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ABSTRAK Latar Belakang : Hipertensi merupakan faktor resiko utama penyakit kardiovaskular,
terutama sindrom koroner akut dan stroke. Peningkatan konsumsi garam berhubungan
dengan kenaikan tekanan darah. Beberapa studi randomized-controlled trial (RCT)
menyatakan bahwa konsumsi rendah garam dapat menurunkan tekanan darah pada
populasi dewasa dengan atau tanpa hipertensi. Variabilitas tekanan darah selama 24 jam
bersifat dinamis. Peningkatan darah nokturnal memiliki makna klinis yang cukup besar,
merupakan salah satu prediktor dari penyebab kerusakan target organ, terutama kejadian
kardiovaskular dan stroke. Asupan garam dapat mempengaruhi variasi tekanan darah 24
jam, yang dalam hal ini dapat juga berpengaruh pada hipertensi nokturnal. Obat penyekat
EKA merupakan obat hipertensi lini pertama yang sering digunakan, terutama pada usia
muda dan hipertensi yang disertai sindrom metabolik, mengingat peranan Sistem Renin
Angiotensin memiliki peranan yang sangat penting dalam patofisiologi hipertensi. Asupan
garam juga memiliki peranan pada patofisiologi terjadinya hipertensi dalam sistem Renin
Angiotensin. Sedikit studi yang meneliti perpaduan obat penyekat EKA dengan asupan
rendah garam dalam menrunkan kejadian hipertensi. Oleh karena itu, Menarik untuk diteliti
pengaruh asupan garam dengan tekanan darah nokturnal pada pasien yang mengkonsumsi
obat penyekat EKA.
Tujuan : Menilai pengaruh asupan garam dengan tekanan darah nokturnal pada pasien
hipertensi yang mendapatkan terapi penyekat EKA.
Metode : Pasien poliklinik berusia 30 ? 50 tahun yang terdiagnosis hipertensi dan belum
pernah mendapatkan anti-hipertensi sebelumnya, dibagi menjadi 2 kelompok (asupan
rendah garam (Na <15 g/hari) dan asupan tinggi garam ≥15 g/hari). Kedua kelompok akan
diberikan lisinopril dan dilakukan pemeriksaan natrium urin 24 jam dan home blood
pressure monitoring..
Hasil Penelitian : Sebanyak 80 pasien hipertensi pasien hipertensi yang belum
mendapatkan terapi diikutsetakan dalam penelitian ini, yang terdiri dari 37 pasien
kelompok rendah garam dan 43 pasien kelompok tinggi garam. Kelompok pasien dengan
asupan rendah garam memliki delta penurunan darah nokturnal sistolik (p<0,001),
diastolic (p<0,001), dan rerata arteri (p<0,001) yang lebih besar dibandingkan pada
kelompok asupan tinggi garam. Rerata asupan garam pada penelitian ini sebesar 16,77
gram/hari. Pada analisa multivariat didapatkan delta penurunan tekanan darah tidak
dipengaruhi oleh usia, jenis kelamin, dislipidemia, IMT, dan durasi tidur.
Kesimpulan : Penelitian ini membuktikan asupan rendah garam dapat mempengaruhi efektivitas terapi penyekat EKA dalam menurunkan tekanan darah nokturnal.
ABSTRACT Background : Hypertension is one of important risk factor of cardiovascular
disease, especially acute coronary syndrome and stroke. High salt intake correlates
to high blood pressure. Some Randomized-Controlled-Trials stated that low salt
intake may decrease blood pressure in adult population with or without
hypertension. Blood pressure variation in 24 hours is not static but dynamically
changes. Increasing nocturnal blood pressure has significantly impacts, and become
one of predictor of target organ damage, especially cardiovascular events and
stroke. Salt intake may interferes both 24 hours blood pressure variation and
nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first
drug of choice anti-hypertensive therapy, especially in young age and associated
with metabolic syndrome, due to important role of Renin Angiotensin Aldosterone
System in pathophysiology of hypertension, whereas salt intake also has role in that
system. Only few of studies that had proved combination of ACE Inhibitors and
low salt intake in decreasing blood pressure in hypertension population. Therefore,
it is so important to know the impact of low salt intake to nocturnal blood pressure
in hypertension patient treated with ACE Inhibitors.
Objectives : To know impact of low salt intake to nocturnal blood pressure in
hypertension patient treated with ACE Inhibitors.
Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreated
hypertension, divided into two groups (low salt intake (Na <15 grams/day) and high
salt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg and
underwent 24-hours sodium urine collection and home blood pressure monitoring
periodically.
Results : There are 80 ambulatory patients diagnosed as untreated hypertension,
consist of 37 patients in low salt intake group and 43 patients in high salt intake
group. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic
(p<0.001), and mean arterial (p<0.001) blood pressure compared with high salt
intake group. Mean salt intake in this study was 16.77 grams/day. Multivariate
analyzes showed that the difference of decreasing nocturnal blood pressure was not
interfered by age, sex, dyslipidemia, BMI, and sleep duration.
Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.;Background : Hypertension is one of important risk factor of cardiovascular
disease, especially acute coronary syndrome and stroke. High salt intake correlates
to high blood pressure. Some Randomized-Controlled-Trials stated that low salt
intake may decrease blood pressure in adult population with or without
hypertension. Blood pressure variation in 24 hours is not static but dynamically
changes. Increasing nocturnal blood pressure has significantly impacts, and become
one of predictor of target organ damage, especially cardiovascular events and
stroke. Salt intake may interferes both 24 hours blood pressure variation and
nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first
drug of choice anti-hypertensive therapy, especially in young age and associated
with metabolic syndrome, due to important role of Renin Angiotensin Aldosterone
System in pathophysiology of hypertension, whereas salt intake also has role in that
system. Only few of studies that had proved combination of ACE Inhibitors and
low salt intake in decreasing blood pressure in hypertension population. Therefore,
it is so important to know the impact of low salt intake to nocturnal blood pressure
in hypertension patient treated with ACE Inhibitors.
Objectives : To know impact of low salt intake to nocturnal blood pressure in
hypertension patient treated with ACE Inhibitors.
Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreated
hypertension, divided into two groups (low salt intake (Na <15 grams/day) and high
salt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg and
underwent 24-hours sodium urine collection and home blood pressure monitoring
periodically.
Results : There are 80 ambulatory patients diagnosed as untreated hypertension,
consist of 37 patients in low salt intake group and 43 patients in high salt intake
group. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic
(p<0.001), and mean arterial (p<0.001) blood pressure compared with high salt
intake group. Mean salt intake in this study was 16.77 grams/day. Multivariate
analyzes showed that the difference of decreasing nocturnal blood pressure was not
interfered by age, sex, dyslipidemia, BMI, and sleep duration.
Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.;Background : Hypertension is one of important risk factor of cardiovascular
disease, especially acute coronary syndrome and stroke. High salt intake correlates
to high blood pressure. Some Randomized-Controlled-Trials stated that low salt
intake may decrease blood pressure in adult population with or without
hypertension. Blood pressure variation in 24 hours is not static but dynamically
changes. Increasing nocturnal blood pressure has significantly impacts, and become
one of predictor of target organ damage, especially cardiovascular events and
stroke. Salt intake may interferes both 24 hours blood pressure variation and
nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first
drug of choice anti-hypertensive therapy, especially in young age and associated
with metabolic syndrome, due to important role of Renin Angiotensin Aldosterone
System in pathophysiology of hypertension, whereas salt intake also has role in that
system. Only few of studies that had proved combination of ACE Inhibitors and
low salt intake in decreasing blood pressure in hypertension population. Therefore,
it is so important to know the impact of low salt intake to nocturnal blood pressure
in hypertension patient treated with ACE Inhibitors.
Objectives : To know impact of low salt intake to nocturnal blood pressure in
hypertension patient treated with ACE Inhibitors.
Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreated
hypertension, divided into two groups (low salt intake (Na <15 grams/day) and high
salt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg and
underwent 24-hours sodium urine collection and home blood pressure monitoring
periodically.
Results : There are 80 ambulatory patients diagnosed as untreated hypertension,
consist of 37 patients in low salt intake group and 43 patients in high salt intake
group. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic
(p<0.001), and mean arterial (p<0.001) blood pressure compared with high salt
intake group. Mean salt intake in this study was 16.77 grams/day. Multivariate
analyzes showed that the difference of decreasing nocturnal blood pressure was not
interfered by age, sex, dyslipidemia, BMI, and sleep duration.
Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure."
