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"Background: cardiovascular diseases (CVD) is the most common cause of death in Indonesia. We aimed to examine risks of CVD in workers aged 40 to 69 year related to their occupational status. Methods: a cross-sectional study in all provinces of Indonesia. Data from a large-scale national health survey called RISKESDAS were used to analyze factors associated with CVD. Analysis was restricted to the working population aged 40 to 69 year. There were 137,378 subjects included in the analysis. Coxs regression analysis was modified to calculate prevalence ratio for the association of CVD with diabetes mellitus (DM), hypertension, stress, body mass index (BMI), smoking, and particular demographic factors. Results:CVD was associated with occupation; white collar workers were about 1.6 times as likely to be diagnosed with CVD as to blue collar workers. However, blue collar workers were more likely to report symptoms of CVD than white collar workers. Prevalence of CVD was higher in women than men, increasing by age and education attainment. Hypertension, DM, stress, and increased BMI added the prediction of CVD: prevalence ratio (PR) was 1.72 (95% CI 1.59-1.86), 3.89 (95% CI 3.43-4.44), 3.02 (95% CI 2.77-3.29) and 1.42 (95% CI 1.28-1.57) for BMI 27 relative to <25 kg/m2, respectively. The study could not explain the association with smoking. Conclusion: this study added evidence of major risk factors which could be modified to reduce CVD. Some associations were likely to reflect access to health care."

"Pendahuluan: Penyakit kardiovaskular sebagai salah satu masalah kesehatan pada jemaah haji Indonesia dan penyebab tertinggi kematian jemaah haji dalam 3 tahun terakhir. Jemaah haji Indonesia sebagian besar pada stratifikasi kesehatan risiko tinggi. Beberapa faktor risiko diprediksi berhubungan dengan kematian jemaah haji akibat penyakit kardiovaskular.Metode: Penelitian observasional dengan desain kasus kontrol. penelitian terhadap 876 jemaah haji. Variabel yang berhubungan dengan kematian jemaah haji antara lain usia, jenis kelamin, indeks massa tubuh, kebiasaan merokok, diabetes mellitus, hipertensi, dislipidemia, gagal ginjal, gagal jantung, penyakit jantung koroner, penyakit paru obstruksi kronik, waktu keberangkatan jemaah. Dilakukan analisis untuk menentukan faktor risiko yang berpengaruh terhadap kematian serta membuat skor prediksi untuk mengestimasi risiko mortalitas.Hasil: Proporsi kematian akibat penyakit kardiovaskular adalah 49,2 % dari seluruh jemaah haji Indonesia tahun 2017. Faktor risiko yang berhubungan dengan kematian jemaah haji antara lain; Usia lebih dari 70 tahun dengan OR 20,51 (IK 95%: 10,238-41,089), penyakit jantung koroner dengan OR 4,236 (IK 95% : 1,292-13,882), hipertensi dengan OR 3,673 (IK 95% :2,555-5,280), diabetes mellitus dengan OR 3,422 (IK 95%: 2,108-5,553), dislipidemia dengan OR 2,067 (IK 95%: 1,366-3,129), indeks massa tubuh overweight dengan OR 0,571 (IK 95%: 0,385-0,848) , indeks massa tubuh obesitas dengan OR 0,239 (IK 95%: 0,134-0,425). Probabilitas risiko kematian akibat penyakit kardiovaskular adalah risiko ringan dengan skor < 5 (19,47%), probabilitas sedang skor 6-9 (62,94%) dan probabilitas tinggi jika skor > 10 (83,3%).Simpulan: Proporsi kematian akibat penyakit kardiovaskular pada jemaah haji Indonesia tahun 2017 adalah 49,2%. Faktor risiko kardiovaskular antara lain; usia tua, hipertensi, diabetes mellitus, penyakit jantung koroner, dislipidemia. Nilai skor > 10 dapat memprediksi risiko mortalitas dengan propabilitas 88,53 %.

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Background: Cardiovascular disease is one of the health problems in Indonesian pilgrims and the highest cause of death for pilgrims in the last 3 years. Indonesian pilgrims are mostly on high health risk stratification. Some risk factors are predicted to be associated with the death of pilgrims due to cardiovascular disease.

Method: Observational study with case control design. Conducted research on 876 pilgrims. A variable that is associated with the death of pilgrims include age, gender, body mass index, smoking habit, diabetes mellitus, hypertension, chronic kidney failure, heart failure, coronary heart disease, chronic obstruction pulmonary disease , the time of departure. Analysis was done to determine the risk factors which effect on death as well as make score predictions and determination for the risk of mortality.

Results: The proportion of deaths from cardiovascular disease was 49,2 % of all Indonesian pilgrims. Risk factors associated with the death of pilgrims include; Age more than 70 years with OR 20,510 (95% CI 10,238-41,089), coronary heart disease with OR 4,236 (95% CI 1,292-13,882), hypertension with OR 3.673 (95% CI 2,555-5,280), diabetes mellitus with OR 3,422 (95% CI 2,108-5,553), dyslipidemia with OR 2,067 (95% CI 1,366-3,129), overweight with OR 0.571 (95% CI: 0.385-0,848), obesity with OR 0.239 (95% CI 0.134-0.425). The probability of the risk of death from cardiovascular disease is a mild risk with a score <5 (19.47%), a medium probability score of 6-9 (62.94%) and a high probability of a score of > 10 (83.3%).

Conclusion: The proportion of deaths from cardiovascular disease was 49,2 %. Cardiovascular risk factors; old age, hypertension, diabetes mellitus, coronary heart disease, dyslipidemia. A score of > 10 has a high risk of mortality."

"Penyakit jantung merupakan penyebab kematian nomor satu di dunia. Pada pasien penyakit jantung, health-related quality of life (HRQoL) merupakan hal yang penting untuk diperhatikan dalam konteks pencegahan dan penanganan penyakit jantung. HRQoL mengindikasikan persepsi pasien mengenai kesehatan fisik dan mentalnya. Salah satu faktor yang dapat memengaruhi HRQoL pasien penyakit jantung ialah kecemasan. Prevalensi kecemasan pasien penyakit jantung ialah sebesar 70% - 80%. Namun demikian, terdapat kemungkinan bahwa pasien penyakit jantung dengan kecemasan yang tinggi dapat memiliki HRQoL yang baik. Hal ini dapat dipengaruhi oleh faktor lain, yaitu strategi koping dan illness perception. Penelitian ini bertujuan untuk melihat bagaimana peran strategi koping dan illness perception sebagai moderator dalam pengaruh kecemasan terhadap HRQoL pasien penyakit jantung. Sebanyak 160 partisipan diberikan pengukuran menggunakan SF-12v2 (HRQoL), PHQ-4 (kecemasan), Brief Cope (strategi koping), dan B-IPQ (illness perception). Hasil penelitian ini menunjukkan bahwa illness perception dapat memoderasi strategi koping yang berperan sebagai moderator dalam pengaruh kecemasan terhadap HRQoL secara signifikan (p = 0,0318). Hasil ini mengindikasikan bahwa low threatening illness perception akan membantu menahan dampak kecemasan yang tinggi terhadap HRQoL pasien penyakit jantung, terlepas dari jenis strategi koping apa yang dimiliki individu. Sementara adanya dampak buruk medium dan high threatening illness perception terhadap HRQoL individu dapat terbantu dengan adanya strategi koping yang adaptif yang dimiliki oleh individu.

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Cardiovascular disease is the number one cause of death in the world. In patients with cardiovascular disease, health-related quality of life (HRQoL) is important to consider in the contested context and treatment. One of the factors that can affect the HRQoL of heart disease is anxiety. The anxiety prevalence of cardiovascular disease patients is 70% - 80%. However, it is possible that cardiovascular disease patients with high anxiety can have an adequate HRQoL. This can be influenced by other factors, namely coping strategies and illness perception.

This study aims to see how the role of coping strategies and illness perception as a moderator in the impact of anxiety on HRQoL of cardiovascular disease patients. All 160 participants who had cardiovascular disease were given measurements using SF-12v2 (HRQoL), PHQ-4 (anxiety), Brief Cope (coping strategies), and B-IPQ (illness perception).

The results of this study shows that illness perceptions can moderate coping strategies that act as moderators in interactions of anxiety and HRQoL significantly (p = 0.0318). This results indicates that low threatening illness perception will help prevent the worsen of HRQoL on cardiovacular disease patients, regardless of what type of coping strategies. While the impact of moderate or high threatening illness perception to HRQoL can be helped by an individuals adaptive coping strategies."

"Penelitian ini bertujuan untuk mengetahui adanya bukti empiris bahwa perceived behavioral control, perceived benefits, perceived barriers, dan perceived susceptibility mampu memprediksi aktivitas fisik pada orang dewasa yang dalam riwayat keluarganya terdapat sejarah penyakit kardiovaskular. Tipe penelitian yang digunakan yaitu kuantitatif, dengan desain korelasional. Data terkumpul dari 101 partisipan dengan rentang usia 20-60 tahun (dewasa muda dan madya). Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan tingkat aktivitas fisik berdasarkan usia, jenis kelamin, dan rutinitas melakukan aktivitas fisik. Analisis regresi berganda menunjukkan bahwa model yang terdiri dari keempat prediktor mampu memperkirakan 14% varians aktivitas fisik, dengan perceived behavioral control dan perceived susceptibility sebagai prediktor terbaik. Temuan ini mengkonfirmasi bahwa perceived behavioral control juga mampu memperkirakan aktivitas fisik pada populasi ini, serupa dengan berbagai populasi lain yang telah diteliti sebelumnya. Selain itu, individu yang memiliki keluarga dengan PKV memiliki pengalaman-pengalaman yang tampaknya membuat mereka mampu menaksir tingkat risiko terkena PKV dengan lebih akurat, yang pada gilirannya juga memberikan kontribusi pada tingkat aktivitas fisik. Dengan demikian, intervensi aktivitas fisik pada orang dewasa dengan riwayat keluarga PKV dapat mempertimbangkan kedua faktor ini.

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This study aims to find empirical evidence that perceived behavioral control, perceived benefits, perceived barriers, and perceived susceptibility are significant predictors of physical activity in adults with a family history of cardiovascular disease. The type of research used is quantitative, with a correlational design. Data were collected from 101 participants with an age range of 20-60 years (young and middle adults). The results showed that there was no difference in the level of physical activity based on age, gender and physical activity routines. Multiple regression analysis showed that the model consisting of the four predictors was able to explain 14% variance of physical activity, with perceived behavioral control and perceived susceptibility as the best predictors. These findings confirm that perceived behavioral control can also estimate physical activity in this population, similar to other populations that have been studied previously. In addition, individuals who have families with PKV have experiences that seem to enable them to assess their risk level for developing CVD more accurately, which in turn contributes to their level of physical activity. Thus, physical activity interventions in adults with a family history of CVD should consider both of these factors."

"Dampak dari penyakit kardiovaskular tidak hanya dirasakan oleh individu namun juga secara global. Pencegahan dan pengawasan perlu dilakukan untuk menurunkan beban yang dihadapi akibat penyakit kardiovaskular dengan pendekatan populasi dan individu. Perawat memiliki peran penting dalam hal promotif, preventif, dan rehabilitatif. Residen mengelola 31 kasus dengan menggunakan pendekatan teori Care, Core, dan Cure dalam memberikan asuhan keperawatan pada pasien dengan gangguan kardiovaskular sebagai cerminan dari peran ners spesialis sebagai pemberi pelayanan dan pendidik. Peran ners spesialis sebagai peneliti dijalani oleh residen dalam menerapkan tindakan keperawatan yang berbasis bukti atau Evidence Based Nurisng EBN berupa pengukuran keterlibatan pasien dengan Patient Activation Measure PAM. Sebagai inovator dan pemimpin kelompok, residen mengembangkan proyek membuat format perencanaan pemulangan pasien dengan pendekatan lima model.

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The impact of cardiovascular disease is not only felt by individuals but also globally. Prevention and supervision have to do to reduce the cardiovascular disease burden by population and individual approach. Nurses have an important role in promotive, preventive, and rehabilitative. Resident manages 31 cases using Care, Core, and Cure theory approaches in providing nursing care to patients with cardiovascular disease as a reflection of the role of specialist ners as service providers and educators. The role of a specialist ners as a researcher is undertaken by the resident in implementing Evidence Based Nursing EBN by measuring patient engagement with Patient Activation Measure PAM . As an innovator and community leader, the resident developed the project to make a discharge planning format using a five model approach."

"ABSTRAKLatar Belakang: Penyakit kardiovaskular adalah penyebab kematian yang paling sering pada pasien AR dengan laju1,5-1,6 kali lebih tinggi dari populasi non AR. Prevalensi gagal jantung pada AR dua kali lipat dibanding non AR. Karakteristik pasien AR Indonesia berbeda dibanding pasien di Negara Barat. Masih sedikit penelitian yang melihat korelasi faktor resiko non tradisional dengan disfungsi diastolik.Tujuan: Mengetahui apakah ada korelasi faktor resiko non tradisional yaitu lama menderita penyakit, derajat aktivitas penyakit dan skor disabilitas dengan disfungsi diastolik pada wanita penderita ARMetode: Desain penelitian adalah potong lintang pada wanita penderita AR yang berobat ke poli Rematologi RSCM dari Oktober 2015-Januari 2016.Sampel penelitian belum pernah dinyatakan menderita penyakit jantung sebelumnya.Disfungsi diastolik dinilai secara ekhokardiografi. Lama menderita sakit diperoleh dengan wawancara langsung, sementara aktivitas penyakit dan tingkat disabilitas dinilai dengan menghitung skor DAS28 dan skor HAQ-DI.Hasil: Disfungsi diastolik dijumpai pada 30,8 % partisipan ( masing-masing 13,5% tingkat ringan dan sedang, dan berat sebesar 3,8% ). Rerata lama menderita AR 26,5 bulan (rentang 2-240), rerata DAS28-CRP 2,69±1,11 sementara DAS28-LED 3,65 (rentang 1,13-7,5), rerata skor HAQ-DI 0,29 (rentang 0-2,38). Hipertropi LV dijumpai pada 34,6% partisipan, rerata EF 66,7±5,76%. Kelainan katup dijumpai pada 34,6% partisipan. Korelasi antara lama sakit, DAS28-CRP, DAS28-LED and skor HAQDI dengan E/A secara berurutan adalah (r= - 0,065; p=0,89), (r=0,393; p=0,38), (r=0,357; p=0,43), (r=0,630; p=0,12) ; sementara dengan E/E? secara berurutan adalah (r=0,136; p=0,77), (r= - 0,536; p=0,21), (r= - 0,393; p=0,38), (r=0,374; p=0,41)Simpulan: Lama menderita sakit, derajat aktivitas penyakit dan derajat disabilitas, tidak memiliki korelasi yang bermakna secara statistik dengan disfungsi diastolik. Angka hipertropi jantung juga cukup tinggi, dan kelainan katup yang paling sering di jumpai adalah regurgitasi ringan.Dengan tingginya angka proporsi disfungsi diastolik pada penelitian ini maka diusulkan agar dirumuskan strategi penatalaksanaan jantung pada pasien-pasien AR untuk mencegah progresifitasnya.

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ABSTRACTBackground: Cardiovascular is the main cause of death in RA, with the rate of 1.5-1.6 times higher than non RA population .The prevalence of HF in RA is 2 times fold of non RA. RA patients characteristics in Indonesia is different from the ones in western. There are only few studies about correlation between non traditional risk factor and diastolic dysfunction in RA patients.Objective: To study the correlation between each of the non traditional risk factors including disease duration,disease activity and disability score with the diastolic dysfunction in women with RA.Methods: A cross-sectional, consecutive sampling study conducted to 52 RA women without any previous history of cardiovascular disease. All participants underwent an echocardiography to asses the diastolic dysfunction and other findings associated. Duration of disease is assesed by direct interview, while the disease activity by calculating DAS28 and disability sore by HAQ-DI.Results: Diastolic dysfunction was found in 30.8 % of study participants ( 13.5 % for each low and moderate grade, while severe was 3.8% ). Mean of disease duration was 26.5 months (range 2-240), mean DAS28-CRP 2.69±1.11 while mean DAS28-ESR 3.65 (range 1.13-7.5), HAQ-DI score 0.29 (range 0-2.38). LV hypertrophy was found in 34.61% participants. Mean EF 66.7±5.76%. Valve abnormality was found in 34.6% study participants. Correlation between duration of disease, DAS28-CRP, DAS28-ESR and HAQDI score with E/A in sequence was (r= - 0.065; p=0.89), (r=0.393; p=0.38), (r=0.357; p=0.43), (r=0.630; p=0.12) ; while with E/E? in sequence was (r=0.136; p=0.77), (r= - 0.536; p=0.21), (r= - 0.393; p=0.38), (r=0.374; p=0.41)Conclusions; Duration of the disease, the disease activity score and disability score in our RA study participants had no correlation with diastolic dysfunction. The most valvular abnormality findings was mild regurgitation. Since there was a big proportion of participants with diastolic dysfunction, it is encouraged to make a stepwise approach of cardiovascular management in patients with RA."

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Latar belakang:Penyebab utama kematian pasien penyakit ginjal kronis (PGK) adalah penyakit kardiovaskular. Stres oksidatif merupakan mediator dalam patogenesis sindrom kardiorenal. Terapi kombinasi penghambat reseptor angiotensin dan statin dapat dipertimbangkan dalam manajemen pasien PGK karena pendekatannya berbeda dalam menekan stres oksidatif.

Tujuan:Penelitian ini bertujuan untuk mengetahui efek irbesartan dan simvastatin terhadap penurunan stres oksidatif melalui pengamatan kadar malondialdehid (MDA) jantung dan serum tikus PGK.

Metode:Penelitian ini menggunakan jantung dan serum tersimpan dari tikus jantan galur Sprague-Dawley yang telah diberikan perlakuan pada penelitian sebelumnya. Terdapat 3 kelompok yakni kontrol normal (sham; n=4), nefrektomi 5/6 (Nx; n=4), dan nefrektomi 5/6 + terapi irbesartan 20mg/kgBB/hari dan simvastatin 10mg/kgBB/hari selama 4 minggu (Nx + Ir-Si; n=4). Kadar MDA sampel jantung dan serum tersimpan diukur dengan metode TBARS. Data dianalisis dengan SPSS menggunakan uji One-Way Anova. Nilai p ≤0.05 dianggap bermakna secara statistik.

Hasil:Pemberian irbesartan 20mg/kgBB/hari dan simvastatin 10mg/kgBB/hari selama 4 minggu menyebabkan kadar MDA yang cenderung meningkat namun tidak bermakna pada organ jantung (p=0,069) dan serum (p=0,091) tikus PGK.

Simpulan:Tidak terdapat perbedaan yang bermakna antara kelompok tikus PGK yang diberi terapi kombinasi irbesartan dan simvastatin dengan kelompok tikus PGK tanpa terapi terhadap hasil rerata kadar MDA jantung dan serum tikus.

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Background:Cardiovascular disease is the main cause of mortality in chronic kidney disease(CKD). Oxidative stress is one of the mediators in cardiorenal syndrome. Combined angiotensin-receptor blockers and statins can be considered in CKDmanagement. 

Purpose:This study aims to determine the effect of irbesartan-simvastatin on reducing oxidative stress by observing malondialdehyde (MDA)levels in the heart and serum of CKD rats model.

Methods:This study uses stored heart tissue and serum from male Sprague-Dawley rats, those had been given treatment in previous study. There are 3 groups which are normal control (sham; n=4), untreated 5/6 nephrectomy (Nx; n=4), and 5/6 nephrectomy + irbesartan 20mg/kgBW/day and simvastatin 10mg/kgBW/day (Nx + Ir-Si; n=4).MDAlevels were measured using TBARS methods. Data were analyzed with SPSSusing One-Way Anova test. p value ≤0.05 is considered statistically significant.

Results:Combined therapy of irbesartan 20mg/kgBW/day and simvastatin 10mg/kgBW/day for 4 weeks caused a tendency in malondialdehyde levels to increase but not statistically significant in heart (p=0.069) and serum (p=0.091)of CKD rats model.

Conclusion:There were no significant differences between group of CKD rats with combined therapy of irbesartan-simvastatin and group of CKD rats without therapy on the MDA levels in heart and serum.

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"ABSTRACTA cross sectional study on cardiovascular disease risk profile was carried out in North Jakarta, Indonesia. One hundred six Chinese individuals (47 men and 59 women) aged 25 years and over were recruited to collect baseline information related to dietary determinants of cardiovascular risk profile.Result showed high prevalence of overweight /obesity and hypertension, especially in men (43% and 48.8%, respectively). The prevalence of current smoker was 12.2% of men and 3.9% of women. The prevalence of hyperlipidemia was 14.6% of men and 9.6% of women. Mean values of BMI, WHR, and blood pressure were significantly higher in men than in women. Body fatness and blood pressure in women were significantly increased with age. In women, total cholesterol and LDL cholesterol were associated with BMI, while triglyceride was associated with WHR.Intake of fresh fish, crabs/lobster/shrimp, sea weed, tomato and spinach decreased with advancing age of men. No food components that significantly correlated with age of women. There were no significant relationship between food intake and other socio-demographic characteristics. In men, lamb and chocolate intake were significantly associated with BMI while rice vermicelli and sweet bread were significantly correlated with blood pressure. Total cholesterol had significant correlation with pork sausage intake of men. In women, HDL cholesterol were significantly associated with ham and beef sausage, while LDL cholesterol were associated with duck intake.These findings suggested that women had more favorable cardiovascular risk profile than men and age was likely to be an important determinant factor for women. Men were more prevalent smoking habit and poorer attitude to health status than women."