Apa Itu evolusi apa Hipertensi

(1)

HIPERTENSI

(2)

APA ITU

HIPERTENSI?

Tekanan darah tinggi (hipertensi) adalah

peningkatan tekanan darah di dalam

arteri (pembuluh darah nadi) di atas

angka normal. Seringkali hipertensi

terjadi tanpa gejala, sehingga penderita

tidak merasa sakit. Pada pemeriksaan

tekanan darah (tensi) akan didapat 2

angka yakni angka yang atas diperoleh

saat jantung berkontraksi (sistolik)

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Klasifikasi Hipertensi : JNC VII

Hypertension is defined as blood pressure



140/90

mmHg

Kategori

Systolic

(mmHg)

Diastolic

(mmHg)

Normal

<120

and <80

Prehypertension

120-139

or 80-89

Stage 1 hypertension

140-159

or 90-99

Stage 2 hypertension

_

₁₆₀

_or

_

₁₀₀

(4)

PENYEBABNYA

APA?

• _{Sekitar 90 %}

_{penderita hipertensi}

tidak diketahui penyebabnya,

disebut sebagai hipertensi esensial

atau hipertensi primer.

• _{Para ahli sependapat bahwa}

hipertensi esensial berhubungan

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KALAU YANG

SEKUNDER?

• Sekitar 5-10% penderita hipertensi

berhubungan dengan

penyakit ginjal

, 1-2%

berhubungan dengan

kelainan hormonal

atau

pemakaian obat tertentu

(misalnya pil

KB).

• Kegemukan (obesitas),

• Gaya hidup yang tidak aktif (malas olah raga,

• Stress,

• alkohol

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Franklin, S.S., J Hypertens 1999; 17 (suppl 5): S29-S36

0

10

20

30

40

50

60

70 18-29

30-39

40-49

50-59

60-69

70-79

80+

SBP

>

140 mm Hg

DBP

>

90 mm Hg

Usia)

P

er

se

n

ta

se

4 11

21

44

54

64 65

USIA YANG PALING RENTAN

(7)

25%

_12.5%

12.5%

50%

Berobat tapi

tidak kontrol

rutin

Berobat dan terkontrol

Yang tidak tahu

Pasien yang

tidak berobat

dan tidak

kontrol

Source : Joffres et al. (1997) Am. J. Hypertension 10: 1097-1102

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KOMPLIKASI HIPERTENSI

Kerusakan tergantung pada:

• seberapa tinggi tekanan

darah

• Berapa lama tidak

terkontrol dan tertangani

Target Gagal Organ

Mata

retinopathy

Ginjal

Gagal Jintang

Otak

stroke

Jantung

Peny.Jantung Koroner

Pembesaran Jantung kiri

Gagal Jantung

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PENGOBATAN

• _DIET.

• _{MENURUNKAN BERAT BADAN.}

(10)

ASK-DNC

PEDIATRIC

OBESE

ATP-III 2001 - Criteria

WORLD OBESITY TRENDS GLOBESITY – DIABESITY

WORLD OBESITY TRENDS GLOBESITY

–

DIABESITY

(Summarized : Tjokroprawiro 2005-2007)

Stage― 3 or the MetS will be "TIME-BOMB DISEASE” in Indonesia ?

Preclinical : the MetS

IFG, IGT, Pedr.-Obese

Healthy Lifestyle

_{Unhealthy Lifestyle}

“Westernized”

_{(Abdominal Obesity)}

Obesity

STAGE – 0

STAGE – 1

STAGE – 2

STAGE – 3

STAGE –

4 Clinical : CAD

T2DM, Pedr.-T2DM, Stroke

3 Blood Pressure

> 130/85 mmHg

4 GDS

> 100 mg/dl

1 Triglyceride

> 150 mg/dl

2 HDL-Chol

< 40 mg/dl

< 50 mg/dl

₊

o

Lingkar Pinggang

> 90 cm > 80 cm

₊

o

PEDIATRIC

T2DM

IDF 2005 - Criteria

44

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ASK-DNC

TEN PRACTICAL GUIDELINES FOR HEALTHY LIFE

GULOH-CISAR = SYNDROME-10

(Tjokroprawiro 1995-2007)

34 Stop Smoking

Daily Regular Exercise :

TAKE MINIMALLY 6-HOUR SLEEP/DAY

Stop Alcohol

Regular Check-Up

Esp. > 40 Years Old : 3, 6 or 12 Months

Limit Sugar Consumption

Restrict Purine Intake : JAS-BUKET

Consume Low Fat Diet : TEK-KUK-CS

₂

Prevent Obesity (Target : BMI < 25)

Measure BP Regularly

(Less than g Sodium/day)

3 +300 kcal/day or 3 km walk

+Sit up 50-100 x/day

JAS-BUKET : Jerohan, Alkohol, Sarden - Burung Dara, Unggas, Kaldu, Emping, Tape

(Bowels, Alcohol, Sardines - Pigeon, Fowls, Meat-Broth, Beaten Nut, Fermented Cassava)

TEK-KUK-CS2 : Telor, Keju - Kepiting, Udang, Kerang - Cumi, Susu, Santen

(Egg, Cheese - Crab, Shrimp, Mussel - Squid, Milk, Coconut - Juice)

"MABUK" (Rich in Chromium) : Mrica, Apel, Brokoli, Udang, Kacang-kacangan; good for DM

Recommended Food Supplements : Green Bean, Onions, Green Tea, Pepper, ARGININE, TKW-PJKA-BK

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INITIATION OF ANTIHYPERTENSIVE TREATMENT : ESC 2OO7

Other risk

factors, OD, or disease

Normal SBP 120-129 or DBP 80-84

High normal SBP 130-139 or DBP 85-89

Grade 1 HT SBP 140-159 or DBP 90-99

Grade 2 HT SBP 160-179 or DBP 100-109

Grade 3 HT

SBP 180 or

DBP  110

No other risk

factors No BP intervention No BP intervention Lifestyle changes for

several months then drug

treatment if BP uncontrolled

Lifestyle changes for several weeks then drug treatment if BP uncontrolled

Lifestyle changes + immediate drug treatment

1-2 risk factors Lifestyle

changes Lifestyle changes Lifestyle changes for

several weeks then drug treatment if BP uncontrolled

Lifestyle changes for several weeks then drug treatment if BP uncontrolled

 3 risk factors,

MS or OD

Lifestyle

changes Lifestyle changes and

consider drug treatment

Lifestyle

changes + drug treatment

Lifestyle

Diabetes Lifestyle

changes

Lifestyle

Established CV or renal

disease

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