Growing Mobility Brings New Public Health Challenges
Hypertension remains one of the world's leading causes of cardiovascular disease, stroke, kidney failure, and premature death. While age, genetics, and unhealthy lifestyles have long been recognized as major contributors, people who travel frequently—particularly maritime travelers—have received far less attention in hypertension research.
Indonesia's growing inter-island transportation network has dramatically increased population mobility. Port workers, fishermen, business travelers, ship crews, and passengers often experience prolonged journeys, irregular sleep schedules, stressful working conditions, and unhealthy lifestyle habits during travel. These conditions can place considerable strain on the cardiovascular system.
Recognizing this gap, researchers from Sam Ratulangi University investigated whether travel-related behaviors themselves contribute to hypertension beyond traditional risk factors such as age and family history.
Examining Hypertension Among Port Travelers
The research was conducted between January and March 2026 at Ampana Port, one of the busiest maritime transit points in Central Sulawesi. The researchers recruited 287 adult travelers and measured their blood pressure using standardized digital equipment while collecting information through structured interviews.
Participants were asked about:
- Frequency of travel
- Duration of each trip
- Smoking habits
- Rest patterns
- Travel-related stress
- Family history of hypertension
- Demographic characteristics
The researchers then analyzed which factors independently predicted hypertension after accounting for age and inherited risk.
Four Out of Ten Travelers Had Hypertension
One of the most striking findings was the high prevalence of hypertension among participants.
Approximately 40.1% of all travelers examined were found to have hypertension, substantially higher than many population estimates reported in Indonesia.
The analysis identified five independent predictors of hypertension:
- Heavy smoking increased the odds of hypertension by 2.37 times.
- Long travel duration raised the risk by 2.13 times.
- High travel frequency increased the likelihood by 2.10 times.
- Family history of hypertension doubled the risk.
- Increasing age consistently elevated hypertension risk, with each additional year associated with a higher probability of developing the condition.
Interestingly, although poor rest patterns appeared to increase hypertension in preliminary analysis, they were not statistically significant after other factors were considered.
Heavy Smoking Emerged as the Strongest Modifiable Risk Factor
Among all lifestyle-related variables, heavy smoking proved to be the most influential factor that individuals can change.
The researchers observed that heavy smokers were nearly two and a half times more likely to experience hypertension than non-smokers. Tobacco use contributes to elevated blood pressure by stimulating the sympathetic nervous system, narrowing blood vessels, increasing heart rate, and damaging blood vessel function over time.
Because smoking is preventable, the findings suggest that smoking cessation programs could substantially reduce cardiovascular disease among highly mobile populations.
Frequent and Long-Distance Travel Also Matters
The study demonstrates that travel itself should be considered an important health determinant.
People who travel frequently often experience repeated disruption of their biological clock, inconsistent meal schedules, prolonged sitting, environmental stress, fatigue, and limited opportunities for physical recovery. Long hours aboard ships or other transportation can also expose travelers to continuous vibration, noise, and psychological stress.
According to the researchers, these repeated physiological stresses accumulate over time and contribute to elevated blood pressure, even after accounting for smoking and hereditary risk.
The findings reinforce growing international evidence suggesting that occupational mobility should receive greater attention in cardiovascular disease prevention.
Why the Findings Matter
Most health surveillance at ports traditionally focuses on infectious diseases. However, the new findings suggest that non-communicable diseases such as hypertension deserve equal attention.
Early blood pressure screening at ports could identify individuals who remain unaware of their condition before serious complications occur.
The researchers recommend integrating routine hypertension screening into health services at ports and transit areas, particularly for:
- Ship crews
- Fishermen
- Frequent business travelers
- Transportation workers
- Passengers with repeated long-distance travel
Smoking cessation support, health education, and targeted cardiovascular promotion programs could also help reduce disease burden among these high-risk groups.
A Contribution to Public Health Policy
The study supports Indonesia's broader efforts to strengthen prevention of non-communicable diseases under the One Health approach.
By recognizing travel-related exposure as a measurable cardiovascular risk factor, health authorities may expand surveillance beyond infectious diseases and develop preventive interventions tailored for highly mobile populations.
As Indonesia continues to improve maritime connectivity, protecting the health of travelers becomes increasingly important not only for individual well-being but also for reducing long-term healthcare costs associated with cardiovascular disease.
Research Perspective
Lead author Sitti Rafiah Musa and colleagues from Sam Ratulangi University conclude that travel frequency, travel duration, and heavy smoking should be considered important predictors of hypertension among maritime travelers. Their findings indicate that many cardiovascular risks associated with mobility are preventable through early detection, smoking cessation, and targeted public health interventions.
Author Profile
Sitti Rafiah Musa, MPH Candidate, is a researcher in the Postgraduate Public Health Sciences Program at Sam Ratulangi University, Indonesia. Her research focuses on epidemiology, public health surveillance, travel health, and the prevention of non-communicable diseases.
Co-authors Grace Debbie Kandou, Windy V. Wariki, Novie H. Rampengan, and Fima L.F.G. Langi are affiliated with the Faculty of Public Health and the Faculty of Medicine at Sam Ratulangi University, with expertise spanning epidemiology, preventive medicine, public health, and clinical medicine.
Source
Article Title: Travel Frequency, Duration, and Heavy Smoking as Independent Predictors of Hypertension Among Travelers: A Cross-Sectional Study in Indonesian Port Transit Areas
Journal: International Journal of Sustainable Applied Sciences (IJSAS)
Publication: Vol. 4, No. 7 (2026)
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