Abstrak:

Penelitian ini bertujuan untuk melakukan evaluasi program latihan Klub Jantung Sehat Pondalisa sekaligus mengetahui hubungan frekuensi dan keteraturan senam terhadap penurunan tekanan darah. Dengan demikian diharapkan akan didapatkan tekanan darah yang terkendali pada anggota KJS Pondalisa khususnya dan masyarakat usia dewasa tua umumnya. Studi kohort retrospektif dilakukan dengan menggunakan data yang terdapat pada buku anggota KJS Pondalisa. Digunakan pendekatan analisis Cox Regression untuk melihat efek frekuensi dan keteraturan senam yang telah dilakukan oleh para anggota KJS Pondalisa selama 1 tahun pertama keanggotaan terhadap penurunan tekanan darah. HR (hazard ratio) digunakan sebagai estimasi RR (risiko relatif) efek frekuensi dan keteraturan senam terhadap penurunan tekanan darah. Anatisis multivariat digunakan untuk mengendalikan variabel-variabel perancu. Sebanyak 132 data anggota K7S Pondalisa dianalisis dalam penelitian ini. Dalam 1 tahun pertama keanggotaan terdapat 11,36% anggota yang melakukan senam 2x1minggu, 39,39 % anggota yang melakukan senam > 8 minggu (9-15 minggu) berturut-turut, dan 11,36% anggota yang melakukan senam 2xlminggu selama > 8 minggu (9-15 minggu) berturut-turut. Tidak ada anggota yang melakukan senam 3xlminggu sesuai program dan tidak ada anggota yang melakukan senam 2x1minggu selama < 8 minggu berturut-turut_ Keteraturan senam anggota maksimum selama 15 minggu. Didapatkan penurunan tekanan darah pada 32,58 % anggota dengan rata-rata penurunan tekanan darah sistolikldiastolik sebesar 6 mmHg/4 mmHg yang dapat dipertahankan minimal selama 1 bulan. Besarnya penurunan TD ini diharapkan dapat bermanfaat dalam menurunkan angka kesakitan dan kematian akibat hipertensi; sedikitnya dapat memperlambat perjalanan penyakit hipertensi serta bermanfaat dalam pencegahan primer. Efek frekuensi senam 2xlminggu terhadap penurunan tekanan darah meningkat sebesar 1 Va dibandingkan dengan frekuensi senam < 2xlminggu [RR 1,01;95%CI [0,43-2,38]. Efek senam teratur 9-15 minggu berturut-turut terhadap penurunan tekanan darah meningkat sebesar 36 % dibandingkan dengan senam teratur < 8 minggu berturut-turut [RR 1,36;95%CI [0,63-2,93]. Senam yang dilakukan 2xlminggu selama 9-15 minggu berturut-tunrt memberikan manfaat penurunan tekanan darah sebesar 34 % dibandingkan dengan senam

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The aim of this research is to evaluate the performance of `Klub Jantung Sehat Pondalisa' as well as the association of frequency and regularity of exercise with blood pressure reduction. The long-term benefit achieved will be adequate control of blood pressure among members of the club and adults as a whole. Retrospective cohort study was conducted, using data found on the member's logbook. Cox Regression analysis approach was used to find the benefit of blood pressure reduction through exercise's frequency and regularity which have been done by all member of KJS Pondalisa during the first year of membership. HR (hazard ratio) was used to estimate the RR (relative risk) of both exercise's frequency and regularity to reduce blood pressure. Confounders were adjusted by multivariate analysis. There were 132 members analyzed in this research. In the first year of membership, there were 11.36% members doing exercise twice weekly, 39.39 % members doing exercise > 8 weeks (9-15 weeks) regularly, and 11.36% members doing exercise twice weekly in > 8 weeks (9-15 weeks) regularly. There were no member doing exercise thrice weekly as programmed. There were no member doing exercise twice weekly in < 8 weeks regularly. The maximum exercise's regularity was 15 weeks. There were 32.58 % blood pressure reduction among members. The mean systolic/diastolic reduction which can be maintained for at least I month were 6 mmHg/4 mmHg, This amount of BP reduction might reduce morbidity and mortality among hypertensives; at least might retard the natural history of hypertension and give benefit to primary prevention. The effect of twice weekly's exercise on blood pressure reduction increase 1 % as compared to less than twice weekly's exercise [RR 1,01;95%CI [0,43-2,38]. Effect of doing 9-15 weeks regular exercise on blood pressure reduction increase 36 % as compared to members doing 8 weeks regular exercise [RR 1,36;95%CI [ 0,63-2,93]. Members doing exercise twice weekly in 9-15 weeks regularly get benefit on blood pressure reduction 34 % more as compared to members doing exercise less than twice weekly in < 8 weeks regularly [RR 1,34;95% CI [0,50-3,60]. There were no difference in blood pressure reduction between members doing exercise less than twice weekly in 9-15 weeks regularly and members doing exercise less than twice weekly in < 8 weeks [RR 0,99;95% CI [ 0,42-2,32]. From this research, we conclude that there was no different effect of blood pressure reduction between twice weekly's exercise and less than twice weekly's exercise. The effect of exercise in 9-15 weeks regularly toward blood pressure reduction is bigger compared with effect of twice weekly's exercise. This fording shows the importance of maintaining exercise's regularity to get benefit of reducing blood pressure. The benefit of twice weekly's exercise for blood pressure reduction will be achieved when it is conducted in 9-15 weeks regularly. Although exercise has been conducted regularly up to 15 weeks, if done less than twice weekly, it will not yield the benefit of blood pressure reduction. There are still many factors which have not been considered such as the duration and intensity of exercise, the role of anti hypertensive drugs, and the presence of other diseases. All of those factors together with the wide range and inconsistent of confidence interval, make the results of this study fail to show the maximal effect of exercise's frequency and regularity to reduce blood pressure in population. Therefore, further research is needed using several degrees of exercise's frequency and regularity, considering also the above mentioned related factors and bigger number of sample size, to obtain the true benefit of blood pressure reduction and more accurate precision.

Abstrak:

Gagal jantung merupakan salah satu jenis penyakit jantung dengan insiden, prevalen serta mortalitas yang terus meningkat. Penelitian ini bertujuan untuk mengetahui pengaruh keteraturan berobat terhadap kesintasan lima tahun penderita gagal jantung kongestif (GJK). Desain penelitian adalah kohort retrospektif. Sampel sebanyak 402 orang penderita baru GJK yang didiagnosis antara tahun 2001 s.d. 2002 dan dirawat di Rumah Sakit Pusat Jantung dan Pembuluh Darah Harapan Kita. Ditemukan penderita GJK yang meninggal selama lima tahun follow up adalah 78 orang (19,4%). Probabilitas kesintasan penderita GJK adalah sebesar 88,65% (tahun pertama), 80,11%(tahun ke dua). 72.22% (tahun ke tiga), 63,75% (tahun ke empat) dan 54,41% (tahun ke lima). Penderita GJK yang tidak teratur berobat mempunyai risiko kematian lebih tinggi dari pada yang berobat teratur. Pada analisis Cox regression keteraturan berobat merupakan yariabel independen pada kesintasan penderita GJK (HR:1,95; 95% Cl: 1.23-3.11). Faktor-faktor Iain yang juga bermakna terhadap kesintasan penderita GJK adalah Ejection Fraction (HR:1,91; 95% Cl:1,18-3,08), Diabetes Melitus (HR:1,85; 95% Cl:1,08-3,18). Beberapa variabel pada penelitian ini hubungannya tidak bermakna terhadap kesintasan penderita GJK yaitu: umur, rokok,functional, riwayat PJK , hipertensi , kreatinin dan tindakan pengobatan. Keteraturan berobat terbukti mempengaruhi probabilitas kesintasan penderita GJK. Penderita GJK disarankan untuk senantiasa melakukan pemeriksaan dan pengobatan secara teratur.

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Heart failure is one of cardiovascular disease which incidence, prevalence and mortality remain height and increased. The purpose of this study was to evaluate the effect of routine medical evaluation (compliance) on five year survival rate of patients hospitalized due to congestive heart failure. The Study design used in this study is retrospective cohort with 402 patients of newly diagnosis congestive heart failure (CHF) admitted in year 2000 to 2001 at National Cardiovascular Center - Harapan Kita, Jakarta. During 5 year follow-up, 78 patients died. Survival at 1 to 5 years was in order of 88,65%, 80,11%, 72,22%, 63,75%, and 54,41%, respectively. CHF patients who did not underwent routine medical evaluation had higher prognostic of death than CHF patients who had medical evaluation routinely. By Cox regression analyses, the independent predictors of mortality were routine evaluation (HR:1,95; 95% CI: 1.23-3.11). low ejection fraction (HR:1,91; 95% CI:1,18-3,08), and diabetes mellitus (HR:1,85; 95%CI:1,08-3,18). Other predictors were not statistically significant, i.e: age, gender, smoking, functional class, coronary heart disease, creatinine, and the medication. The status of compliance is an independent predictor of survival for patients with CHF, besides low ejection tiaction and diabetes mellitus. These evaluation, like the other research, suggested the importance of compliance in the treatment of CHF.

Abstrak:

Latar Belakang: Hipertensi yang tidak ditangani dengan baik dapat menyebabkan berbagai komplikasi seperti stroke, penyakit jantung koroner, gagal ginjal, dan kebutaan, serta meningkatkan beban biaya kesehatan. Walaupun berbagai kemajuan telah tercapai dalam tata laksana hipertensi, namun keberhasilan terapi belum memuaskan. Tujuan studi adalah mengetahui pengaruh pemberian L. plantarum Dad-13 dalam membantu menurunkan tekanan darah penderita hipertensi. Metode: Studi uji klinis acak terkontrol dilakukan terhadap pasien hipertensi berusia di atas 40 tahun yang berobat di Rumah Sakit Siloam Lippo Village sejak Juli 2018 hingga Desember 2021. Evaluasi tekanan darah sebelum dan sesudah diberikan L. plantarum Dad-13 dan plasebo dilakukan selama 4 minggu. Analisa bivariat dilanjutkan multivariat dengan Generalized Estimating Equation (GEE) dilakukan untuk mendapatkan perbedaan tekanan darah dan populasi L. plantarum dalam tinja dengan nilai p<0.05. Hasil: Didapatkan 57 dan 56 sampel pada kelompok kontrol dan perlakuan. Rerata perubahan tekanan darah sistolik pada kelompok kontrol dan perlakuan adalah -3,63+6,59 dan -3,23+6,93 mmHg, rerata perubahan tekanan darah diastolik pada kelompok kontrol dan perlakuan adalah -1,65+5,18 dan -2,73+4,89 mmHg. Log10 CFU L. plantarum pada kelompok kontrol dan perlakuan pada akhir penelitian adalah 3,61+0,86 dan 3,93+0,89. Pada analisis GEE secara keseluruhan tekanan darah sistolik kelompok perlakuan lebih rendah 1,915 mmHg dibandingkan kelompok kontrol, sedangkan tekanan darah diastolik kelompok perlakuan lebih tinggi 2,301 mmHg dibandingkan kelompok kontrol. Simpulan: Terdapat kecenderungan bahwa tekanan darah sistolik kelompok perlakuan lebih rendah daripada kelompok kontrol, sedangkan tekanan darah diastolik kelompok kontrol lebih rendah daripada kelompok perlakuan

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Background: Untreated hypertension could cause multiple complications such as stroke, coronary arterial disease, kidney failure, and blindness, and also increased medical cost. Many progress has been made in the management of hypertension, but the result is still unsatisfactory. The aim of the study is to explore the effect of L. plantarum Dad-13 supplementation to improve blood pressure control in hypertensive patients. Methods: This randomized controlled trial study was conducted to hypertension patients aged above 40 y.o. in Siloam Lippo Village Hospital on July 2018-December 2021. Blood pressure was evaluated before and after consumption of L. plantarum Dad-13 and placebo in 4 weeks period. Bivariat followed by multivariate analysis using Generalized Estimating Equation (GEE) were done to get blood pressure and fecal L. plantarum population difference with p value < 0.05. Results: A total of 57 and 56 samples in control and treatment groups. Mean systolic pressure difference in control and treatment groups were -3,63+6,59 and -3,23+6,93 mmHg, while mean diastolic pressure difference in control and treatment groups were -1,65+5,18 and -2,73+4,89 mmHg. Log10 CFU L. plantarum in control and treatment groups in the end of study were 3,61+0,86 and 3,93+0,89. GEE analysis found overall systolic pressure in treatment group was lower 1,915 mmHg compared to control group, while overall diastolic pressure in control group was lower 2,301 mmHg compared to treatment group. Conclusion: There were tendencies of lower systolic pressure in treatment group compared to control group, and lower diastolic pressure in control group compared to treatment group

Abstrak: ABSTRAKDisertasi ini menilai dinamika perubahan IMT dan tekanan darah pada wanita pasca menopausedi Kota Bogor, dengan desain studi longitudinal dan kualitatif. Analisis data panel dilakukanpada data sekunder dari ldquo;Studi Kohor Faktor Risiko Penyakit Tidak Menular rdquo; dengan follow up2. Hasil penelitian pada wanita pasca menopause antara lain prevalensi hipertensi 66,1 daninsiden rate 5 kasus per 100 orang-tahun. Model fixed effect menemukan hubungan bermaknaantara perubahan IMT dengan perubahan sistolik dan diastolik. Dinamika IMT dengan sistolikdengan R2 within 2 . Setelah disesuaikan dengan tingkat aktifitas fisik, peningkatan 1 kg beratbadan pada normotensi telah meningkatkan tekanan darah sistolik 1,5 mmHg dan diastolik 0,9mmHg, pada hipertensi terkendali sistolik 2,7 mmHg dan diastolik 1,3 mmHg, pada hipertensitidak terkendali sistolik 3,7 mmHg dan diastolik 1,3 mmHg. Setelah disesuaikan dengan derajatmerokok, penurunan dinamika IMT 1 telah menurunkan sistolik sekitar 2-3 mmHgdibandingkan IMT stabil. Trigliserida berpotensi menjadi marker lipid baru, sedangkan faktorpsikososial dan merokok berkontribusi pada pengendalian hipertensi.

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ABSTRACTThis study aims at evaluating the dynamics of change in BMI and blood pressure ofpostmenopausal women in Bogor by using both longitudinal data and qualitative study.Analyzing the 2 years follow up panel data of A Cohort Study of Non Communicable Diseases rsquo Risk Factors rdquo , this study showed that the prevalence of hypertension in postmenopausal womenis 66.1 , while the incidence rate reaches 5 cases per 100 person years. The fixed effectestimations confirmed that changes in systolic and diastolic pressure would follow changes inBMI. Moreover, after controlling with a physical activity, this study still found that there isstrong correlation between dynamics of BMI and systolic pressure, Normotensive patientsexperienced 1 kg of weight gain will increase their systolic pressure by 1.5 mmHg, theirdiastolic pressure by 0.9 mmHg. Furthermore, patients with under controlled hypertension whoare experienced 1 kg of weight gain will increase their systolic pressure by 2.7 mmHg, diastolicpressure by 1.3 mmHg. In contrast, patients with uncontrolled hypertension would have highersystolic pressure 3.7 mmHg and diastolic pressure around 1.3 mmHg. By controlling smokingactivity, 1 reduction in dynamic BMI would lower a systolic pressure as much as 2 3 mmHgcompared to a stabilized BMI. Other findings of this study are that triglyceride serves apotential of new lipid marker,while psychosocial factors and smoking behavior could contributeto controlled hypertension.

Abstrak: Penyakit kardiovaskuler merupakan penyebab kematian utama penduduk dunia (30%). Untuk menghadapi masalah ini perlu diketahui distribusi penyakit kardiovaskuler terhadap faktor-faktor risikonya secara lebih spesifik. Penelitian ini bertujuan untuk mengetahui gambaran penyakit kardiovaskuler pada pasien rawat inap di Rumah Sakit Jantung dan Pembuluh Darah (RSJPD) Harapan Kita Tahun 2012. Penelitian ini menggunakan data sekunder dari rekam medik RSJPD Harapan Kita menggunakan desain studi cross sectional dengan jumlah sampel 339 orang dianalisis secara univariat.Hasil menunjukkan Ischemic Heart Diseases merupakan penyakit dengan proporsi terbesar yaitu 43,36%. Berdasarkan letak lesi, penyakit jantung memiliki proporsi terbesar yaitu 87,02%. Penyakit kardiovaskuler cenderung mengenai kelompok usia 51-60 tahun dengan proporsi 29,79%. Penyakit kardiovaskuler cenderung menyerang laki-laki dan orang dengan tingkat pendidikan menengah. Diketahui bahwa proporsi pasien hipertensi dan diabetes mellitus cenderung lebih besar di antara pasien penyakit pembuluh darah otak daripada pada pasien penyakit jantung ataupun pasien penyakit pembuluh darah perifer.

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Cardiovascular disease is the most common death cause (30%) . To face the problem it’s necessary to know the distribution of cardiovascular disease specifically to its risk factors. This research aims to describe the cardiovascular disease among the hospitalized patients in Harapan Kita Cardiovascular Hospital in 2012. This research uses the secondary data from Harapan Kita Cardiovascular Disease medical record and also uses cross sectional design with 339 sample and analyzed in univariate.The results show that among the cardiovascular diseases in inpatient unit in Harapan Kita Cardiovascular Hospital, Ischemic Heart Diseases is the diseases with the biggest proportion which is 43,36%. According to lesion location, heart disease has the biggest proportion which is 87,02%. Cardiovascular diseases tend to affect the 51-60 years old group of age by 29,79% among other age groups. Cardiovascular diseases tend to affect men and those who have middle educational level. The results also show that proportion of patients with hypertension and Diabetes Melitus tends to be bigger among cererovascular diseases patients than heart diseases patients or peripheral vascular diseases patients.