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"Latar belakang. Pengukuran tekanan darah di klinik (TDK) saat ini masih dianggap sebagai metoda referensi dalam mendiagnosis dan follow-up pasien hipertensi,tetapi disebabkan adanya fenomena white-coat hypertension dan masked hypertension terlihat semakin jelas informasi yang diberikan seringkali tidak adekuat tentang status tekanan darah pasien yang sebenarnya. Hipertensi sendiri dikaitkan dengan kerusakan target organ dan salah satu diantaranya ke organ ginjal. Pemeriksaan indeks resistensi renalis (RRI) dapat menjadi prediktor disfungsi ginjal dan dapat mencerminkan tingkat aterosklerosis sistemik. Khususnya pada kasus hipertensi, peningkatan RRI dihubungkan dengan berat dan lama nya durasi hipertensi esensial. Tujuan dari penelitian ini adalah melihat nilai pengukuran tekanan darah di rumah (TDR) dibandingkan TDK dalam memprediksi nilai RRI. Metode. Tujuh puluh dua pasien hipertensi dalam terapi obat antihipertensi diambil secara konsekutif untuk studi potong lintang ini, mulai bulan Maret hingga Mei 2013 di poli rawat jalan Pusat Jantung Nasional Harapan Kita, Jakarta. Pasien menjalani pemeriksaan TDK saat kontrol dan TDR dilakukan selama 4 hari dimana keduanya memakai alat osilometri yang tervalidasi. Pemeriksaan Doppler renal dilakukan pada semua pasien untuk mendapatkan nilai RRI. Hasil. Uji korelasi antara nilai TDR dan TDK mempunyai korelasi yang baik untuk sistolik maupun diastolik (r = 0,48/0,45 , p < 0,001). Pada uji korelasi regresi didapatkan korelasi yang bermakna antara nilai sistolik TDR dengan nilai RRI (r=0,118 dengan p=0,032), dan korelasi ini tidak signifikan baik untuk sistolik TDK, dan diastolik baik TDK dan TDR. Dari uji multipel regresi melihat prediktor independen terhadap nilai RRI didapatkan nilai sistolik TDR merupakan prediktor independen. Kesimpulan. Penelitian ini menunjukkan bahwa TDR merupakan prediktor yang baik dari nilai RRI sebagai penilaian kerusakan target organ, dan metode ini lebih superior dibandingkan TDK.

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Introduction. Office blood pressure monitoring still considered as method of reference for diagnosing an follow up hypertension patients, but due to white coat hypertension and masked hypertension it seems the information inadequate for the real blood pressure status. Hypertension itself was related to target organ damage and one of them is renal damage. Renal Resistive index (RRI) can be a predictor of renal dysfunction and it reflect sistemic atherosclerosis. Especially for hypertension, increase of RRI is related to severity and duration of essential hypertension. Our objective was to assess the value of home blood pressure (HBP) monitoring in comparison to office blood pressure in predicting renal resistive index value(RRI).

Methods. Seventy two hypertension patients on medication was consecutively included in our cross sectional study, starting from March to Mei 2013 at National Cardiac Centre Harapan Kita Hospital Outpatient clinic. Office Blood pressure was measured when patients controlled to the clinic and HBP was measured for 4 workdays with the same validated electronic device. Renal Doppler was performed to measured RRI value.

Results. Correlation test between HBP and OBP showed a good correlation for systolic and diastolic (r=0,48/0,45, p<0,001). The correlation regretion test showed a good correlation between systolic HBP with renal resistive index (r=0,118 with p=0,032), and this correlation was not significant for systolic OBP, and diastolic OBP and HBP. In multiple regression analysis assessing independent predictor for RRI, systolic HBP was seen as the only independent predictor.

Conclusions. This result suggest that home BP was a better predictor of RRI as assessment for target organ damage, and this method was superior compared to the blood pressure measurement at the clinic."

"Latar Belakang. Hipertensi merupakan faktor utama penyebab gagal jantung yang saat ini sudah menjadi pandemi dunia, terutama dalam bentuk gagal jantung dengan preservasi fraksi ejeksi ventrikel. Kontrol terhadap hipertensi secara tradisional dilakukan berdasarkan pemeriksaan rutin ke fasilitas kesehatan yang diikuti dengan pengaturan terapi yang diberikan. Saat ini pengukuran tekanan darah rumah ditempatkan sebagai pemeriksaan tambahan yang dapat memberikan informasi tambahan mengenai kontrol tekanan darah sehingga mencegah terjadinya kerusakan target organ. Penelitian ini bertujuan untuk mengevaluasi hubungan antara nilai pengukuran tekanan darah rumah dengan derajat disfungsi diastolik sebagai indikator kerusakan target organ.Metode. Studi potong lintang yang dilakukan di Departemen Kardiologi dan Kedokteran Vaskular FK UI / RS Pusat Jantung Nasional Harapan Kita, Jakarta pada kelompok pasien hipertensi dari poliklinik rawat jalan yang telah mendapatkan terapi rutin. Pengukuran tekanan darah rumah dilakukan dengan alat yang terstandarisasi. Pemeriksaan ekokardiografi lengkap terhadap parameter diastolik dilakukan dan dikelompokkan berdasarkan derajat disfungsi diastoliknya.Hasil. Sebanyak 56 pasien ikut dianalisa dalam penelitian ini, dengan rerata umur subyek adalah 51,2 + 7,2 thn dan sebagian besar wanita (58,9%). Didapatkan disfungsi diastolik derajat I pada 11 subyek (19,6%), derajat II pada 19 subyek (33,9%). Parameter fungsi diastolik E/A memiliki hubungan linear yang paling signifikan terhadap TD Rumah sistolik setelah dikontrol terhadap usia, jenis kelamin, IMT, dan DM (R2=0,27;p<0,01). Uji ANOVA menemukan perbedaan rerata TD Rumah Sistolik yang signifikan antara fungsi diastolik normal dan disfungsi diastolik derajat 2 (p=0,02). Uji regresi logistik menemukan perbedaan yang signifikan antara TD Rumah sistolik <127 mmHg dengan TD >135 dengan OR 12,68 (IK 2.03-79.08;p<0.01).Kesimpulan. Pengukuran TD Rumah Sistolik memiliki hubungan signifikan terhadap derajat disfungsi diastolik. Gangguan parameter fungsi diastolik dapat terjadi pada tekanan darah yang lebih rendah daripada target yang umum digunakan saat ini.

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Background. Hypertension the main factor leading to heart failure which has become a world pandemic, especially in the form of heart failure with preserved ejection fraction. Traditional control for hypertension comprise of regular outpatient clinic visits followed by adjustment of the drug regimen. Recently, home blood pressure monitoring has been been accepted as an additional tool to provide more information on blood pressure control and prevent target organ damage. This study aim to evaluate the relationship between home blood pressure measurement with the degree of diastolic dysfunction as an indicator of target organ damage.

Methods. A cross-sectional study performed at Cardiology and Vascular Medicine Department FK UI / National Cardiac Centre Harapan Kita, Jakarta, on a group of hypertensive patients in the outpatient clinic currently receiving active treatment. Home blood pressure measurement are performed with a standarized device. Full echocardiography study on diastolic function parameters are performed and grouped based on the diastolic dysfunction grade criteria.

Result. Fifty six patients are enrolled in this study with average age of 51,2 + 7,2 y.o. which are mostly women (58,9%). Grade I diastolic dysfunction was found in 11 subjects (19,6%), Grade II on 19 subjects (33,9%). One parameter of diastolic dysfunction, E/A ratio, have the strongest linear correlation with systolic HBP after adjusted for age, sex, BMI, and DM (R2=0,27;p<0.01). ANOVA test found a significant difference on mean of systolic HBPM between normal and grade II diastolic dysfunction (p=0.02). Logistic regression test showed significant difference between <127 and >135 mmHg of systolic HBPM with OR 12,68 (CI 2.03-79.08;p<0.01).

Conclusion. Systolic HBPM have a significant relationship to the degree of diastolic dysfunction. A worsening of diastolic function parameter can occur on a level of blood pressure lower then the target level commonly used today."

"Tidur yang cukup merupakan kebutuhan dasar yang sangat dibutuhkan untuk pemeliharaan fungsi kardiovaskular. Penelitan ini merupakan penelitian descriptive correlative dengan desain studi cross sectional yang bertujuan mengidentifikasi hubungan antara kualitas tidur dengan tekanan darah pada pasien hipertensi. Penelitian dilakukan di Puskesmas Beji-Depok terhadap 97 pasien hipertensi rawat jalan yang dipilih dengan teknik consecutive sampling. Kualitas tidur diukur menggunakan kuesioner Pittsburgh Sleep Quality Index (PSQI), sedangkan tekanan darah diukur menggunakan sphygmomanometer digital. Hasil penelitian menunjukkan mayoritas responden yaitu sebanyak 87 orang (89,7 %) memiliki kualitas tidur buruk (PSQI ≥ 5), sedangkan hanya 10 orang (10,3 %) memiliki kualitas tidur baik (PSQI ≤ 5). Rata-rata tekanan darah responden secara keseluruhan 145,19/86,15 mmHg. Hasil analisis uji T independent menunjukan secara statistik tidak ada hubungan yang signifikan antara kualitas tidur dengan tekanan darah. Namun, secara klinis hasil analisis data menunjukkan responden yang memiliki kualitas tidur buruk memiliki tekanan darah lebih tinggi daripada responden yang memiliki kualitas tidur baik dengan mean differece sistolik sebesar 6,228 mmHg dan mean difference diastolik 4,409 mmHg.

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Adequate sleep is a basic need which is important to maintain cardiovascular system function. It is a descriptive correlative study using cross sectional approach which aims to identify the relationship between sleep quality and blood pressure on hypertensive patient. The research was conducted in Public Health Center of Beji-Depok towards 97 participants recruited using consecutive sample method. Sleep quality is measured using Pittsburgh Sleep Quality Index (PSQI) and blood pressure is measured using digital sphygmomanometer.

The result shows that 83 participants (89.7 %) have poor sleep quality (PSQI ≥ 5) while only 10 partcipants (10.3 %) have good sleep quality (PSQI ≤ 5). The average blood pressure of all participants is 145.19/86.15 mmHg. Statistical analysis using T independent test shows there is no significant relationship between sleep quality and blood pressure. However, in clinical basis the result shows a significant difference. Clinically speaking, participants with poor sleep quality indicates higher blood pressure compare to those with better sleep quality with systolic mean difference of 6.228 mmHg and diastolic mean difference of 4.409 mmHg."

"Rendahnya kepatuhan dan self efficacy menjadi masalah yang signifikan untuk penggunaan obat hipertensi. Keterbatasan tenaga kesehatan menyebabkan pemberian informasi sulit dilakukan. Tujuan penelitian ini adalah untuk mengevaluasi efektivitas konseling dibandingkan dengan leaflet terhadap peningkatan self efficacy dan kepatuhan pasien serta penurunan tekanan darah pasien menggunakan obat hipertensi di Puskesmas Pancoran Mas dan Puskesmas Beji Depok. Rancangan penelitian ini menggunakan quasi eksperimen. Pengambilan data dilakukan dari bulan Maret sampai Juni 2013 dengan 37 pasien pada kelompok yang mendapatkan konseling dan 36 pasien pada kelompok yang mendapatkan leaflet. Penilaian self efficacy menggunakan skala MUSE dan untuk kepatuhan menggunakan MMAS 8. Hasil penelitian menunjukkan konseling dan leaflet dapat meningkatkan self efficacy (P=0,000) dan kepatuhan (P=0,000) pasien, serta dapat menurunkan tekanan darah sistol (P=,010) pada kelompok konseling dan menurunkan tekanan darah sistol (P=0,000) maupun diastol (P=0,019) pada kelompok leaflet. Tidak ada perbedaan antara kelompok konseling dan leaflet dalam meningkatkan self efficacy (P=0,401) dan kepatuhan pasien P=(0,374) serta menurunkan tekanan sistol (P=0,663) dan tekanan diastol (P=0,466).

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Low adherence and self efficacy was significant problem for using medication. However, the limitation of medical personnel makes medical information service is very hard to be done. The research purpose was to evaluate the effectiveness of counselling and leaflet againts self efficacy and adherence as well as the blood pressure of hypertension patients using the medication in Puskesmas Beji and Puskesmas Pancoran Mas Depok. Data collection was conducted from March to June 2013 with with 37 patients in the group receiving counseling and 36 patients in the group receiving leaflets. Self efficacy assessment using MUSE scale and adherence using the MMAS 8.

The result showed that counselling and leaflet can increase patient adherence (P=0.000) and self efficacy (P=0.000) and can lower systolic blood pressures (P=0.010) in group counseling and lowers systolic (P=0.000) and diastolic blood (P=0.019) pressure in the leaflet group. There was no difference between group counseling and leaflets to increase self-efficacy (P= 0.401) and patient adherence (P=0.374) and lower systolic pressure (P = 0.663) and diastolic pressure (P = 0.466)."

"Hipertensi merupakan masalah utama kesehatan masyarakat di Indonesia. Dari Riskesdas tahun 2007 dilaporkan prevalensi penduduk Indonesia usia di atas 18 tahun yang menderita hipertensi mencapai 31,7%. Hipertensi seringkali disertai perubahan-perubahan metabolik, salah satunya dislipidemia. Penelitian ini bertujuan untuk membuktikan hubungan kadar High Density Lipoprotein (HDL) terhadap kendali tekanan darah pada pasien hipertensi. Penelitian dilaksanakan dengan metode cross sectional menggunakan data sekunder dari 117 rekam medis pasien hipertensi poliklinik penyakit dalam RSUPN Dr. Cipto Mangunkusumo Jakarta. Uji hipotesis dilakukan menggunakan uji Chi-square. Dari hasil penelitian didapatkan jumlah pasien hipertensi tidak terkendali sebanyak 48 pasien (41%). Jumlah pasien hipertensi tidak terkendali dengan kadar HDL rendah sebanyak 11 pasien (61,1%), sedangkan jumlah pasien hipertensi terkendali dengan kadar HDL rendah sebanyak 7 pasien (38,9%). Dari penelitian ini didapatkan proporsi pasien hipertensi tidak terkendali dengan kadar HDL rendah secara signifikan lebih besar dibandingkan pasien hipertensi terkendali dengan kadar HDL rendah, namun nilai p=0,060 (p>0,05) yang didapatkan menyimpulkan bahwa secara statistik tidak ada hubungan bermakna antara kadar HDL terhadap kendali tekanan darah pada pasien hipertensi poliklinik penyakit dalam RSUPN Dr. Cipto Mangunkusumo Jakarta.

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Hypertension is a major public health problem in Indonesia. Riskesdas 2007 reported the prevalence of Indonesia's population aged over 18 years who suffering hypertension achieve 31.7%. Hypertension is often accompanied by metabolic changes, one of them is dyslipidemia.

This study aims to prove the association of High Density Lipoprotein (HDL) level to blood pressure control in hypertensive patients. Research is carried out by cross sectional method using secondary data from 117 medical records of hypertensive patients at internal medicine clinic Cipto Mangunkusumo general hospital. Hypothesis testing is done using the Chi-square test.

From the results, the number of uncontrolled hypertensive patients were 48 patients (41%). The number of uncontrolled hypertensive patients with low HDL level were 11 patients (61.1%), while the number of controlled hypertensive patients with low HDL level were 7 patients (38.9%).

From this study, the proportion of uncontrolled hypertensive patients with low HDL level is significantly greater than controlled hypertensive patients with low HDL level, but the value of p = 0.060 (p> 0.05) were obtained concluded that no statistically significant relationship between the level of HDL to blood pressure control in hypertesive patients at internal medicine clinic Cipto Mangunkusumo general hospital."

"Hipertensi menduduki tempat kedua sebagai penyakit tidak menular terbanyak di Indonesia. Penyakit ini menyebabkan kerusakan multi organ hingga kematian. Hipertensi yang terkendali diharapkan dapat menunda komplikasi. Saat ini, hampir seperlima penduduk Indonesia obes. Obesitas berkaitan dengan kemunculan hipertensi namun belum diketahui hubungannya terhadap pengendalian hipertensi. Oleh karena itu, dilakukan penelitian mengenai hubungan obesitas terhadap kendali tekanan darah pasien hipertensi agar dapat membantu dalam penatalaksanaan hipertensi. Desain penelitian adalah cross-sectional mempergunakan data rekam medik pasien hipertensi poliklinik IPD RSUPN Cipto Mangunkusumo, Jakarta. Sejumlah 117 data terkumpul. Didapatkan prevalensi hipertensi tidak terkendali sebanyak 41%, dengan rasio terbanyak pada subjek laki-laki. Prevalensi obesitas sebesar 50,4%, dengan rasio terbanyak pada subjek perempuan. Pada kelompok obesitas didapatkan proporsi hipertensi terkendali 64,4%, dan hipertensi tidak terkendali 35,6%. Sedangkan pada kelompok tidak obes didapatkan proporsi hipertensi terkendali 53,4%, dan hipertensi tidak terkendali 46,6 % dengan nilai p = 0,228 (p>0,05), RP 0,765 dengan IK 95% 0,492 ? 1,188. Dengan demikian dapat disimpulkan bahwa tidak terdapat hubungan bermakna antara obesitas dengan hipertensi tidak terkendali.

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Hypertension is the second most prevalent non-communicable disease in Indonesia capable of causing multi organ damages even death. The essential target in hypertension management is to achieve controlled blood pressure in order to delay its complications. Nowadays, approximately one in five Indonesian has become obese. Obesity itself is highly associated with hypertension occurrence. Yet, there is no distinct evidence that show its association to hypertension control. Thus, this research is aimed to find the association between obesity in hypertensive patients to the blood pressure control.

Method used in this study is cross-sectional. As much as 117 secondary datas were collected from patients? medical records in Internal Medicine clinic diagnosed with hypertension. The prevalence of uncontrolled hypertension is 41% , dominated by male subjects. The prevalence of obesity among subjects is 50.4%, with higher proportion in females. Within the obese group, the proportion of controlled hypertension reaches 64.4%, while proportion for uncontrolled is 35.6%. Meanwhile, in the non-obese group, the proportion of controlled hypertension is 53.4%, whereas uncontrolled is 46,6%. The p-value result is 0.228 (p >0.05) with PR 0.765 with 95% CI 0.492 ? 1.188. Therefore, it can be concluded that there is no significant association between obesity with uncontrolled hypertension."

"Terapi komplementer yang dapat diberikan pada pasien hipertensi primer adalah teknik relaksasi, salah satunya adalah terapi masase. Tujuan penelitian ini untuk mengetahui pengaruh terapi masase menggunakan minyak aromaterapi terhadap tekanan darah pasien hipertensi primer. Penelitian ini menggunakan desain eksperimen semu dengan rancangan rangkaian waktu (Time Series Design) dengan teknik pengambilan sampel consecutive sampling. Besarnya sampel pada penelitian ini 42 orang, dimana jumlah responden pada kelompok terapi masase menggunakan minyak aromaterapi 24 orang dan kelompok terapi masase menggunakan minyak VCO (virgin coconut oil) 18 orang. Setiap responden mendapatkan terapi masase pada area kaki, punggung, bahu, lengan atas, leher dan kepala selama 30 menit 2 kali per minggu selama 3 minggu. Hasil penelitian didapatkan ada pengaruh terapi masase menggunakan minyak aromaterapi terhadap penurunan tekanan darah sistolik-diastolik pasien hipertensi primer (p value < 0,05). Terapi masase menggunakan minyak aromaterapi lebih efektif menurunkan tekanan darah sistolik dibandingkan dengan terapi masase menggunakan minyak VCO. Sedangkan terapi masase menggunakan minyak VCO lebih efektif menurunkan tekanan darah diastolik dibandingkan dengan terapi masase menggunakan minyak aromaterapi. Penelitian ini merekomendasikan bahwa terapi masase menggunakan minyak aromaterapi dapat digunakan untuk menurunkan dan mengendalikan tekanan darah tinggi pasien hipertensi primer serta perlu dikembangkan penelitian lebih lanjut.

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Message therapy is one of the complementary therapies that can be given to Primary Hypertension Patient. This study aims to examine the influence of message therapy using aroma therapy oil on primary hypertension patient’s blood pressure. The quasi experiment with time series design was used in this study. Forty two respondents were recruited using consecutive sampling method, where 24 respondents were grouped into message using aroma therapy and another 18 respondents using VCO (virgin coconut oil). Each of respondents had message therapy on foot, back, shoulder, upper arm, neck, and head areas for 30 minutes twice a week within 3 weeks.

The result shows that there was significant influence of message using aroma therapy oil on hypertension patient's blood pressure (p value < 0,05). Message using aroma therapy oil was more effective in decreasing systolic blood pressure compare to those who had message with VCO. However, message using VCO was more effective in decreasing diastolic blood pressure compare to those who had message with aroma therapy oil.

It is recommended that message using aroma therapy oil can decrease and maintain normal systolic blood pressure on primary hypertension patients. This study needs further investigation on how message and other complementary therapy can maintain normal blood pressure."

"ABSTRAK Latar belakang. Hipertensi merupakan salah satu kondisi yang paling banyakditemukan pada pelayanan kesehatan primer yang dapat meningkatkan mortalitas danmorbidita apabila tidak mendapatkan pengobatan yang tepat. Beberapa penelitianmenunjukkan respon penurunan tekanandarah pada ras kulit hitam berbeda dibandingras kulit putih dengan antihipertensi golongan penyekat EKA, hal ini ditunjangdengan perbedaan PRA pada kedua kelompok ras ini. Belum terdapat data tentangrespon tekanan darah pasien hipertensi ras melanesiadengan pemberian penyekatEKA yang ditunjang dengan pemeriksaan kadar PRA pada kelompok ras ini.Objektif. Menilai apakah terdapat perbedaan respon terapi terhadap penyekat enzimkonversi angiotensin (EKA) pada pasien hipertensi ras melanesia dan ras nonmelanesia.Metode. Penelitian ini adalah penelitian kohort prospektif yangdilakukan di kotaJayapura bulan September-November 2015terhadap 85 subyek usia 30 sampai 55tahun dengan hipertensi yang belum pernah diobati sebelumnya. Subyek terbagi atas2 grup yaitu ras Melanesia (n=34) dan ras Non Melanesia(n=51). Kedua grup tersebutdiberikan lisinopril dosis awal 5 mg. Pemeriksaan tekanan darah dilakukan pada awaldan diulangi setiap 7 hari selama 4 minggu berturut-turut.Hasil. Terdapat perbedaan respon tekanan darah pasien hipertensi ras Melanesia danras Non Melanesia. Perbedaan tekanan darah sistolik sebesar 24,5 ± 9,4 mmHg padasubyek ras Melanesia dan pada subyek Non Melanesia sebesar 34,5 ± 13,5 mmHg(p<0,001). Perbedaan tekanan darah diastolik subyek ras Melanesia sebesar 13,3±5,5mmHg dan pada subyek Non Melanesia sebesar 22,6±9,3 mmHg (p<0,001).Perbedaan tekanan rerata arteri pada subyek ras Melanesia sebesar 17,1±5,6 mmHgdan pada subek ras Non Melanesia sebesar 26,21±8,8 mmHg (p<0,001). ReratakadarPlasma Renin Activity (PRA) pada subyek ras Melanesia sebesar 1,48[1,86]ng/ml/jam dan pada subyek ras Non Melanesia rerata kadar PRA sebesar 1,1[1,47]ng/ml/jam. Tidak terdapat hubungan yang bermakna rerata kadar PRA pada keduakelompok ras ini (p=0,564).Kesimpulan. Terdapat perbedaan penurunan tekanan darah (sistolik, diastolik dantekanan rerata arteri) dengan pemberian penyekat EKA pada kelompok ras Melanesiadan kelompok ras Non Melanesia dan hal ini tidak berhubungan bermakna denganrerata kadar PRA pada kedua kelompok ini sehingga kemungkinan terdapat faktor lain yang mempengaruhi respon penurunan tekanan darah dengan penyekat EKA.ABSTRACT Hypertension is one of the most commonconditionsin primary healthcare that increase mortality and morbidity if it does not receive appropriate therapy.Several studies show that blacks response differently compared with white inconjunction with a decrease of blood pressure in response to administer ACEinhibitor. The studies supported by PRA differences in both group of race. There areno data ofblood pressure response in hypertensive patientsinMelanesian race byadministeringACE inhibitor supported withPRA levels examination in thisgroup ofrace.Objective. To compare therapeutic response ofangiotensin converting enzymeblockers (ACE)inhibitorinreducing blood pressure between MelanesianandNonMelanesian hipertensive patients.Method. This study is a prospective cohort study conducted in the city ofJayapura September to November 2015. We found85 subjects aged 30 to 55 yearsoldwith hypertensionnever be treated before. Subjects are divided into twogroups, namely the Melanesian race (n = 34) and non Melanesian race (n = 51).Both groups were given an initial dose of 5 mg of lisinopril. Blood pressurechecks performed at baseline and repeated every 7 days for 4 weeks in a row.Results. There are differences in the response of blood pressure in hypertensivepatientofMelanesian race and Non Melanesiarace. Reduction ofsystolic bloodpressure of 24.5 ± 9.4 mmHg in subject Melanesian race and on the subject ofNon Melanesian 34.5 ± 13.5 mmHg (p < 0.001). Reduction ofdiastolic bloodpressure of subjectsMelanesians of 13.3 ± 5.5 mmHg, and on the subject of NonMelanesia 22.6 ± 9.3 mmHg (p<0.001). Reduction ofmean arterial pressure insubjectMelanesian race at 17.1 ± 5.6 mmHg andNon Melanesian race at 26.21 ±8.8 mmHg (p < 0.001). Mean Plasma Renin Activity (PRA) on the subject of theMelanesian race at 1.48 [1.86] ng/ml/h and on the subject of nonMelanesian racePRA average level of 1.1 [1.47] ng/ml/hr. There was no significant relationshipmean PRA levels in both these racial groups (p = 0.564).Conclusion. There aredifferences in blood pressure reduction (systolic, diastolicpressure and mean arterial pressure) with administer of ACE inhibitor inMelanesianand Non Melanesiagroup of race. There is no significant relation withaveragePRAlevels in both group of race. Another factors affectsresponses of reduction blood pressure with administer ofACEinhibitor may be considered.;Background. Hypertension is one of the most commonconditionsin primary healthcare that increase mortality and morbidity if it does not receive appropriate therapy.Several studies show that blacks response differently compared with white inconjunction with a decrease of blood pressure in response to administer ACEinhibitor. The studies supported by PRA differences in both group of race. There areno data ofblood pressure response in hypertensive patientsinMelanesian race byadministeringACE inhibitor supported withPRA levels examination in thisgroup ofrace.Objective. To compare therapeutic response ofangiotensin converting enzymeblockers (ACE)inhibitorinreducing blood pressure between MelanesianandNonMelanesian hipertensive patients.Method. This study is a prospective cohort study conducted in the city ofJayapura September to November 2015. We found85 subjects aged 30 to 55 yearsoldwith hypertensionnever be treated before. Subjects are divided into twogroups, namely the Melanesian race (n = 34) and non Melanesian race (n = 51).Both groups were given an initial dose of 5 mg of lisinopril. Blood pressurechecks performed at baseline and repeated every 7 days for 4 weeks in a row.Results. There are differences in the response of blood pressure in hypertensivepatientofMelanesian race and Non Melanesiarace. Reduction ofsystolic bloodpressure of 24.5 ± 9.4 mmHg in subject Melanesian race and on the subject ofNon Melanesian 34.5 ± 13.5 mmHg (p < 0.001). Reduction ofdiastolic bloodpressure of subjectsMelanesians of 13.3 ± 5.5 mmHg, and on the subject of NonMelanesia 22.6 ± 9.3 mmHg (p<0.001). Reduction ofmean arterial pressure insubjectMelanesian race at 17.1 ± 5.6 mmHg andNon Melanesian race at 26.21 ±8.8 mmHg (p < 0.001). Mean Plasma Renin Activity (PRA) on the subject of theMelanesian race at 1.48 [1.86] ng/ml/h and on the subject of nonMelanesian racePRA average level of 1.1 [1.47] ng/ml/hr. There was no significant relationshipmean PRA levels in both these racial groups (p = 0.564).Conclusion. There aredifferences in blood pressure reduction (systolic, diastolicpressure and mean arterial pressure) with administer of ACE inhibitor inMelanesianand Non Melanesiagroup of race. There is no significant relation withaveragePRAlevels in both group of race. Another factors affectsresponses of reduction blood pressure with administer ofACEinhibitor may be considered.;Background. Hypertension is one of the most commonconditionsin primary healthcare that increase mortality and morbidity if it does not receive appropriate therapy.Several studies show that blacks response differently compared with white inconjunction with a decrease of blood pressure in response to administer ACEinhibitor. The studies supported by PRA differences in both group of race. There areno data ofblood pressure response in hypertensive patientsinMelanesian race byadministeringACE inhibitor supported withPRA levels examination in thisgroup ofrace.Objective. To compare therapeutic response ofangiotensin converting enzymeblockers (ACE)inhibitorinreducing blood pressure between MelanesianandNonMelanesian hipertensive patients.Method. This study is a prospective cohort study conducted in the city ofJayapura September to November 2015. We found85 subjects aged 30 to 55 yearsoldwith hypertensionnever be treated before. Subjects are divided into twogroups, namely the Melanesian race (n = 34) and non Melanesian race (n = 51).Both groups were given an initial dose of 5 mg of lisinopril. Blood pressurechecks performed at baseline and repeated every 7 days for 4 weeks in a row.Results. There are differences in the response of blood pressure in hypertensivepatientofMelanesian race and Non Melanesiarace. Reduction ofsystolic bloodpressure of 24.5 ± 9.4 mmHg in subject Melanesian race and on the subject ofNon Melanesian 34.5 ± 13.5 mmHg (p < 0.001). Reduction ofdiastolic bloodpressure of subjectsMelanesians of 13.3 ± 5.5 mmHg, and on the subject of NonMelanesia 22.6 ± 9.3 mmHg (p<0.001). Reduction ofmean arterial pressure insubjectMelanesian race at 17.1 ± 5.6 mmHg andNon Melanesian race at 26.21 ±8.8 mmHg (p < 0.001). Mean Plasma Renin Activity (PRA) on the subject of theMelanesian race at 1.48 [1.86] ng/ml/h and on the subject of nonMelanesian racePRA average level of 1.1 [1.47] ng/ml/hr. There was no significant relationshipmean PRA levels in both these racial groups (p = 0.564).Conclusion. There aredifferences in blood pressure reduction (systolic, diastolicpressure and mean arterial pressure) with administer of ACE inhibitor inMelanesianand Non Melanesiagroup of race. There is no significant relation withaveragePRAlevels in both group of race. Another factors affectsresponses of reduction blood pressure with administer ofACEinhibitor may be considered."

"ABSTRAKIsometric Handgrip Exercise merupakan salah satu terapi non farmakologis yang dikembangkan untuk menurunkan tekanan darah pasien hipertensi. Penelitian ini bertujuan untuk mengidentifikasi pengaruh isometric handgrip exercise terhadap perubahan tekanan darah pasien hipertensi. Desain penelitian quasi experiment dengan pendekatan control group pretest posttest design pada 44 responden meliputi kelompok kontrol dan kelompok intervensi. Kelompok intervensi mendapatkan latihan handgrip selama 3 menit, sekali sehari dan dilakukan selama 5 hari. Kedua kelompok dilakukan pengukuran tekanan darah sebelum dan setelah latihan pada hari 1 dan ke 5. Hasil penelitian menunjukkan bahwa ada pengaruh isometric handgrip exercise (IHG) terhadap perubahan tekanan darah pasien hipertensi. kesimpulan penelitian ini adalah isometric handgrip exercise secara bermakna dapat menurunkan tekanan darah sistolik dan tekanan darah diastolik. Hasil penelitian ini diharapakan menjadi dasar isometric handgrip exercise (IHG) sebagai intervensi keperawatan yang mandiri dan inovatif pada asuhan keperawatan klien dengan hipertensi

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ABSTRACTAn Isometric Handgrip Exercise is one of the non-pharmacological therapies that is developed to lower blood pressure in hypertensive patients. The aim of the study was to identify the effect of isometric handgrip exercise on changes in blood pressure in hypertensive patients. A Quasi experimental research design approach pretest posttest control group design was employed with 44 respondents included control and intervention groups. The intervention group got handgrip exercise for 3 minutes, once a day and performed for 5 days. Both groups performed measurements of blood pressure before and after exercise on days 1 and 5. The results showed that there is influence of isometric handgrip exercise on changes in blood pressure in hypertensive patients. Conclusion of this study is the isometric handgrip exercise (IHG) can significantly lower systolic blood pressure and diastolic blood pressure. The result of this study recommended that isometric handgrip exercise (IHG) can bean independen and innovative therapeutic nursing intervension in nursing care of patients with hypertension."

"Slow deep breathing (SDB) adalah tindakan nonfarmakologis untuk menurunkan tekanan darah pasien hipertensi primer. Penelitian ini bertujuan untuk mengetahui efektifitas SDB terhadap penurunan tekanan darah pasien hipertensi primer. Metode penelitian ini menggunakan desain Randomized Clinical Trial dengan pretest dan post test control group. Sampelnya 142 responden, meliputi 33 responden kelompok rendah garam (RG), 37 responden kelompok SDB, 39 responden kombinasi kelompok SDB dan RG; dan 33 responden kelompok kontrol. Sampel diambil dengan cara randomisasi. Hasil penelitian menunjukan penurunan tekanan darah secara bermakna terutama pada kelompok SDB. Tekanan darah sistolik menurun 28,59 mmHg (P value=0,002) dan tekanan darah diastolik 16,92 mmHg (P value=0,007). Analisis dengan uji Tukey diketahui tekanan darah sistolik yang berbeda secara bermakna yaitu antara SDB dan kelompok kontrol (P value=0,001). Tekanan darah diastolik yang berbeda secara bermakna, yaitu: RG dan SDB-RG (P value=0,046); RG dan kelompok kontrol (P value=0,003); SDB dan SDB-RG (P value=0,038) serta SDB dan kelompok kontrol (P value=0,005). Penelitian ini merekomendasikan penerapan SDB untuk membantu menurunkan prevalensi hipertensi sehingga meminimalkan komplikasi yang mungkin timbul.

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Slow deep breathing is a nonpharmacology therapy to reduce blood pressure in patients with primary hypertension. The purpose of this study was to determine the effectiveness of slow deep breathing exercise to reduce blood pressure in patients with primary hypertension in Atambua East Nusa Tenggara. The method of this research was a quantitative research: a randomized clinical trial design with pretest and post test control group. The sample was 142 respondents, which consisted of 33 respondents in the lower salt (RG) group, 37 respondents in the slow deep breathing (SDB) group, 39 respondents in the combination of SDB-RG group; and 33 respondents in the control group. The method of sampling used a randomization.

The results showed that there were differences in the reduction of systolic blood pressure in SDB group for 28.59 mm Hg and diastolic blood pressure for 16.92 mmHg. The result of Anova analysis showed that there was a significant decrease on average of systolic blood pressure (p = 0.002) and diastolic blood pressure (p = 0.007). Further analysis by Tuckey test of systolic blood pressure found that between SDB group and control group were significantly different, however the other groups was not significant. (P = 0.001). After undergoing further Tukey analysis we found that the systolic blood pressure of four groups has significant differences. The SDB and controlling groups have P value=0,001 differences. RG and the controlling groups have P value=0,003 differences. SDB and SDB-RG groups have P value=0,038 differences. And SDB and controlling groups have P value=0,005 differences. This research would like to suggest applied non-pharmacological actions particularly toward SDB groups in order to decrease the prevalence of hypertension. This will minimize consequences caused by this problem."