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ABSTRACT"

"Nefropati diabetik disebabkan oleh peningkatan aktivitas NADPH oksidase NOX yang diinduksi angiotensin II dan hipergikemia. Terapi ACE-inhibitor dan ARB memiliki potensi dalam menghambat aktivitas NOX. Namun perbandingan efektivitas keduanya belum diketahui. Peningkatan Aktivitas NOX ditandai oleh penurunan NADPH serum dan laju filtrasi glomerulus LFG. Namun hubungan antara NADPH serum dengan LFG juga belum diketahui. Tujuan dari penelitian ini adalah membandingkan kadar NADPH serum dan eLFG pada pasien diabetes melitus DM tipe 2 yang mendapat terapi ACE-inhibitor dan ARB serta menilai hubungan NADPH serum dengan eLFG. Penelitian ini menggunakan metode cross sectional. Pengambilan sampel dilakukan pada periode April hingga Mei 2018 di RSCM dan Puskesmas Kecamatan Pasar Minggu. Subjek dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat terapi ACE-inhibitor n=11 dan kelompok yang mendapat terapi ARB n=25. Kadar NADPH dan kreatinin serum diukur menggunakan metode kolorimetri. Kelompok ARB memiliki rata-rata konsentrasi NADPH yang lebih tinggi 9,61 1,33 dibandingkan dengan kelompok ACE-Inhibitor 6,56 1,5 namun tidak memiliki perbedaan yang bermakna p>0,05. Selain itu kelompok ARB juga memiliki rata-rata eLFG 66,24 3,95 yang lebih tinggi dibandingkan dengan kelompok ACE-Inhibitor 61,11 7,41 namun tidak memiliki perbedaan yang signifikan p>0,05. Namun demikian terdapat hubungan yang bermakna dan positif antara kadar NADPH serum dengan eLFG r= 0,383.

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Diabetic nephropathy is caused by increased activity of NADPH oxidase NOX induced angiotensin II and hyperglycaemia. ACE inhibitor and ARB therapy have the potential to inhibit NOX activity. But the comparison of the effectiveness of both is unknown. Increased NOX activity is characterized by decreased serum NADPH and glomerular filtration rate GFR. However, the association between serum NADPH and GFR is also unknown. The purpose of this study was to compare serum NADPH and eGFR levels in type 2 diabetes mellitus DM patients who receiving ACE inhibitor and ARB therapy and also to evaluate serum NADPH association with eGFR. This research use cross sectional method. Sampling was conducted from April to May 2018 at RSCM and Puskesmas Kecamatan Pasar Minggu. Subjects were divided into 2 groups, the group receiving ACE inhibitor therapy n 11 and the group receiving ARB therapy n 25. NADPH and serum creatinine levels were measured using colorimetric method. The ARB group had a higher mean serum NADPH concentration 9.61 1.33 than the ACE Inhibitor group 6.56 1.5 but did not have a significant difference p 0.05 . In addition the ARB group also had an average eGFR 66.24 3.95 higher than the ACE Inhibitor group 61.11 7.41 but did not have a significant difference p 0.05. However, there was a significant and positive relationship between serum NADPH levels and eGFR r 0.383."

"Disfungsi ginjal adalah salah satu komplikasi kronik pada pasien diabetes melitus tipe 2 DM tipe 2 yang diketahui sebagai nefropati diabetik. Salah satu penanda yang digunakan sebagai pendeteksi kerusakan ginjal adalah rasio albumin kreatinin UACR. Selain UACR, kolagen tipe IV banyak diteliti terkait fungsinya sebagai pendeteksi awal nefropati diabetik. Tujuan penelitian ini adalah untuk menilai perbedaan UACR, kadar kolagen tipe IV urin, serta mengetahui hubungan keduanya pada pasien yang menerima terapi angiotensin-converting enzyme inhibitors ACEI dan angiotensin receptor blockers ARB sebagai kelas yang menghambat perkembangan nefropati diabetik pada pasien DM tipe 2. Penelitian dilakukan dengan menggunakan studi cross sectional dan teknik pengambilan consecutive sampling. Terdapat dua kelompok dalam penelitian ini, pasien dengan terapi ACEI n = 14 dan ARB n = 26. Kolagen tipe IV urin dianalisis dengan menggunakan ELISA kit. Albumin dan kreatinin urin diukur dengan menggunakan metode imunoturbidimetri dan kolorimetri. Kadar kolagen tipe IV urin dihitung dengan normalisasi pengukuran kolagen tipe IV urin dengan kadar kreatinin urin. Pada nilai UACR, rerata kedua kelompok ACEI = 276,61 65,119 g/mg kreatinin urin; ARB = 87,25 24,743 g/mg kreatinin urin menunjukkan perbedaan bermakna p = 0,019, kedua kelompok ACEI = 117,14 37,36 ng/mg kreatinin urin; ARB = 14,19 1,46 ng/mg kreatinin urin juga menunjukkan perbedaan bermakna pada kadar kolagen tipe IV urin p < 0,001. Uji korelasi antara nilai UACR dan kadar kolagen tipe IV urin menunjukkan hubungan moderat pada kedua kelompok penelitian r = 0,489; p = 0,001. Hasil menunjukkan bahwa kelompok ARB memiliki tingkat kolagen tipe IV urin yang lebih rendah dibandingkan dengan ACEI, sehingga terapi dengan ARB kemungkinan dapat menghambat perkembangan nefropati diabetik.

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Renal dysfunction is one of chronic complications in type 2 diabetes mellitus patients T2DM known as diabetic nephropathy DN. Urine albumin creatinine ratio UACR is a widely used test for detection of DN. Beside of UACR, type IV collagen has been studied to its function as an early detection of DN. The aim of this study was to compare differences in UACR, urinary type IV collagen, and their correlation in patients with angiotensin converting enzyme inhibitors ACEI versus angiotensin receptor blockers ARB treatment as classes with respect to delay the development of DN in patients with type 2 diabetes by using cross sectional study and consecutive sampling method. There were 2 groups in this study, patients with ACEI n 14 and ARB therapy n 26. Urinary type IV collagen were analyzed using ELISA kit. Urine albumine and urine creatinine was measured by using immunoturbidimetry and colorimetric method. Urinary type IV collagen levels were calculated by normalizing type iv collagen with urine creatinine levels. Results showed that UACR ACEI 276,61 65,119 g mg urine creatinine ARB 87,25 24,743 g mg urine creatinine showed significant differences p 0.019, urinary type IV collagen ACEI 117,14 37,36 ng mg urine creatinine ARB 14,19 1,46 ng mg urine creatinine showed significant differences p 0.001. Correlation between UACR and urinary type IV collagen presented a moderate correlation in both studied groups r 0.489 p 0.001. The results showed that group with ARB treatment have lower level of urinary type IV collagen compared to groups with ACEI treatment, conclude that ARB more likely to inhibit the development of DN."

"NADP terbentuk sejalan dengan pembentukan radikal bebas anion superoksida O2 - yang dapat menyebabkan stres oksidatif dan berujung pada komplikasi ginjal yang disebut dengan nefropati diabetik pada pasien diabetes melitus tipe 2. Salah satu faktor yang dapat meningkatkan radikal bebas O2 - adalah peningkatan angiotensin II pada ginjal dan dapat dihambat oleh penghambat sistem renin-angiotensin, yaitu inhibitor ACE dan ARB. Penelitian ini bertujuan untuk mengetahui perbandingan terapi inhibitor ACE dan ARB dalam mengatasi stres oksidatif yang diukur melalui kadar NADP serum dan dikorelasikan dengan nilai estimasi laju filtrasi glomerulus eLFG sebagai parameter yang sudah sering digunakan untuk menandakan perubahan fungsi ginjal. Kadar NADP serum diukur menggunakan uji NADP /NADPH dengan metode kolorimetri dan nilai eLFG dihitung menggunakan persamaan CKD-EPI. Penelitian ini dilakukan di RSUPN Dr. Cipto Mangunkusumo dan Puskesmas Kecamatan Pasar Minggu. Subjek penelitian dibagi menjadi dua kelompok pasien diabetes melitus tipe 2, yaitu kelompok yang mendapat inhibitor ACE n = 11 dan kelompok yang mendapat ARB n = 25 . Rata-rata kadar NADP serum pada kelompok inhibitor ACE adalah 3,4576 pmol/ml dan pada kelompok ARB adalah 5,6240 pmol/ml p = 0,091, sedangkan nilai eLFG pada kelompok inhibitor ACE adalah 61,109 ml/menit/1,73 m2 dan pada kelompok ARB adalah 66,240 ml/menit/1,73 m2 p = 0,510. Korelasi antara kadar NADP serum dengan nilai eLFG r = -0,032; p = 0,851. Data hasil penelitian menunjukkan bahwa inhibitor ACE dan ARB tidak berbeda signifikan dalam menurunkan kadar NADP serum dan mempertahankan fungsi ginjal, selain itu tidak terdapat korelasi signifikan antara kadar NADP serum dengan nilai eLFG pada kedua kelompok sampel.

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NADP is formed in line with the formation of superoxide anion O2 free radical which can cause oxidative stress and lead to renal complications called diabetic nephropathy in type 2 diabetes mellitus. One of the factors that can increase O2 free radical is increased angiotensin II in the kidneys and can be inhibited by the inhibitor of the renin angiotensin system, ie ACE inhibitors and ARBs. This study aims to determine the comparison of ACE inhibitor and ARB therapy in overcoming oxidative stress measured through serum NADP levels and correlate them with estimated glomerular filtration rate eGFR as a parameter that has been frequently used to indicate changes in renal function. Serum NADP levels were measured using an NADP NADPH assay by colorimetric method and eGFR values were calculated using the CKD EPI equation. This research was conducted at Dr. Cipto Mangunkusumo National Central General Hospital and District Health Clinics Pasar Minggu. The subjects were divided into two groups of patients with type 2 diabetes mellitus, the group receiving ACE inhibitors n 11 and the group receiving ARBs n 25. The mean serum NADP level in the ACE inhibitor group was 3,4576 pmol ml and in the ARB group was 5,6240 pmol ml p 0,091, whereas the eGFR value in the ACE inhibitor group was 61,109 ml minute 1,73 m2 and in the ARB group was 66,240 ml minute 1,73 m2 p 0,510. The correlation between serum NADP levels and eGFR values r 0,032 p 0,851. The results showed that ACE inhibitors and ARBs did not differ significantly in reducing serum NADP levels and maintaining renal function, and there was no significant correlation between serum NADP levels and eGFR values in both groups."

"Angiotensin Converting Enzyme ACE Inhibitor merupakan salah satu golongan obat hipertensi sehingga perlu dikonsumsi dalam jangka waktu yang lama, selain itu adanya kemungkinan pasien memiliki komorbiditas juga tinggi sehingga terdapat kemungkinan meningkatnya potensi interaksi obat. Tujuan penelitian ini adalah untuk menganalisis interaksi obat golongan ACE Inhibitor pada pasien hipertensi di Rumah Sakit Karya Bhakti Pratiwi periode Juli ndash; Desember 2016. Jenis penelitian ini adalah deskriptif-analitik dengan metode cross sectional pada data resep dan rekam medis pasien rawat inap periode Juli ndash; Desember 2016 yang mendapat obat hipertensi golongan ACE Inhibitor dengan satu atau lebih item obat lain, termasuk antihipertensi lainnya yang dipilih dengan metode purposive sampling. Analisis dilakukan terhadap 120 lembar resep dari 71 pasien. Berdasarkan penelitian ini dapat disimpulkan bahwa obat-obat ACE Inhibitor memiliki potensi interaksi dengan obat lain pada 75 lembar resep 53,96 dengan total kasus interaksi sebanyak 139 kasus terdiri dari 52 kasus interaksi mayor dan 87 kasus interaksi moderat. Hasil uji Mann Whitney menunjukkan adanya hubungan antara polifarmasi dengan potensi interaksi obat p < 0,05 dan tidak ada hubungan antara jenis kelamin serta patofisiologi dengan potensi interaksi obat p > 0,05 dari uji Chi-Square. Hubungan usia dengan potensi interaksi obat juga tidak bermakna signifikan berdasarkan hasil uji Kruskal-Wallis p > 0,05.

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Angiotensin Converting Enzyme ACE Inhibitor as an antihypertensive drugs need to be consumed for long periods of time and there might be comorbidities among the patients so that increased the risk of drug interaction. This study aimed to analyse the drug interaction of ACE Inhibitor in hypertensive patients at Karya Bhakti Pratiwi period of July ndash December 2016. This was an analytical descriptive cross sectional study on prescriptions and medical records of hospitalized patients period July ndash December 2016 who got ACE Inhibitor with one or more other drugs, include other antihypertensive drugs, which were selected by purposive sampling method. The analysis was conducted on 120 prescriptions from 71 patients.

This study concluded that ACE Inhibitor had a potential drug interactions with other drugs on 75 prescriptions 53,96, with total of 139 cases, consisiting of 52 cases of major interaction and 87 cases of moderate interaction. Mann Whitney test showed that there was a significant relationship between polypharmacy with potential drug interactions p 0,05 and there was no significant relationship between gender and patofisiology with potential drug interactions p 0,05 on Chi Square test. There was no significant relationship between age with potential drug interactions based on Kruskal Wallis test p 0,05."

"Besarnya jumlah penderita hipertensi di dunia merupakan masalah yang patut diperhatikan. Walaupun penemuan obat antihipertensi sudah banyak dilakukan namun penurunan jumlah pasien tidak signifikan. Salah satu alternatif pengobatan hipertensi adalah penggunaan tanaman obat mengingat terdapat banyak masalah efek samping dari penggunaan obat konvensional. Tanaman obat yang digunakan sebagai antihipertensi bekerja dengan berbagai mekanisme, salah satunya adalah penghambatan angiotensin converting enzyme (ACE). Tujuan penelitian ini adalah untuk mengetahui aktivitas penghambatan ACE dari tanaman obat Indonesia dan kandungan kimia dari tanaman tersebut. Berbagai penelitian mengenai penghambatan ACE telah dilakukan, namun belum terdapat penelitian mengenai aktivitas penghambatan ACE dari tanaman yang terdapat di Indonesia. Uji penghambatan aktivitas ACE dilakukan dengan menggunakan substrat Hipuril-L-Histidil-L-Leusin (HHL) dan metode spektrofotometri. Serbuk simplisia dimaserasi menggunakan etanol 80%. Berdasarkan pengujian pada sepuluh tanaman, tiga ekstrak tanaman dengan aktivitas penghambatan yang baik adalah ekstrak dari daun Ocimum americanum L., buah Carissa carandas L., dan herba Mirabilis jalapa L. dengan nilai IC50 berturut-turut, 32,92 μg/mL; 33,36 μg/mL; dan 50,95 μg/mL. Ekstrak daun Ocimum americanum L. mengandung alkaloid, flavonoid, terpenoid, tanin, saponin dan antrakuinon. Ekstrak herba Mirabilis jalapa L. mengandung alkaloid, flavonoid, antrakuinon, tanin, dan terpenoid. Sedangkan ekstrak buah Carissa carandas L. mengandung glikosida, flavonoid dan terpenoid.

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The large number of patients with hypertension in the world should be worried. Although the discovery of antihypertensive drugs has been done but the decline in the number of patients was not significant.. The use of medicinal plants for treating hypertension is common since there are problems with side effects from the conventional medicine. Medicinal plants used as antihypertensive work with a variety of mechanisms, one of which is the inhibition of angiotensin converting enzyme (ACE).

The purpose of this study was to determine the inhibitory activity of ACE from medicinal plants in Indonesia and chemical constituents of the plants. Test inhibition of ACE activity performed using substrate Hipuril-L-Histidil-L- Leucine (HHL) and spectrophotometric methods. Powdered crude drug was macerated using 80% ethanol.

Based on the testing of ten plants, three active extracts are Ocimum americanum L. leaves, Carissa carandas L. fruits, and Mirabilis jalapa L. herbaceous with IC50 values respectively 32.92 μg/mL, 33.36 μg /mL, and 50.95 μg/mL. Leaf extracts of Ocimum americanum L. contain alkaloids, flavonoids, terpenoids, tannins, saponins and anthraquinones. Herbaceous of Mirabilis jalapa L. contain alkaloids, flavonoids, terpenoids, tannins, and anthraquinones. While the fruit extracts of Carissa carandas L. contain glycosides, flavonoids and terpenoids."

"Penyakit Jantung Bawaaan (PJB) Tetralogy of Fallot (TOF) merupakan PJB sianotik (biru) terbanyak. Tatalaksana definitif operasi sedini mungkin. Hampir semua pembiayaan menggunakan BPJS Kesehatan berdasarkan tarif INA-CBG. Adanya selisih negatif tarif INA-CBG tahun 2016 dengan tagihan perawatan operasi TOF menyebabkan banyak rumah sakit tidak mengoperasi dan merujuk ke RSJPD Harapan Kita. Dengan adanya tarif INA-CBG terbaru tahun 2023 yang mengalami kenaikan, diperlukan penelitian apakah terdapat selisih negatif. Perlu dianalisa faktor yang berhubungan dengan tagihan perawatan serta kepatuhan Clinical Pathway (CP) TOF. Penelitian observasional deskriptif cross sectional mengambil sampel pasien perawatan operasi total koreksi TOF tahun 2022 sejumlah 82 pasien. Hasil penelitian didapatkan sebagian besar usia ≥1 tahun, perempuan, status gizi normal, ada diagnosa sekunder, severitas PPK I (ringan) dan INA-CBG II (sedang), tidak ada komplikasi, kelas III, median lama CPB 103,5 menit dan AoX 55 menit, lama rawat post operasi 6 hari dan total 8 hari. Faktor yang berhubungan dengan tagihan perawatan adalah komplikasi, kelas rawat dan lama rawat CP. Hal yang belum sesuai dengan CP TOF yaitu lama rawat, pemeriksaan laboratorium, radiologi, pemakaian obat, alkes dan BMHP. Masih terdapat selisih negatif antara total tagihan perawatan pasien operasi total koreksi TOF tahun 2022 dengan total tarif INA-CBG terbaru tahun 2023.

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Tetralogy of Fallot (TOF) is the most common cyanotic Congenital Heart Disease (CHD). Definitive management is surgery earliest as possible. Almost all financing uses BPJS Kesehatan based on INA-CBG rate. Negative difference between the 2016 INA-CBG rates and TOF surgery treatment bill make many hospitals not operating and refering to Harapan Kita Hospital. With increasing in the latest 2023 INA-CBG rates, research for negative difference is needed. Analyzing factors related to care bills and adherence to TOF Clinical Pathway (CP) is studied too. This cross-sectional descriptive observational study took a sample of 82 patients undergoing TOF total  correction in 2022. Results showed that most were aged ≥1 year, female, normal nutritional status, had secondary diagnoses, severity of PPK I (mild) and INA-CBG II (moderate), no complications, class III, median duration of CPB 103.5 minutes and AoX 55 minutes, length of postoperative care 6 days and total of 8 days. Factors related to treatment bills are complications, class of care and CP length of care. Things not in accordance with the TOF CP are length of stay, laboratory, radiology, drug, medical equipment and BMHP use. There is still negative difference between the 2022 TOF total correction treatment patient bills and the latest 2023 INA-CBG rate."

"ABSTRAKLatar Belakang: Gagal jantung merupakan salah satu masalah kesehatan global dengan angka yang meningkat setiap tahunnya. Pengobatan gagal jantung melibatkan berbagai golongan obat, salah satunya adalah digoksin sebagai komponen terapi tertua pada gagal jantung. Penggunaan digoksin masih kontroversial karena selain batas terapeutik sempit, terdapat berbagai faktor yang dapat meningkatkan risiko terjadinya intoksikasi.Tujuan: Menganalisis kejadian intoksikasi, rehospitalisasi, dan kesintasan dalam setahun pada pasien gagal jantung yang mendapat digoksin.Metode: Studi analitik observasional dengan desain potong lintang dilakukan di Rumah Sakit Pusat Jantung dan Pembuluh Darah Harapan Kita pada bulan Januari 2017 hingga Desember 2018. Pasien gagal jantung yang mendapatkan terapi digoksin dan diperiksa kadar digoksin serum diikutsertakan dalam penelitian. Intoksikasi didefinisikan sebagai peningkatan kadar digoksin serum ≥ 2 ng/ml disertai dengan perubahan EKG tipikal intoksikasi dan minimal satu gejala non-kardiak. Dilakukan analisis terhadap faktor-faktor risiko pada pasien dan gejala intoksikasi menggunakan uji X2, sedangkan angka kesintasan dan rehospitalisasi dalam setahun dianalisis dengan rumus Kaplan Meyer.Hasil: Sebanyak 195 subyek penelitian yang terdiri dari 22 (11,3%) subyek dengan kadar digoksin subterapeutik, 43 (22,1%) subyek dengan kadar terapeutik, 70 (35,9%) subyek dengan kadar supraterapeutik dan 60 (30,8%) subyek dengan kadar toksik diikutsertakan dalam studi ini. Didapatkan sebanyak 32 (16,4%) subyek mengalami intoksikasi. Insufisiensi renal merupakan faktor risiko yang sangat memengaruhi kejadian intoksikasi digoksin, dengan risiko sebesar 2,5 kali (p=0,016; RR=2,484). Angka rehospitalisasi pada pasien gagal jantung yang mendapat dan tidak mendapat digoksin adalah sebesar 11,8% dan 29,2% (p=0,085). Angka kesintasan dalam setahun pada pasien gagal jantung yang mendapat digoksin di RS JPDHK tahun 2017-2018 adalah 300 hari (259 hari pada yang mengalami intoksikasi, dan 307 hari pada yang tidak mengalami intoksikasi).Kesimpulan: Proporsi intoksikasi digoksin pasien gagal jantung pada penelitian ini adalah 16,4%. Insufisiensi renal merupakan faktor risiko yang memengaruhi kejadian intoksikasi digoksin. Terdapat kecendrungan pengurangan rehospitalisasi pada pasien yang mendapat digoksin.

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ABSTRACTBackground: Heart failure is one of the most prevalent global health problems with increasing number every year. Treatment of heart failure involves various classes of drugs, one of which is digoxin as the oldest therapy for heart failure. The use of digoxin is still controversial because of a narrow therapeutic limit, there are various factors that can increases the risk of intoxication.Objective: To analyze digoxin intoxication, rate of rehospitalization as well as one-year survival in patients with heart failure who were prescribed digoxin.Methods: An observational analytic study with a cross-sectional design was conducted at the Harapan Kita National Cardiovascular Center from January 2017 to December 2018. Heart failure patients who received digoxin therapy and had been examined for serum digoxin levels were included in the study. Intoxication was defined as having increased serum digoxin level exceeding 2 ng/ml along with electrocardiogram changes and a minimum of one non-cardiac symptomsRisk factors of intoxication were analyzed by Chi-square test, and one year survival was analyzed with Kaplan Meyer method.Results: A total of 195 study subjects consisting of 22 (11,3%) subjects with subtherapeutic digoxin levels, 43 (22,1%) were therapeutic, and 70 (35,9%) supratherapeutic and 60 (30,8%) toxic digoxin level were included in the study. There were 32 (16.4%) subjects having digoxin intoxication in this study. Renal insufficiency was revield as significant influencing factor of digoxin intoxication with 2.5 fold increasing risk. Overall, one-year survival of heart failure patients receiving digoxin was 300 days (259 days in non-intoxication group and 307 days in intoxication group). One-year rehospitalization was 11,8% in patients who received digoxin, and 29,2% in those without digoxin (p=0.085).Conclusion: The proportion of digoxin intoxication in heart failure patient is 16,4%. Renal insufficiency was reviled as significant influencing factor of intoxication. There was a tendency of reduced hospitalization in those who received digoxin."

"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."