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Penelitian ini dilakukan untuk mengetahui peran penggunaan obat antihiperlipidemia terhadap penurunan kadar kolesterol total.Penelitian analitik dengan rancangan Nested Case Control ini memanfaatkan data sekunder dari studi prospektif CARES (Cardiovascular Risk Estimation and Screening) tahun 2000 pada kelompok Crystal Club dan data primer untuk melengkapi kekurangan pada data. Dengan menggunakan total error laboratorium Prodia sebesar 10% maka kasus adalah mereka yang mengalami penurunan kadar kolesterol total 10% atau lebih selama kurang lebih satu bulan sedangkan kontrol adalah yang mengalami penurunan kadar kolesterol total kurang dari 10% atau mengalami peningkatan selama kurang lebih satu bulan juga.Dari 227 responden pada awal pemeriksaan terdapat 83,7% yang memiliki kadar kolesterol total > 200 mg/dl. Pada pemeriksaan yang kedua jumlah responden berkurang menjadi 191 responden. Untuk mengetahui peran penggunaan obat antihiperlipidemia dilakukan wawancara kembali. Dari 82 responden berhasil diwawancarai. Dari 82 responden 44 responden tidak menggunakan obat dan 38 responden menggunakan obat anttbiperlipidemia. Rata-rata penurunan terbesar diperoleh pada mereka yang menggunakan obat jenis atorvastatin yaitu sebesar 23,19%.Hasil penelitian menunjukkan bahwa penurunan kadar kolesterol total > 10% berhubungan dengan menggunakan obat antihiperlipidemia (OR = 5,91, 95% Cl 2,07 ; 16,88) dan pendidikan tinggi (OR = 5,28, 95% CI 1,59 ; 17,54) . Probabilitas penurunan kadar kolesterol total tertinggi pada mereka yang menggunakan obat antihiperlipidemia dan berpendidikan tinggi (75%). Bila dilihat dari jenis obat yang dikonsumsi maka penurunan kadar kolesterol total > 10% berhubungan dengan penggunaan obat jenis lain (OR = 1,35, 95% CI 0,28 ; 6,54), obat jenis statin lain (OR = 4,58, 95% CI 0,80 ; 26,04) dan obat jenis atorvastatin (OR = 19,93, 95% CI 4,21 ; 94,43) serta pendidikan tinggi (OR = 5,31, 95% Cl 1,40 ; 20,25). Probabilitas penurunan kadar kolesterol total tertinggi pada mereka yang menggunakan obat jenis atorvastatin dan berpendidikan tinggi (91%). Dan bila dilihat dari jumlah obat yang digunakan maka penurunan kadar kolesterol total berhubungan dengan penggunaan obat kurang dari 30 butir (OR = 3,36, 95% CI 0,75 ; 15,01) dan penggunaan obat sebanyak 30 butir selama satu bulan (OR = 7,47, 95% CI 2,33 ; 23,91) serta pendidikan tinggi (OR = 5,15, 95% CI 1,53 ; 17,30). Probabilitas penurunan kadar kolesterol total tertinggi pads mereka yang menggunakan obat antihiperlipidemia sebanyak 30 butir dan berpendidikan tinggi (80%).Berdasarkan hasil penelitian maka perlu dilakukan penelitian leblh lanjut untuk melihat efek dari penggunaan obat antihiperlipidemia terhadap penurunan risiko penyakit jantung koroner maupun risiko penyakit kardiovaskular lainnya.Daftar Pustaka : 64 (I982-2002)
The Role of Using Antihyperlipidernic on The Lowering of Total Cholesterol Level.The objective of this study is to examine the role of using antlhyperlipidemic on the lowering of total cholesterol level.This study is an analytical study with nested case control designed by using secondary data from prospective CARES (Cardiovascular Risk Estimation and Screening) study in 2000 and by using primary data to complete it. By using 10% total error from Prodia laboratory, the cases is people who get >10% decrease of total cholesterol level in one month, and control is people who get <10% decrease or increase of total cholesterol level as the same time.From 227 respondents in the early examination there are 83.7% who have X200 mg/dl total cholesterol level. In the second examination the number of respondents were decreased to 191 respondents. In order to examine the role of antihyperlipidemic, re-interview was conducted to 82 respondents. In which 38 respondents used the drugs whereas 44 didn't. Respondents who used atorvastatin had highest decrease of cholesterol level (23.19% on average).The result indicates that X10% decrease of total cholesterol level was related to the using of antihyperlipidemic (OR = 5.91, 95% CI 2.07 ; 16.88) and high educational level (OR - 5.28, 95% CI L59 ; 17.54). The highest probability of the decrease of total cholesterol level is people who take antihyperlipidemic and have high educational level (75%). According to the variety of drugs that being consumed, ?l0% decrease of total cholesterol level related to other drugs (OR = 1.35, 95% CI 0.28 ; 6.54), other statin drugs (OR = 4.58, 95% CI 0.80 ; 26.04), atorvastatin (OR = 19.93, 95% CI 4.21 ; 94.43), and people with high educational level (OR = 5.31, 95% CI 1.40 ; 20.25). The highest probability of decrease of total cholesterol level is people who take atorvastatin and high educational level (91%). According to the number of drug that being consumed, ?10% decrease of total cholesterol level was related to the use of < 30 pills antihyperlipidemic in one month (OR = 3.36, 95% CI 0.75 ; 15.01), the use of 30 pills in one month (OR = 7.47, 95% CI 2.33 ; 23.91), and who have high educational level (OR = 5,15, 95% CI 1,53 ; 17,30). The highest probability of the decrease of total cholesterol level is people who take 30 pills antihyperlipidemic in one month and high educational level (80%).Based on these results, it is very important to conduct several follow-up studies to confirm the effect of antihyperlipidemic on the decrease of coronary heart disease's risk or other cardiovascular diseases.References : 64 (1982-2002)
Proporsi ketidakpatuhan penderita Tb paru berobat di beberapa daerah di Indonesia, angkanya bervariasi dan umumnya masih tinggi mulai dari 30 % sampai dengan 65 %. Kepatuhan berobat sangat penting karena berhubungan dengan resistensi. Di Kota Padang Propinsi Sumatera Barat penderita Tb paru dengan pengobatan kategori 1, tidak patuh berobat sebesar 38,88 %, sehingga kemungkinan terjadinya resistensi masih cukup tinggi. Tujuan penelitian ini adalah untuk mengetahui hubungan persepsi penderita terhadap peran pengawas menelan obat dengan kepatuhan penderita Tb paru berobat di kota Padang tahun 2001. Penelitian ini dilaksanakan dalam waktu satu setengah bulan dengan menggunakan data primer.Rancangan yang digunakan dalam penelitian ini adalah kasus kontrol. Sampelnya adalah sebagian atau seluruh penderita tuberkulosis paru berumur 15 tahun atau lebih yang berobat ke Puskesmas di Kota Padang dari 1 Januari 2001 s/d 31 Desember 2001 yang memdapat obat anti tuberkulosis (OAT) kategori I. Jumlah sampel sebesar 260 responden, yang terdiri dari 130 responden sebagai kasus dan 130 responden sebagai kontrol.Hasil penelitian menunjukkan bahwa probabilitas penderita Tb paru BTA positif yang tidak patuh berobat terpapar oleh aktivitas PMO kurang baik 18,95 kali lebih besar, dibandingkan dengan probabilitas penderita Tb paru BTA positif yang terpapar dengan aktivitas PMO baik, setelah dikontrol oleh penghasilan keluarga dan pengetahuan penderita.Pengukuran dampak potensial memberikan informasi adanya kantribusi aktivitas PMO kurang baik terhadap terjadinya ketidakpatuhan penderita Tb paru BTA positif berobat di Kota Padang sebesar 81,46 %.Penelitian ini menyarankan kepada pengelola program perlu meningkatkan pengetahuan dan motivasi pengawas menelan obat, agar dalam melaksanakan tugas pengawasannya berjalan secara aktif. Meningkatkan pengetahuan penderita mengenai penyakit Tb paru serta akibat bila tidak patuh berobat. Dan perlu di teliti lebih lanjut terhadap variabel jenis PMO dan pekerjaan serta penghasilan keluarga dengan sampel yang lebih besar.
The Relationship of the Perception of Tb Patients on the Role of Treatment Observer and Compliance of Pulmonary Tuberculosis Patients in Padang, 2001The proportion of tuberculosis patients who does not take treatment regularly in Indonesia varies with areas, with the number ranging from 30 to 65%. Regularity in taking treatment is very crucial because it relates to drug resistance. In Padang, West Sumatra, category I tuberculosis sufferers who do not take treatment regularly is 38, 88%. Hence, the possibility of resistance is still high. The objective of the research is to study the perception relationship between the role of drug intake supervisors (DIS) or treatment observer and compliance of pulmonary tuberculosis patient attending the treatment in Padang in 2001. This study was conducted during a month and a half period using primary data.The design used is case-control study. Its sample consists of all pulmonary TB patient age 15 or above who take treatment at public health centers in Padang from January 1 to December 31, 2001. All of TB patient received-category I anti-tuberculosis drugs. The size of the sample is 260; the respondents consist of 130 as cases and another 130 as controls. The study found that the probability of positive sputum acid fast bacilli (category I) pulmonary TB patient who do not take treatment regularly under insufficient supervision of drug intake supervisors (DIS) is 18.95 times higher than the probability of category I pulmonary TB patients who do not take treatment regularly under sufficient supervision of drug intake supervisors (DIS), after improvement of family income and knowledge level of TB patients.As a conclusion, potential impact measurement provide information that insufficient activities of drug intake supervisors contribute to the irregularity of category I pulmonary TB patients in taking treatment in Padang of 81.46%.It is recommended to all program directors to improve knowledge and motivation of treatment observer and compliant in order to increase effectiveness of their supervisory duties. In addition, they should also improve knowledge of pulmonary TB patients and communicate negative impacts of not taking treatment regularly. And research of this kind should be expanded in the future, especially that relates to drug intake supervisors types, jobs, and family income, with bigger samples.
The prevalence of hypertension continues to increase in the world. Based on Riskesdas 2018, the prevalence of hypertension in Indonesia is quite high at 34,1%. One of the risk factor for hypertension that can be changed is hypercholesterolemia. The results of health examinations screening of employees at Soekarno Hatta Airport in 2017 showed a high rate of hypercholesterolemia. The purpose of this study was to determine the magnitude of the association between hypercholesterolemia and the incidence of first stage hypertension in employees at Soekarno Hatta Airport. This study used a cross sectional design from secondary data on Posbindu PTM activities in the Soekarno Hatta Port Health Office in 2017. The research subjects were employees in government agencies and BUMN at Soekarno Hatta Airport who conducted health checks at Posbindu PTM in 2017, totaling 411 people. This study uses multivariate cox regression analysis and the magnitude of the effect was expressed in the prevalence ratio (PR). The results showed that the prevalence of stage 1 hypertension in employees with hypercholesterolemia was 28,4%. High cholesterol levels have a risk of 1,19 (95% CI: 0,73-1,96) to cause stage 1 hypertension. Optimizing Posbindu PTM activities in the workplace is expected to control hypercholesterolemia and hypertension
Saat ini Indonesia tengah mengalami transisi demografi dan transisi epidemiologi. Beberapa cirinya antara lain di satu sisi terjadi penurunan angka kematian bayi dan anak karena penyakit infeksi, namun dipihak lain karena kemajuan bidang ekonomi dan meningkatnya pelayanan kesehatan maka terjadi peningkatan jumlah populasi penduduk tua.Hasil studi indeks massa tubuh di dua belas kota besar di Indonesia (1996) bahwa prevalensi overweight mencapai 16-22.5% dan 4% diantaranya menderita obesitas. Obesitas mencerminkan kandungan lemak tubuh. Lemak tubuh yang berhubungan dengan penyakit jantung koroner adalah lemak tubuh yang spesifik terdapat didalam rongga perut. Selain obesitas, untuk deteksi penyakit jantung- koroner sering diukur melalui kadar kolesterol. Gambaran kadar kolesterol dapat dilihat dari beberapa temuan, antara lain oleh penelitian Tim Monica Jawa Tengah (1996) yakni rata-rata Kolesterol Total sebesar 204.0 mg/dl. Sementara penelitian di Yogyakarta (1996) diperoleh rata-rata kadar Kolesterol Total sebesar 201.9 mg/dl, rata-rata kadar Kolesteol LDL sebesar 128.1 mg/dl dan rata-rata kadar Kolesterol HDL sebesar 52.6 mg/dl.Untuk mengetahui kandungan lemak secara spesifik yang terdapat didalam rongga perut dapat dilihat dari nilai rasio lingkar pinggang-lingkar pinggul/waist to hip ratio. Selanjutnya oleh penulis berasumsi bahwa lemak yang terkandung didalam rongga perut berhubungan dengan kadar kolesterol.Dalam penelitian ini diperoleh nilai rata-rata rasio lingkar pinggang-pinggul (RLPP) sebesar 0.86 dengan standar deviasi 0.06. Jika dikelompokkan berdasarkan Bray, maka 8.5% responden laki-laki termasuk kategori RLPP risiko (>0.95) dan 64.3% responden perempuan termasuk kategori RLPP risiko (0.80).Responden memiliki rata rata Kolesterol Total sebesar 208.37 mg/dl, dan rata-rata Kolesterol LDL sebesar 136.48 mg/dl dengan standar deviasi sebesar 37.52 mg/dl, serta rata-rata Kolesterol HDL sebesar 44.80 dengan standar deviasi 10.42 mg/dl.Rasio lingkar pinggang pinggul secara bermakna berhubungan dengan Kolesterol Total. Kadar Kolesterol Total meningkat sejalan dengan meningkatnya nilai RLPP setelah dikontrol oleh IMT dan Umur. RLPP, IMT dan Umur secara bermakna berkontribusi sebesar 11.00% tehadap kadar Kolesterol Total. Kontribusi RLPP sebagai variabel independen utama dalam persamaan terhadap Kolesterol Total sebesar 29.0%.Rasio lingkar pinggang pinggul secara bermakna berhubungan dengan Kolesterol LDL. Kadar Kolesterol LDL meningkat sejalan dengan meningkatnya nilai RLPP setelah dikontrol oleh IMT dan Umur. RLPP, IMT dan Umur secara bermakna berkontribusi sebesar 6.10% tehadap kadar Kolesterol LDL. Kontribusi RLPP sebagai variabel independen utama dalam persamaan terhadap Kolesterol LDL sebesar 26.2%.Rasio lingkar pinggang pinggul secara bermakna berhubungan dengan Kolesterol HDL. Kadar Kolesterol HDL menurun sejalan dengan meningkatnya nilai RLPP setelah dikontrol oleh umur dan merokok . RLPP, umur dan merokok secara bermakna berkontribusi sebesar 11.00% tehadap kadar Kolesterol HDL. Kontribusi RLPP sebagai variabel independen utama dalam persamaan terhadap Kolesterol HDL sebesar 46.0%.Peningkatan 1 unit RLPP meningkatkan 51.0 mg/dl Kolesterol Total, peningkatan 1 unit IMT meningkatkan 2.49 mg/dl Kolesterol Total, peningkatan 1 unit Umur meningkatkan 0.72 mg/dl Kolesterol Total. Peningkatan 1 unit RLPP meningkatkan 16.95 mg/dl Kolesterol LDL, peningkatan 1 unit IMT meningkatkan 1.65 mg/dl Kolesterol LDL, peningkatan 1 unit Umur meingkatkan 0.61 mg/dl Kolesterol LDL. Peningkatan 1 unit RLPP menurunkan 17.75 mg/dl Kolesterol HDL, dan merokok dapat menurunkan 5.80 mg/dl Kolesterol HDL.Berdasarkan temuan tersebut selanjutnya direkomendasikan untuk dilakukan pemasaran sosial sebagai wahana kampanye untuk skrining lemak dalam rongga perut melalui pengukuran lingkar pinggang dan lingkar pinggul. Penyuluhan menurunkan berat badan bagi individu yang mengalami kegemukan dan penyuluhan berhenti merokok serta mencegah merokok. Juga perlu dilakukan penelitian lanjutan secara analitik dengan rancangan kasus kontrol khusus bagi penderita kegemukan.
The Relationship between Waist to Hip Ratio and Cholesterol Levels among Adult Population in Surakarta City 1996Now days, Indonesia has been in transition period both in demography and epidemiology. Several signs are identified, for example in one hand, among children, the infant mortality rate and infections diseases decrease but in another hand the prospect to have a long life in the old population improve because of better economics and health services.The results of body mass index studies from twelve big cities in Indonesia (1996) show that the prevalence of overweight was ranged 16-22.5% and 4% for obesity. Obesity reflects the body fat contained in the body. The body fat that related to coronary heart diseases is body fat, specifically found in stomach hollow. Besides obesity, the blood cholesterol level is commonly used for early detecting of coronary heart diseases.The study in cholesterol levels has been reported in several areas, e.g. MONICA research team 1996 found that the average total cholesterol in Central lava was 204.0 mg/dl and in Yogjakarta (1996) was 201.9 mg/dl whereas the average of LDL cholesterol and HDL cholesterol were 128.1 mg/dl and 52.6 mg/dl, respectively in Yogjakarta area.The ratio of waist to hip specifically describes the fat level in stomach hollow. This study is aimed to evaluate the relationship between fat in stomach hallow and the level of cholesterol using total cholesterol, LDL cholesterol and HDL cholesterol.This study found that the average of waist and hip ratio (RLPP) among the population aged 25-64 years was 0.86 ± 0.06. The result also shows that based on Bray's classification, 8.5% was categorized as population at risk in man (more than 0.95) and for women was 64.3% (more than 0.80). In addition, the total cholesterol level was208.37 ± 40.67mg/dl, LDL cholesterol was 136.48 + 37.52 mg/dl and HDL cholesterol was 44.80 ± 10.42mg/dl.The relationship between RLPP and Total cholesterol is statistically significant. Increasing total cholesterol is likely increases RLPP controlled by BMI and age. The contribution of RLPP, BMI and age to total cholesterol are 11.0%. Independently, RLPP as a main variable contributes 29.0% to total cholesterol.RLPP is significant correlated to the LDL cholesterol. Increasing LDL cholesterol is likely increases RLPP controlled by BMI and age. The contribution of RLPP, BMI and age to LDL cholesterol are 6.1%. RLPP as a main variable contributes 25.2% to LDL cholesterol, independently.In HDL cholesterol found that HDL is statistically significant to RLPP. Increasing LDL is likely increases RLPP controlled by age and smoking status. The contribution of RLPP, age, and smoking status to HDL cholesterol are 11.0%. RLPP as a main variable contributes 46.0% to HDL cholesterol, independently.Interestingly, this study suggested that the increase of 1 unit RLPP would increase 51.0 mg/dl of total cholesterol. The increase of 1 unit of IMT would increase 2.49 mg/dl of total cholesterol and the improvement of 1 unit of age would increase 0.72 mg/dl of total cholesterol. For LDL cholesterol, 1 unit RLPP would increase 16.95 mg/dl of LDL cholesterol. The increase of 1 unit of IMT would increase 1.65 mg/dl of LDL cholesterol and the improvement of 1 unit of age would increase 0.61 mg/dl of LDL cholesterol. For HDL, 1 unit RLPP would decrease 17.75 mg/dl of HDL cholesterol. The increase of 1 unit of smoking status would decrease 5.8mg/d1 of HDL Cholesterol.In conclusion, maintaining an ideal body weight, decreasing the rate of fat stomach hollow development and not smoking are the best way for preventing the increase of LDL cholesterol and the- decrease of HDL cholesterol. It can be recommended that routine assessment of waist and hip in normal population may be socialized as indices to control fat stomach hollow levels. In addition, non-formal education in relation to normal body weight and stop smoking as well as prevent smoking would be prioritized. Furthermore, it is recommended for further investigation using case-control with the same topic in regard to RLPP and cholesterol.
Background: Farmers are the main activities in rural areas. Hypertension is the most commonand acquired cardiovascular disorder that can be acquired from socioeconomic, demographic,and epidemiological transitions. The purpose of this study was to determine asosiation andcontribution LDL cholesterol to hypertension.Method: The design in this study was a cross sectional study. This study used secondary datafrom Siskohatkes (computerized integrated haj computerized system). The population is allpilgrims who work as farmers in the rural areas of South Sumatra Province. Secret sample 411productive ages (15-64 years). The main independent variable is LDL and the major dependentis hypertension. Data were analyzed using univariate, bivariate and multivariate using multiplelogistic regression. Potential compensation uses a meaningless risk (AR%) while the measureuses the Odds ratio (OR)Result: Multivariate analysis of the final model with multiple regression, there was arelationship between LDL cholesterol with hypertension, P = 0.001, OR 2.284 with 95% CI(1,474-3,540) after intervention by time and BMI. Based on the trigger using AR%, get a valueof 4.0 or 40%. This means if the cholesterol level <160 mg / dl can prevent hypertension by40% in the population.Conclusion: There is a significant relationship between LDL cholesterol and hypertension afteradjusted age and BMI.Keywords: LDL cholesterol, Hypertension, Farmer, Rural.
ABSTRAK
Penyakit jantung koroner merupakan pembubuh utama di negara maju maupunnegara berkembang. Salah satu faktor risiko utama penyebab arterosclerosis adalahhiperkolesterolemia yang ditunjukkan dengan peningkatan kadar kolesterol LDL.Perubahan pola hidup yang ditandai dengan kurangnya mengkonsumsi buah dansayuran serta banyak mengkonsumsi makanan yang tinggi lemak, merupakan salahsatu risiko terjadinya peningkatan kadar kolesterol LDL. Penelitian ini bertujuanuntuk mengetahui hubungan asupan serat dengan kadar kolesterol LDL pendudukusia 25-65 tahun di Kelurahan Kebon Kalapa Bogor tahun 2013. Penelitian dilakukandengan desain cross sectional menggunakan data baseline Studi Kohor Faktor RisikoPenyakit Tidak Menular Badan Litbangkes tahun 2011. Analisis multivariatemenggunakan regresi logistik. Hasil analisis data diperoleh proporsi kolesterol LDLtinggi sebesar 78.3% dengan rata-rata kadar kolesterol 120 mg/dl. Rata-rata asupanserat sebesar 7 gram/hari dengan proporsi asupan serat <6.6 gram/hari sebesar 50.5%.Hasil multivariate menunjukkan asupan serat rendah merupakan faktor protektif (OR= 0.182) terhadap kadar kolesterol LDL tinggi setelah dikontrol oleh variabel umur,asupan lemak dan asupan protein nabati. Faktor determinan dalam model ini terhadapkadar kolesterol LDL adalah asupan protein nabati (OR = 13.356). Model ini mampumemprediksi kejadian kadar kolesterol LDL sebesar 79.4% dan sisanya dipengaruhioleh variabel lain yang tidak tercantun didalam model. Dengan melakukanpenyuluhan akan pentingnya mengkonsumsi makanan yang banyak mengandungserat merupakan salah satu upaya pencegahan terjadinya penyakit yang berhubungandengan arterocslerosis. Merubah pola makan dengan memperbanyak konsumsi buahakan mengurangi kadar kolesterol LDL dalam darah.
ABSTRACT
Coronary heart disease considers as one of the major killers both in developedand developing countries. One of the main risk factors that caused artherosclerosis ishypercholesterolemia which indicates by elevated LDL cholesterol level. Life stylechanging by lack of consuming fruits and vegetables while excess in consuming foodhigh in fat content considered one of risk to have elevated cholesterol level. The aimof this research is to identify the relationship between fiber consumption and thecontent of LDL cholesterol for the people of 25-65 years of age at Kebon KelapaVillage in Bogor on the Year of 2013. The research is conducted by Cross Sectional.The analytic design utilizes the baseline data from Cohort Study of ContagiousDisease Risk Factors of the Research and Development of Health Agency of theRepublic of Indonesia in the year of 2011. Stratification is used in analyzing data andcog regression is utilized in multivariate analysis. The analysis of the result obtainedthat the prevalence of LDL cholesterol is 78.3% with the average of cholesterolcontent 120 mg/dl. The average of daily fiber consumption is 7 gram/day with theproportion of fiber consumption <6.6 gram/day is 50.5%. The result of multivariateanalysis indicates that low fiber consumption considers as a protective factor(OR=0.182) toward high level of LDL cholesterol level after having controlled bysuch variables as age, consumptions of fat and vegetable protein. Determinant factorin this model toward LDL cholesterol content is the consumption of vegetable protein(OR=13.356). This model has the ability to predict in experiencing LDL cholesterollevel 79.4% and the remaining would be influenced by other factors that have notwritten down in the model. By educating the community about the important ofconsuming high fiber foods consider as one of the effort to prevent the occurrence ofdiseases relate with artherosclerosis. Changing the eating pattern by consuming morefiber will decrease the content of cholesterol level in the blood
