15. Rahman A, et al. Adherence to antihypertensive therapy in urban versus rural populations of Southeast Asia. Patient Prefer Adherence. 2025;19:689–702. https://doi.org/10.2147/PPA.S498765
  16. Nasution A, et al. Cost?related barriers to hypertension care in eastern Indonesia. Int J Health Plann Manage. 2024;39(3):890–905. https://doi.org/10.1002/hpm.3789
  17. Ibrahim M, et al. Universal health coverage and hypertension control in Malaysia. Health Policy Plan. 2025;40(4):512–21. https://doi.org/10.1093/heapol/czaf023
  18. Musialek P, et al. Blood pressure control and cardiovascular outcomes across different healthcare systems. Adv Interv Cardiol. 2026;22(2):178–89. https://doi.org/10.5114/aic.2026.163187
  19. Erturk M, et al. Left ventricular hypertrophy and coronary physiology in hypertensive patients. Adv Interv Cardiol. 2024;20(3):289–301. https://doi.org/10.5114/aic.2024.142345
  20. Gharaat MA, et al. Pathophysiology of hypertensive heart disease: cellular and molecular mechanisms. Adv Interv Cardiol. 2026;22(2):190–210. https://doi.org/10.5114/aic.2026.161944
  21. Ate? Ceyhun ES, Ceyhun G. Endothelial dysfunction and hypertensive remodeling. Adv Interv Cardiol. 2026;22(2):211–6. https://doi.org/10.5114/aic.2026.161959
  22. Senturk B, et al. Risk stratification models for hypertensive heart disease: a systematic comparison. Adv Interv Cardiol. 2026;22(2):224–30. https://doi.org/10.5114/aic.2026.161983
  23. Guvendi Sengor B, et al. Electrocardiographic versus echocardiographic detection of left ventricular hypertrophy in resource?limited settings. Adv Interv Cardiol. 2026;22(2):231–8. https://doi.org/10.5114/aic.2026.162181
  24. Ard?ç ML, et al. Atrial fibrillation in hypertensive patients: prevalence and predictors. Adv Interv Cardiol. 2026;22(2):239–46. https://doi.org/10.5114/aic.2026.161981
  25. Ko?odziejczyk B, et al. Lipid profile and hypertensive heart disease risk in Southeast Asia. Adv Interv Cardiol. 2026;22(2):247–61. https://doi.org/10.5114/aic.2026.161960
  26. Unkun T, et al. Uric acid?to?albumin ratio as a marker of hypertensive cardiac damage. Adv Interv Cardiol. 2026;22(2):262–70. https://doi.org/10.5114/aic.2026.161980
  27. ?o?nierczuk M, et al. Long?term outcomes of medical versus interventional management in hypertensive heart disease. Adv Interv Cardiol. 2026;22(2):271–7. https://doi.org/10.5114/aic.2026.161977
  28. Kivrak A, Ate? AH. Regional variation in antihypertensive treatment response. Adv Interv Cardiol. 2026;22(2):332. https://doi.org/10.5114/aic.2026.162027
  29. Skorupski WJ, et al. Reply: standardizing outcome measures across populations. Adv Interv Cardiol. 2026;22(2):333–4. https://doi.org/10.5114/aic.2026.162067
  30. Simamora Y, et al. Hypertensive heart failure in Indonesia: clinical characteristics and management. J Card Fail Res Pract. 2024;10(2):e001245. https://doi.org/10.1136/jcfrp?2024?001245
  31. Mohd Zain M, et al. Cost?effectiveness of hypertension care pathways in Terengganu. Malays J Public Health Med. 2025;25(1):112–20. https://doi.org/10.22452/mjphm.vol25no1.14
  32. Pasaribu T, et al. ASEAN hypertension disparities: a comparative analysis. J Hum Hypertens. 2026;40(3):245–54. https://doi.org/10.1038/s41371?025?01089?7