Available online at:

https://jurnal.unikastpaulus.ac.id/index.php/ispnm
Volume 1, No 1, Oktober 2023

THE RELATIONSHIP BETWEEN STRESS LEVEL AND BLOOD PRESSURE LEVEL IN

ADULTS WITH HYPERTENSION IN DESA BEAMESE KECAMATAN CIBAL

Felomena Murni1, Yohana Hepilita2 and Oliva Suyen Ningsih3

Email: felomenamurni@gmail.com1, yhepilita32@gmail.com2

ABSTRACT
Stress results in increased peripheral vascular resistance and cardiac output, these things will stimulate
sympathetic nerve activity which will trigger the work of the heart and cause an increase in blood
pressure. The prevalence of hypertension in Desa Beamese, Kecamatan Cibal in October-December
2022 amounted to 140 adults, the number of people with hypertension has increased compared to June-
August 2022 which amounted to 93 adults. The purpose of this study was to determine the relationship
between stress levels and blood pressure levels in the adult age group with hypertension in Desa
Beamese, Kecamatan Cibal. The method used in this research is descriptive correlation with a cross-
sectional approach. The sample in this study amounted to 73 adult age groups with hypertension in Desa
Beamese, Kecamatan Cibal using purposive sampling technique. The measuring instrument used was a
stress level questionnaire and blood pressure measurement observation sheet. Data analysis using Chi-
square. The results of the research analysis showed that there was a relationship between stress levels
and blood pressure levels in the adult age group with hypertension in Desa Beamese, Kecamatan Cibal
with a p value of 0.000. Based on the results of the study, it is concluded that there is a relationship
between stress levels and blood pressure levels in the adult age group with hypertension in Desa
Beamese, Kecamatan Cibal. The results of this research recommend to Primary Health Care at Desa
Beamese to assess stress levels in the adult age group with hypertension and perform stress management
that can be practiced simply by the community.
Keywords: Stress, Blood Pressure, Adults with hypertension

INTRODUCTION nearly one billion people worldwide and is one

of the leading causes of premature death
Hypertension is a condition of high
(Ministry of Health of the Republic of
blood pressure with systolic pressure above 140
Indonesia, 2019). By 2020 about 1.56 billion
mmHg and diastolic pressure above 90 mmHg
adults will be living with hypertension.
(World Health Organization, 2013). Blood
Hypertension kills nearly 8 billion people every
pressure above 140/90 mmHg also applies to
year. The prevalence of hypertension will
adults over 18 years (Sanger & Lainsamputty,
continue to increase (Ministry of Health of the
2020). Hypertension is often called the silent
Republic of Indonesia, 2019). Hypertension
killer because it generally has no symptoms
affects almost 26% of the adult population
until it develops into serious complications.
worldwide and by 2025 it is projected that 29%
Hypertension symptoms can differ between
of the world's population (1.5 billion adults)
individuals, depending on factors such as blood
will experience hypertension.
pressure level, age, cause, medical history,
presence of complications and general health In the same range of years, the
(Muyossaro, 2014). Hypertension affects incidence of hypertension is higher in the

1 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
population in developing countries than Some common causes of stress are work
developed countries, even as many as 75% of problems, economic factors, household
people with hypertension live in developing problems, lack of sleep and other problems
countries (Tri & Arum, 2019) and an increase (Saleh et al., 2014). There are several types of
of 8.1%. Hypertension in Southeast Asia has diseases associated with stress, one of which is
killed 1.5 million people and one third of adults hypertension (Delavera et al., 2021).
live with hypertension. The prevalence rate of
Based on research conducted by
hypertension in Indonesia is around 31.7% or 1
Basmanelly, and Huriani (2014), on the
in 3 adults has hypertension and 76.1% do not
relationship between stress levels and the
realize they have hypertension. Hypertension in
degree of hypertension in hypertension patients
Indonesia itself is the number 3 cause of death
in the Andalas Padang Health Center Working
after stroke and tuberculosis, which is 6.7% of
Area in 2014, the results of the correlation test
the death population at all ages (Ansar J,
obtained a correlation value (r) of the level of
Dwinata I, 2019). The results of the Basic
stress with the degree of hypertension of 0.486
Health Research (Riskesdas, 2017) of health
and a significance value of 0.000 and a positive
research and development showed that the
direction, meaning that the higher the level of
prevalence of hypertension nationally reached
stress, the higher the degree of hypertension and
31.7%. In Indonesia there is an increase in the
based on the results of research conducted by
prevalence of hypertension. The overall
Upik Pebriyani (2021) at the kedaton health
prevalence of hypertension in Indonesia in 2015
center in Lampung province, it was found that
was 26.5%. In 2015, it was explained that the
most respondents had a moderate level of stress
prevalence of hypertension ranged from 17-
as many as 30 people (44. 1%), some
22%. Hypertension prevalence determined
respondents experienced stage one
based on the criteria of Bordeline Hypertension,
hypertension as many as 34 people (50.0%).
namely blood pressure with a range of 141/91-
159-94 mmHg, is estimated to be 4.8-18.8% Stress can trigger the onset of
(Hamria et al., 2020). hypertension through sympathetic nervous
system activity which results in intermittent
Adulthood is a period where
(erratic) increases in blood pressure (Andria,
individuals have a level of maturity in thinking
2013). When a person experiences stress, the
and can behave wisely in deciding a problem.
hormone adrenaline will be released and will
People who are in the adulthood phase tend to
then increase blood pressure through arterial
experience stress because they have changes or
contraction (Vasoconstriction) and increased
characteristics of physical and psychological
heart rate. If stress continues, blood pressure
maturity such as, adulthood tends to be
will remain high so that a person will
problematic because of reproductive age,
experience hypertension (South, 2014).
emotional, value changes, adjustment to a new
Hypertension has a bad impact on health,
life, and dependence. In addition, in today's
among others, hypertension will lead to stroke,
society, people also experience increasingly
aneurysm, heart failure, heart attack, kidney
diverse problems as a result of modernization
damage, visual impairment, and other
and world development. Social relationship
complications. Hypertension even causes death
problems and demands can cause stress in a
for a person (Nuraini, 2015).
person. According to Prawesti (2012), one of
the causes of increased blood pressure is stress. Desa Beamese is a village included in the
Stress is an unpleasant physical or working area of the Beamese outpatient health
psychological pressure, stress can stimulate the center which serves part of the Cibal District
adrenal glands which release the hormone area. Based on preliminary data taken from
adrenaline and spur the heart to beat faster and Primary Health Care at Desa Beamese during
stronger, so that blood pressure will increase. October-December in 2022 the number of

2 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
people with hypertension was known to be 140 Table 4.1 Frequency of Adult Age Group
adults. Every month an average of 47 people. Characteristics in Desa Beamese,
The number of people with hypertension has
increased because compared to June-August Kecamatan Cibal (n=73)
2022 the number of people with hypertension
was 93 adults, an average of 31 adults per
Age Frequency Percentage
month. Based on this and seeing the various (n) (%)
causes associated with hypertension in other 20-29 12 16,4
research sites, the authors feel interested in 30-39 37 50,7
researching the relationship between stress 40-45 24 32,9
levels and blood pressure levels in the adult age Total 73 100
group with hypertension in Desa Beamese, Gender Frequency Percentage
(n) (%)
Kecamatan Cibal. Male 35 47,9
Female 38 52,1
Total 73 100
RESEARCH METHODS Source: Primary Data 2023

This research is a type of quantitative
research using the Cross-sectional method, in
which researchers emphasize the time of
measurement or observation of data on
independent and dependent variables only once
at a time (Nursalam, 2013).
The population in this study was the
Adult Age Group in Desa Beamese, Kecamatan
Cibal with a total of 93 adult age groups with
hypertension. While the samples taken in this
study were 73 adult age groups with
hypertension in Desa Beamese, Kecamatan
Cibal.
The sampling technique used in this
study was purposive sampling, namely
sampling with certain considerations (Aziz,
2011). The samples taken were 73 adult age
groups with hypertension in Desa Beamese,
Kecamatan Cibal which were adjusted to the
provisions made by the researcher, namely
based on the inclusion and exclusion criteria.
Based on table 4.1, it can be concluded that the
age of 20-29 years is as many as 12 respondents
(16.4%). Age 30-39 years as many as 37
respondents (50.7%) and age 40-45 years as
many as 24 respondents (32.9%). Frequency
based on gender obtained the most dominant
number is female, namely 38 respondents
(52.1%) and male gender totaling 35
respondents (47.9%).
2. Respondents' Stress Level
The results of the research that has been
conducted, show the frequency and percentage
of respondents' stress levels as follows:
Based on Table 4.2 frequency based on
Respondents' Stress Level in Desa Beamese,
Kecamatan Cibal (n=73)
Stres Level Frequ Perce
ency ntage
(n) (%)
Normal-Mild 23 31,5

Moderate- 50 68,5
RESULTS Severe
1. Respondent Characteristics by Age and Total 73 100,0

Gender Source: Primary Data 2023

The results showed that the Based on table 4.2 shows that of the 73
respondents experiencing normal-light stress,
characteristics of the respondents were as 23 respondents (31.5%), moderate-heavy
follows: stress 50 respondents (68.5%). Based on the

3 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
 Group in Desa Beamese, Kecamatan
Blood Pressure Level Chi
Tota Squ Cibal
Stress Pre Stage 1 Stage 2 l are
levels HypertenHyperten Hyperten
Test Table 4.4 Cross Tabulation Between Stress
sion sion sion
n % n % n % N % 0,00 Levels and Blood Pressure Levels in the Adult
Norma 9 12,3 10 13,7 4 5,5 23 31,5 0 Age Group with Hypertension in Desa
l- Mild Beamese, Kecamatan Cibal
Moder 2 2,7 9 12,3 39 53,4 50 68,5
ate-
Severe
Blood Pressure Level Chi
Total 11 15,1 19 26,0 43 58,9 73 100, Stres
0 To Squ
s Pre Stage 1 Stage 2 tal are
frequency of stress levels, the most level Hypert Hypert Hypert Test
respondents are moderate-heavy stress with 50 s ension ension ension
respondents. n % n % n % N% 0,
Nor 9 12,3 10 13,7 4 5,5 2 31, 00
mal- 35 0
Mild 2 2,7 9 12,3 39 53,4
3. Respondent's Blood Pressure Level
Mode 5 68,
rate- 05
Based on research conducted by researchers in Sever
Desa Beamese, Kecamatan Cibal, the e
following respondents' blood pressure levels Total 11 15,1 19 26,0 43 58,9 7 10
were obtained: 3 0,0

Table 4.3 Frequency Based On Respondents' Based on table 4.4, it is known that the results
Blood Pressure Level In Desa Beamese, of cross tabulation between stress and blood
Kecamatan Cibal (N=73) pressure levels in the adult age group with
hypertension, the number of respondents with
Blood Pressure Frequency Percentage
Level (n) (%)
normal-light stress levels with pre-hypertension
Pre 11 15,1 blood pressure levels is as many as 9 people
Hypertension (12.3%), respondents with normal-light stress
Stage 1 19 26,0 levels with stage 1 hypertension blood pressure
Hypertension
Stage 2 43 58,9 levels are as many as 4 people (5.5%). 10
Hypertension people (13.7%), respondents with normal-light
Total 73 100,0 stress levels with stage 2 hypertension blood
Source: Primary Data 2023 pressure levels were 4 people (5.5%). While
respondents with moderate-heavy stress levels
Based on table 4.3, the results of the blood
with pre-hypertension blood pressure levels
pressure level of the respondents were as
were 2 people (2.7%), stage 1 hypertension was
follows those suffering from pre-hypertension
9 people (12.3%) and stage 2 hypertension was
were 11 respondents (15.1%), respondents
39 respondents (53.4%).
suffering from stage 1 hypertension were 19
respondents (26.0%) and those suffering from
stage 2 hypertension were 43 respondents
(58.9%). DISCUSSION

4. Relationship Between Stress Levels and The characteristics of respondents

based on the results of the analysis obtained
Blood Pressure Levels in the Adult Age from this study of the size of the respondents
found that most of the respondents were adults
with ages 30-39 were the most respondents

4 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
compared to ages 20-29 years. Systolic blood
pressure increases with increasing age, but
diastolic pressure increases along with systolic
blood pressure until the age of 55 years, which
then decreases due to the process of arterial
stiffness due to atherosclerosis or increased
blood pressure caused by increased resistance
of peripheral blood vessels (Nugroho, 2013).
The results of this study are in line with research
conducted by (Natalia, 2018) which shows that
there is a relationship between age and blood
pressure in patients with hypertension, with the
results of 31 respondents aged 26-30 years there
were 17 respondents (22%) who experienced
hypertension, while of the 47 respondents aged
31-35 years there were 27 respondents (35%)
who experienced hypertension.
Based on the results of the study
obtained from gender, it shows that men who
suffer from hypertension are fewer while
women suffer more from hypertension due to
increasing age, women experience
premenopause and hormonal changes resulting
in increased blood pressure and due to heredity
from the family, if one of the families has
hypertension, it is likely that the respondent will
also experience hypertension. Poor diet such as
consuming excessive salt and the influence of
stress on women in terms of taking care of
husbands, children and work at home so that
they neglect to do health checks, this results in
more women suffering from hypertension
(Maulidiana, 2018). This research is also in
accordance with the research of Rantiningsih
(2015) which shows that out of 100
respondents, those who experience
hypertension tend to be women as many as 72
respondents (72%).
Based on the stress level of the
respondents, it shows that most of the adult age
group in Beamese village, Cibal sub-district,
experienced moderate-severe stress and the
least experienced normal-light stress. Stress is
the body's reaction or response to psychosocial
stressors (mental pressure or the burden of life).
Adulthood has developmental tasks including:
adulthood chooses friends to hang out with (as
5 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
a future husband and wife), adulthood has the
task of learning to live with a husband and wife,
adulthood begins to live in a family or family
life, manage a household, start working in a
position, begin to take responsibility as a citizen
properly, and adulthood acquires a social group
that is in line with the values of its
understanding (Ahjuri, 2019). Adulthood is a
period full of problems and emotional tensions,
a period of social isolation, a period of
commitment and a period of dependence,
changes in values, creativity and adjustment to
new ways of life (Putri, 2018). Stress is caused
by several factors including economic factors,
social factors, environmental factors, work
problems, and domestic problems. A person is
said to experience moderate stress when the
stressor faced lasts longer than a few hours to
several days. At the individual level begins to
experience muscle tension, sleep disturbances,
and light body. A person with mild stress will
last for a few minutes or a few hours,
individuals with mild stress will experience
increased vigor, sharp vision, and a feeling of
not relaxing. While severe stress lasts for
several months and even up to several years. In
severe stress individuals will experience
impaired social relationships, difficulty
sleeping, decreased concentration, inability to
do simple work and increased feelings of fear
(Priyoto, 2014).
Stress has a bad impact on individuals
where stress will adversely affect the physical
condition, namely individuals feel fatigue and
weakness, other things that are felt are
headaches, dizziness, eating disorders, pain,
body aches and muscle tension, easily sick or
decreased body health, sleep disorders and
digestive disorders. Another impact of stress is
very high emotions, irritability, crying more
easily, bad mood, more sensitive, irritable,
depressed and tend to be alone, and have an
impact on cardiovascular disease, and heart
rhythm disorders (Barnes, 2013). Stress can
cause sympathetic nervous system activity
which can lead to increased release of
norepinephrine from sympathetic nerves in the
heart and blood vessels, leading to increased
cardiac output and increased systemic vascular
resistance. Furthermore, the adrenal medulla
secretes more catecholamines (epinephrine and
norepinephrine). Activation of the sympathetic
nervous system can increase circulating
angiostenin II, aldosterone and vasopressin
which can increase systemic vascular
resistance. Prolonged elevation in angiotensin
II and ketocolamine can cause hypertrophy of
the heart and blood vessels which both can
contribute to a sustained increase in blood
pressure resulting in increased blood pressure
and the occurrence of hypertension. The results
of this study are in accordance with research
conducted by Sartika (2014) which shows that
the level of stress in adulthood is mostly in the
moderate category as many as 20 respondents
(66.7%) of 30 respondents. Research that has
been conducted in Beamese village, Cibal sub-
district about the relationship between stress
levels and blood pressure levels in adult age
groups with hypertension obtained a sample of
73 respondents. The results showed that most of
the adult age group in Beamese village, Cibal
sub-district, experienced stage 2 hypertension
with 43 respondents.
Hypertension is a condition of high
blood pressure with systolic pressure above 140
mmHg and diastolic pressure above 90 mmHg
WHO, 2013). Hypertension is defined as a
condition when blood pressure in the blood
vessels increases. This can occur because the
heart works hard to pump blood to meet the
body's oxygen and nutrient needs, if left
untreated this disease can interfere with the
function of vital organs such as the heart and
kidneys (Elvira & Anggraini, 2019). Blood
pressure is the pressure exerted on the walls of
the arteries. The peak pressure that occurs when
the ventricles contract is called systolic
pressure, while the lowest pressure that occurs
when the heart is at rest is called diastolic
pressure (Smetlzer & Bare, 2013).
The results showed that there is a
significant relationship between stress and the
degree of blood pressure in the adult age group
in Beamese village, Cibal sub-district. This is
6 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
evidenced by the results of the analysis using
the Chi-square statistical test with a p value =
0.000. This value means that there is a
relationship between stress levels and blood
pressure levels in the adult age group in
Beamese village, Cibal sub-district. The results
of this study are also in accordance with
research conducted by Sugiharto (2016) there is
a relationship between stress and the incidence
of hypertension with a p value = 0.003, this is
thought to be through sympathetic nerve
activity. Increased nerves can increase blood
pressure intermittently (erratically). Stress will
increase peripheral vascular resistance and
cardiac output so that it will stimulate
sympathetic nerve activity. The stress is related
to work, social class, economy and personal
characteristics.
Patients who experience stress can be
seen or felt from changes that occur in the body,
for example in the cardiovascular system, the
heart and blood vessel system can be disrupted
due to stress. For example, the heart is
pounding, the blood vessels widen (dilatation)
or narrow (contriction) so that the person
concerned looks red or pale. Based on the
researcher's analysis, there are respondents who
are in normal - mild stress but have a degree of
blood pressure of stage 1 hypertension and
stage 2 hypertension because there are still
respondents who do not control blood pressure
regularly with bad lifestyles such as smoking,
consuming excess salt, consuming alcohol and
heavy physical activity so that respondents with
normal - mild stress experience a degree of
blood pressure of stage 1 hypertension and
stage 2 hypertension. While respondents who
respondents who experience moderate-heavy
stress but have a degree of pre-hypertension
blood pressure because respondents control
their blood pressure regularly and control their
lifestyle well. So that even though respondents
have moderate-heavy stress, their blood
pressure is at the pre-hypertension blood
pressure level.
CONCLUSION Basmenelly, M.Kep SK.M B., Emil Huriani
SM, A. The Relationship between Stress Level
Based on the results of the research and
and Hypertension Degree in the Work Area of
discussion, it can be concluded as follows
Puskesmas Andalas Padang in 2014. Ners J
1. The description of stress levels in Nursing.
the adult age group in beamese
Delavera, A., Siregar, K. N., Jazid, R., &
village, cibal sub-district, was
Eryando, T. (2021). The Relationship of
found to have the highest level of
Psychological Conditions Stress with
moderate-heavy stress at 50
Hypertension in the Population Over the Age of
respondents (68.5%) and the least
15 years old in Indonesia. Bikfokes Journal,
level of normal-mild stress was 23
1(3), 148-159.
respondents (31.5%).
2. The description of the degree of Elvira, M., & Anggraini, N., 2019. Factors
blood pressure in the adult age Associated with the Incidence of Hypertension.
group with hypertension in Akademika Baiturrahim Journal, 8(1), pp. 78-
Beamese village, Cibal sub-district 89.
that the majority experienced stage
Hamria, Mien, & Saranani, M. (2020). The
2 blood pressure levels totaling 43
Relationship between Lifestyle of
respondents (58.9%) and the rest
Hypertension Patients with the Incidence of
experienced pre-hypertension
Hypertension in the Working Area of the
totaling 11 respondents (15.1%).
Batalaiworu Health Center, Muna Regency.
3. There is a relationship between
Journal of Nursing, 4(1), 17-21.
stress levels and blood pressure
https://stikesks-kendari.e-
levels in the adult age group with
journal.id/JK/article/view/239
hypertension in Beamese village,
Cibal sub-district with a p value = Ministry of Health of the Republic of Indonesia.
0.000. (2019). National report RISKESDAS 2018.
Jakarta
Muyossaro, P. (2014) Factors that cause
REFERENCES
Hypertension: Jakarta
Ajhuri, K. F. (2019). Developmental
Nuraini, B. (2015). Risk Factors of
Psychology An Approach Across the Life Span.
Hypertension. J Majority, 4(5), 10-19.
Yogyakarta: Penebar Media Pustaka
Nursalam. Nursing Science Research
Ansar J, Dwinata I, M. A. (2019). Determinants
Methodology. Jakarta: Salemba Medika.2013.
of Hypertension Incidence in Posbindu Visitors
In: Livibond, SH & Lobibond, PF. Depression
in the Ballaparang Health Center Working
Anxiety Stress Scale 21 (DASS 21).1995
Area, Makassar City. National Journal of
Health Sciences, 1(3), 28-35. Nugroho K, Sanubari T, Rumondor J. 2013
Risk Factors for Hypertension Incidence
Andria, K. M. (2013). The Relationship
Between Exercise Behavior, Stress and Diet Natali, D., Hasibuan, P. & H., 2014.
with Hypertension Level in the Elderly. Journal Relationship between Age and Hypertension in
of Promkes, 1(2), 111-117. residents of Sintang District, West Kalimantan.
Barnes, A.P., & Montefusco, J.E (2013). Role Priyoto.2014. Stress Management Concept.
of stress in psychological disorders. New York: Yogyakarta: Nuha Medika
Nova Science Publisher, Inc.

7 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery
Putri, A. F. (2018). The Importance of Early
Adults Completing Their Developmental
Tasks. SCHOULID: Indonesian Journal of
School Counseling, 3(2), 35.
https://doi.org/10.23916/08430011
Saleh, M., Kep, M., J, S. K., Huriani, E., & Mn,
S. (2014). THE RELATIONSHIP BETWEEN
STRESS LEVELS AND THE DEGREE OF
HYPERTENSION IN HYPERTENSIVE
PATIENTS IN THE WORK AREA OF THE
ANDALAS PADANG HEALTH CENTER IN
2014. Ners Journal of Nursing, 10(1), 166-175.
Sanger, A. Y., & Lainsamputty, F. (2020). IN
PATIENTS WITH HYPERTENSION. Journal
Nutrix, 6(1), 1-8.
Sartika. 2014. Relationship between Stress
Level and Hypertension Level in Middle Adult
in Nitten Nogotirto Gamping Sleman
Yogyakarta.
http://digilib.unisayogya.ac.id/450/1/NASKA
H%20PUBLIKASI_SARTIKA_20101020115
3
Suoth, M., Bidjuni, H., Malara, R.T. 2014. The
Relationship between Lifestyle and the
Incidence of Hypertension at the Kolongan
Health Center, Kalawat District, North
Minahasa Regency. Unsrat ejournal Vol.2
No.1.
Smeltzer, S.C. & Bare, B.G. (2013). Brunner &
Suddarth Medical-Surgical Nursing Textbook,
8th Edition: EGC
Tri, Y., & Arum, G. (2019). HIGEIA
JOURNAL OF PUBLIC HEALTH. 3(3), 345-
356.
Upik, Pebriyani. (2021). Relationship between
Stress Level and Hypertension Degree.
World Health Organization. A global brief on
Hypertension - World Health Day 2013. WHO.
2013

8 | PROSIDING
Seminar Internasional: Scope Of Practice Of Nursing And Midwifery