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"Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Her serum potassium level was always low that associated with inappropriate kaliuresis. Blood gas analysis revealed metabolic alkalosis. Sonography of the adrenal gland showed right hipoechoic architecture; CT scan of the abdomen confirmed an right adrenal tumor measured 4 cm in its greatest dimension. Endocrine evaluation revealed high plasma aldosterone concentration, suppressed plasma renin activity, aldosterone/renin ratio of 112 and confirmed the diagnosis of primary aldosteronism. She underwent unilateral adrenalectomy. Histopathological report from excised adrenal tumor were compatible to benign adrenocortical adenoma. The patient discharge home with well controlled blood pressure and normokalemia. No clinical symptoms was reported in follow-up.

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Hiperaldosteronisme primer merupakan kelainan adrenal dimana sekresi hormon aldosteron terjadi secara otonom. Kami melaporkan sebuah kasus seorang wanita suku Jawa berusia33 tahun yang datang karena hipertensi yang sulit dikendalikan, kelemahan, kram otot, dan sesak nafas saat aktivitas yang memberat dalam kurun waktu 6 tahun belakangan ini. Riwayat hipertensi sudah berlangsung sejak usia 20 tahun. Kadar kalium serum selalu rendah dengan kaliuresis yang berlebihan. Dari analisa gas darah didapatkan metabolik alkalosis. Sonografi abdomen memperlihatkan arsitektur hipoekoik pada daerah suprarenal dekstra; pada CT scan abdomen terdapat tumor adrenal dekstra berukuran 4 cm. Evaluasi endokrin menunjukkan konsentrasi aldosteron plasma yang meningkat, aktivitas renin tersupresi dengan rasio aldosteron/renin 112 dan mengkonfirmasi hiperaldosteronisme primer. Pasien tersebut kemudian menjalani adrenalektomi unilateral. Laporan histopatologi dari tumor adrenal sesuai dengan adenoma korteks adrenal benigna. Pasien kemudian dapat rawat jalan dengan tekanan darah yang lebih terkontrol dengan kalium serum yang normal. Saat ini tidak ada keluhan lagi"

"Pendahuluan Timbal merupakan salah satu bahan penting yang banyak digunakan di industri. Industri baterai timbal-asam menggunakan timbal dalam jumlah besar yang meningkatkan pajanan timbal ditempat kerja dan diperkirakan dapat mempengaruhi tekanan darah selama bertahun-tahun. Tujuan dari laporan ini adalah untuk menyajikan bukti tentang pengaruh pajanan timbal ditempat kerja terhadap kejadian hipertensi pada pekerja. Metode Pencarian literatur dilakukan melalui basis data elektronik dari PubMed, Scopus dan Cochrane. Kriteria inklusi yang diterapkan yaitu tinjauan sistematis, meta analisis, studi kohort, studi kasus kontrol, studi potong lintang, pekerja dengan pajanan timbal ditempat kerja dan dampak hipertensi atau tekanan darah tinggi. Artikel terpilih kemudian dinilai secara kritis menggunakan kriteria yang relevan dari Oxford Centre for Evidence-Based Medicine. Hasil Tiga studi potong lintang yang relevan disertakan. Studi oleh Thongsringklee M. dkk, Singamsetty dkk serta Sudjaroen dkk menunjukkan bahwa pekerja dengan paparan timbal secara langsung memiliki risiko lebih tinggi untuk terjadi hipertensi dibandingkan dengan pekerja dengan paparan tidak langsung (OR adj 1.38, 95% CI 1.01-1.89; OR 1.97, 95% CI 1.96-2.17; dan OR 1.4, 95% CI 0.97-1.73, secara berurutan) dan bermakna secara statistik, meskipun studi oleh Sudjaroen dkk tidak. Kesimpulan dan rekomendasi Bukti saat ini tidak memberikan bukti yang kuat untuk mengkonfirmasi bahwa paparan timbal dapat menyebabkan hipertensi pada pekerja. Disarankan bagi pekerja yang terpapar timbal secara langsung untuk lebih waspada karena dua dari tiga studi melaporkan kemungkinan timbal meningkatkan risiko hipertensi. Diperlukan penelitian lebih lanjut dengan desain penelitian yang lebih baik untuk memberikan bukti yang kuat bahwa paparan timbal dapat meningkatkan risiko hipertensi pada pekerja.

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Background Lead is still one of the essential materials in many industries. The lead-acid battery industry consumes the largest amount of lead which make lead exposure increases at the workplace and has been suspected to influenced blood pressure for many years. The aim of this evidence-based case report is to present the evidence about the effect of occupational lead exposure on the incidence of hypertension in worker. Method The literature searching was conducted through PubMed, Scopus and Cochrane Library. The inclusion criteria were Systematic Review, Meta-Analysis, Cohort Study, Case- control Study, Cross-sectional Study, worker with occupational lead exposure, and hypertension or high blood pressure outcome. The selected articles were then critically appraised using relevant criteria by the Oxford Center for Evidence-Based Medicine. Result Three relevant cross-sectional studies were included. Studies by Thongsringklee M. et al, Singamsetty et al. and Sudjaroen et al. showed that workers with direct-lead exposure have more risk for hypertension than workers with indirect-lead exposure (OR adj 1.38, 95% CI 1.01-1.89; OR 1.97, 95% CI 1.96-2.17; and OR 1.4, 95% CI 0.97-1.73, respectively) and significant statistically, although the last study wasn’t. Conclusion and recommendation The current evidences do not show strong evidence to ensure that lead exposure can cause hypertension in worker. It is recommended to be more alert for workers with direct-lead exposure because two out of three studies reported the possibility that lead increase the risk of hypertension in worker. Further research with better study design is needed to provide strong evidence that lead exposure can increase the risk of hypertension in worker."

"Hipertensi adalah salah satu penyakit tidak menular yang berkontribusi pada sebagian besar kematian di dunia. Sebagai fasilitas pelayanan kesehatan tingkat pertama, puskesmas berperan dalam tindakan preventif, promotif, dan kuratif terhadap hipertensi. Praktik kolaborasi interprofesi menjadi salah satu faktor yang berkontribusi pada penatalaksanaan klien hipertensi. Penelitian ini bertujuan untuk mengidentifikasi bagaimana persepsi tenaga kesehatan terhadap praktik kolaborasi interprofesi dalam penanganan klien hipertensi di Kota Bekasi. Penelitian dilakukan di 9 Puskesmas di Kota Bekasi, yaitu dokter, perawat, bidan, apoteker/ asisten apoteker, kesehatan masyarakat, dan ahli gizi. Desain penelitian ini menggunakan desain penelitian deskriptif cross-sectional, sampel 112 responden dengan teknik quota sampling. Instrumen yang digunakan adalah Perception of Collaboration Model Questionnaire (PINCOM-Q) versi Bahasa Indonesia. Hasil penelitian menunjukkan persepsi kolaborasi interprofesi pada kategori baik (50,9%) dan kurang baik (49,1%). Hasil penelitian dapat menjadi landasan bagi tenaga kesehatan untuk mengevaluasi praktik kolaborasi interprofesi pada pelayanan hipertensi.

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Hypertension is a non-communicable disease that contributes to the majority of deaths in the world. As a first-level health service facility, community health centers play a role in preventive, promotive, and curative measures against hypertension. The practice of interprofessional collaboration is one of the factors that contribute to the management of hypertensive clients. This study aims to identify the perceptions of health workers regarding the practice of interprofessional collaboration in treating hypertensive clients in Bekasi City. The research was conducted at 9 Community Health Centers in Bekasi City, namely doctors, nurses, midwives, pharmacists/pharmacist assistants, public health, and nutritionists. This research design uses a cross-sectional descriptive research design, a sample of 112 respondents using a quota sampling technique. The instrument used was the Indonesian version of the Perception of Collaboration Model Questionnaire (PINCOM-Q). The research results show that perceptions of interprofessional collaboration are in the good (50.9%) and poor (49.1%) categories. The results of the research can be a basis for health workers to practice interprofessional collaboration in hypertension services."

"Praktik Kerja Profesi Apoteker di Apotek Kimia Farma No. 389 bertujuan untuk memahami peranan, tugas, dan tanggung jawab apoteker di apotek serta melihat secara langsung proses pengelolaan apotek, dan melakukan praktik pelayanan kefarmasian sesuai dengan ketentuan peraturan perundang-undangan. Tugas khusus yang diberikan selama melaksanakan praktik kerja profesi apoteker berjudul Pemberian Informasi Obat dan Pelayanan Kefarmasian ke Rumah Pasien Hipertensi di Apotek Kimia Farma No. 389. Tugas khusus ini diberikan agar mahasiswa memahami dan menerapkan pelayanan kefarmasian di apotek.

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Profesional field work of apothecary at Apotek Kimia Farma No. 389 aims to understand the roles, duties, and responsibilities of pharmacists in the pharmacies and see the process of pharmacy management, and to practice of pharmaceutical care according the provisions of the legislation. Special assignment given during the profesional field work of apothecary entitled Giving Information and Home Pharmacy Care in Patients with Hypertension at Kimia Farma No. 389. Special assignment is given to make students understand and practice pharmaceutical care of apotechary."

"Kadar Zinc dan Cuprum pada Penderita Hipertensi Primer dan Normotensi. Salah satu pencetus hipertensi primer yaitu paparan radikal bebas. Pembentukan radikal bebas dalam tubuh dapat dicegah dengan antioksidan. Peran zinc dan cuprum adalah sebagai kofaktor dari enzim antioksidan endogen superoksida dismutase (SOD). Penelitian ini bertujuan untuk menganalisis perbedaan kadar serum zinc dan cuprum pada kelompok hipertensi primer dan normotensif. Penelitian ini merupakan penelitian observasional analitik dengan desain cross sectional dan metode simple random sampling. Subjek adalah orang yang berusia 40-70 tahun, mengunjungi Rumah Sakit Haji Surabaya, dan terdiri dari 15 responden hipertensi primer dan 15 responden normotensif (kelompok pembanding). Data dikumpulkan melalui wawancara dan uji laboratorium klinis sampel darah. Konsentrasi serum zinc dan cuprum diukur dengan metode AAS (Spektrofotometer Serapan Atom). Data dianalisis dengan chi-square dan independent T-test. Hasil penelitian menunjukkan bahwa tingkat rata-rata serum zinc dan cuprum responden pada kelompok hipertensi primer lebih rendah daripada kelompok normotensif. Namun, secara statistik tidak ada perbedaan yang signifikan (p=0,852) kadar serum zinc antara kelompok hipertensi primer dan kelompok normotensi, tapi ada perbedaan yang signifikan pada kadar serum cuprum (p=0,022). Kesimpulannya adalah ada yang berbeda dari kadar serum cuprum antara dua kelompok sedangkan untuk kadar serum zinc tidak berbeda.;One of the causes of primary hypertension is an exposure to free radicals. The formation of free radicals in the body can be prevented by taking antioxidants. Zinc and copper are cofactors of endogenous antioxidant enzyme superoxide dismutase. This study aimed to analyze the differences of zinc and copper levels in primary hypertensive and normotensive patients. This was an analytical observational study with cross sectional design and simple random sampling method. Subjects were patients aged 40-70 years at Haji General Hospital consisting of 15 primary hypertensive patients and 15 normotensive individuals (comparison group). Data was collected through interviews and laboratory test of blood samples. Zinc and Copper serum concentrations were measured by AAS. Data were analyzed by chi-square and independent samples t-test. The results showed that the mean levels of zinc and copper in primary hypertensive patients was lower than normotensive. However, statistically there was no difference in zinc serum levels (p=0.852) in the two groups, and there was a significant difference in copper serum levels (p=0.032). It can be concluded that there were differences in copper serum levels between the two groups but not with the levels of zinc.

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One of the causes of primary hypertension is an exposure to free radicals. The formation of free radicals in the body can be prevented by taking antioxidants. Zinc and copper are cofactors of endogenous antioxidant enzyme superoxide dismutase. This study aimed to analyze the differences of zinc and copper levels in primary hypertensive and normotensive patients. This was an analytical observational study with cross sectional design and simple random sampling method. Subjects were patients aged 40-70 years at Haji General Hospital consisting of 15 primary hypertensive patients and 15 normotensive individuals (comparison group). Data was collected through interviews and laboratory test of blood samples. Zinc and Copper serum concentrations were measured by AAS. Data were analyzed by chi-square and independent samples t-test. The results showed that the mean levels of zinc and copper in primary hypertensive patients was lower than normotensive. However, statistically there was no difference in zinc serum levels (p=0.852) in the two groups, and there was a significant difference in copper serum levels (p=0.032). It can be concluded that there were differences in copper serum levels between the two groups but not with the levels of zinc."

"Introduction: Portal hypertension may cause gastrointestinal complications; one of the most serious is a ruptured esophageal varices. Portal hypertension is also the main cause of hypersplenism, which in turn could lead to pancytopenia. Despite adequate therapy, some cases of hypersplenism could not be resolved. Partial splenic embolization (PSE) is an effective alternative method to treat this condition. Method: We reported two cases of hypersplenism treated with PSE. The first case was a 10- year-old girl with pancytopenia and a history of recurrent esophageal ligation. The second case was a 32-year-old man with recurrent episodes of hematemesis for two years before admission. Results: After the PSE procedure, the first patient’s white blood cell and platelet doubled in one month after procedure and stable at follow-up three months later, with no complaint of hematemesis. The second patient’s platelet doubled five days after the procedure. The first patient developed a complication of a splenic abscess, but after antibiotic administration and pus drainage, the condition was resolved. Conclusion: PSE is an effective method to treat hypersplenism secondary to the hypertensive portal. Treatment goals successfully achieved include improvement in blood count and control of bleeding. There are risks following PSE, but with adequate treatment, it can be overcome. Keywords: hypersplenism, partial splenic embolization, portal hypertension, pancytopenia"

"Latar belakang: Prehipertensi dan hipertensi berhubungan dengan berbagai komplikasi pada hampir seluruh organ, tetapi sering diabaikan oleh dewasa muda di daerah pedesaan. Penelitian ini bertujuan untuk mengetahui prevalensi prehipertensi dan hipertensi pada dewasa muda di pelayanan kesehatan dasar di daerah pedesaan Cicurug, Kabupaten Sukabumi, Jawa Barat.Metode: Studi potong lintang ini dilakukan di Pusat Kesehatan Masyarakat (Puskesmas) Cicurug, Kabupaten Sukabumi, Jawa Barat. Subjek penelitian adalah pasien balai pengobatan yang diambil secara konsekutif pada hari Senen sampai Sabtu pada bulan September 2012, berusia antara 18?25 tahun, tidak hamil atau dalam kondisi syok. Subjek diwawancara (usia, jenis kelamin, aktivitas fisik, waktu duduk, perilaku merokok, minum alkohol, dan riwayat keluarga) dan diperiksa oleh tenaga kesehatan (berat, tinggi, indeks massa tubuh [IMT], tekanan darah sistolik dan diastolik).Hasil: Dari 111 dewasa muda, 34,2% memiliki prehipertensi dan 17,1% memiliki hipertensi. Jika dibandingkan menurut jenis kelamin, wanita lebih banyak mengalami prehipertensi, tetapi hipertensi lebih banyak terjadi pada pria. Riwayat keluarga dari ibu dan bapak tidak berhubungan baik dengan prehipertensi maupun hipertensi jika dibandingkan dengan normotensi. Aktivitas total tidak terlihat berhubungan dengan prehipertensi (OR = 2,6; p = 0,052), dan juga hipertensi (OR = 1,758; p = 0,498). IMT berhubungan dengan hipertensi (OR = 3,354; p = 0,041), tetapi tidak berhubungan dengan prehipertensi (OR = 2,343; p = 0,099).Kesimpulan: Prevalensi prehipertensi dan hipertensi cukup tinggi pada dewasa muda di pelayanan kesehatan dasar di daerah pedesaan. Intervensi untuk mencegah penyakit yang lebih lanjut perlu dilakukan sejak dini dengan modifikasi gaya hidup karena tekanan darah berhubungan dengan faktor risiko yang dapat diubah, seperti IMT dan aktivitas total.

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Background: Prehypertension and hypertension were related with many complications of nearly every organ, but often neglected by young adults in rural area. This research was done to observe the prevalence of prehypertension and hypertension among young adult in a primary health care of rural area at Cicurug, Sukabumi District, West Java.

Methods: This cross-sectional study was done in Cicurug Public Health Center, Sukabumi District, West Java. The subjects were consecutively recruited from the outpatient clinic on Monday until Saturday in September 2012,18?25 years old, not pregnant nor having shock. They were interviewed about their age, gender, physical activity, sitting hours, smoking habit, alcohol consumption, and family history and examined by trained health professionals (weight, height, body mass index [BMI], systolic and diastolic blood pressure).

Results: From 111 young adults, 34.2% had prehypertension and 17.1% had hypertension. Within sex groups, the prevalence of prehypertension was higher in females, whereas hypertension was occurred more in males. Neither of family history from mother nor father were associated with prehypertension and hypertension compared with normotension. Total activity was not associated with prehypertension (OR = 2.6; p = 0.052) and hypertension (OR = 1.758; p = 0.498). BMI was associated with hypertension (OR = 3.354; p = 0.041) and not associated with prehypertension (OR = 2.343; p = 0.099).

Conclusion: Prevalence of prehypertension and hypertension were relatively high among young adult in primary health care of rural area. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as BMI and total activity."

"Terapi komplementer yang dapat diberikan pada pasien hipertensi primer adalah teknik relaksasi, salah satunya adalah terapi masase. Tujuan penelitian ini untuk mengetahui pengaruh terapi masase menggunakan minyak aromaterapi terhadap tekanan darah pasien hipertensi primer. Penelitian ini menggunakan desain eksperimen semu dengan rancangan rangkaian waktu (Time Series Design) dengan teknik pengambilan sampel consecutive sampling. Besarnya sampel pada penelitian ini 42 orang, dimana jumlah responden pada kelompok terapi masase menggunakan minyak aromaterapi 24 orang dan kelompok terapi masase menggunakan minyak VCO (virgin coconut oil) 18 orang. Setiap responden mendapatkan terapi masase pada area kaki, punggung, bahu, lengan atas, leher dan kepala selama 30 menit 2 kali per minggu selama 3 minggu. Hasil penelitian didapatkan ada pengaruh terapi masase menggunakan minyak aromaterapi terhadap penurunan tekanan darah sistolik-diastolik pasien hipertensi primer (p value < 0,05). Terapi masase menggunakan minyak aromaterapi lebih efektif menurunkan tekanan darah sistolik dibandingkan dengan terapi masase menggunakan minyak VCO. Sedangkan terapi masase menggunakan minyak VCO lebih efektif menurunkan tekanan darah diastolik dibandingkan dengan terapi masase menggunakan minyak aromaterapi. Penelitian ini merekomendasikan bahwa terapi masase menggunakan minyak aromaterapi dapat digunakan untuk menurunkan dan mengendalikan tekanan darah tinggi pasien hipertensi primer serta perlu dikembangkan penelitian lebih lanjut.

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Message therapy is one of the complementary therapies that can be given to Primary Hypertension Patient. This study aims to examine the influence of message therapy using aroma therapy oil on primary hypertension patient’s blood pressure. The quasi experiment with time series design was used in this study. Forty two respondents were recruited using consecutive sampling method, where 24 respondents were grouped into message using aroma therapy and another 18 respondents using VCO (virgin coconut oil). Each of respondents had message therapy on foot, back, shoulder, upper arm, neck, and head areas for 30 minutes twice a week within 3 weeks.

The result shows that there was significant influence of message using aroma therapy oil on hypertension patient's blood pressure (p value < 0,05). Message using aroma therapy oil was more effective in decreasing systolic blood pressure compare to those who had message with VCO. However, message using VCO was more effective in decreasing diastolic blood pressure compare to those who had message with aroma therapy oil.

It is recommended that message using aroma therapy oil can decrease and maintain normal systolic blood pressure on primary hypertension patients. This study needs further investigation on how message and other complementary therapy can maintain normal blood pressure."

"LATAR BELAKANG: Hipertensi merupakan salah satu masalah kesehatan yang turut berperan dalam peningkatan angka morbiditas dan mortalitas stroke, gagal jantung dan gagal ginjal. Morbiditas dan mortalitas hipertensi meningkat dengan makin banyaknya faktor risiko yang dimiliki, makin tinggi tekanan darah dan makin lama seseorang menderita hipertensi. Sampai saat ini mekanisme pasti terjadinya hipertensi belum jelas. Belakangan ini disfungsi endotel juga dikaitkan dengan hipertensi. Tujuan penelitian ini untuk mendapatkan gambaran kadar sVCAM-1 dan MAU, membuktikan adanya hubungan antara kadar sVCAM-1 dan MAU, menganalisis pengaruh usia, gender, obesitas, terkendali tidaknya hipertensi, lama sakit dan kadar kolesterol terhadap kadar sVCAM-1 dan MAU pada penderita hipertensi primer.BAHAN DAN METOPE: Penelitian ini menggunakan 65 subyek non diabetik dengan kadar hs-CRP < 5 mgIL dan protein win < 3+. Dilakukan pemeriksaan kadar sVCAM-1, K-LDL, albumin dan kreatinin urin terhadap subyek dengan protein win negatif atau trace, sedangkan subyek dengan protein urin 1+ atau 2+ hanya dilakukan pemeriksaan kadar sVCAM-1 dan K LDL. Penetapan kadar sVCAM-1 berdasarkan prinsip quantitative sandwich enzyme immunoassay, penetapan kadar K-LDL berdasarkan prinsip enzimatik homogen, penetapan kadar albumin urin berdasarkan prinsip imunoturbidimetri, penetapan kreatinin urin berdasarkan metode kinetik Jaffe dan MAU dinyatakan dengan rasio albumin 1 kreatinin urin.HASIL: Hasil penelitian menunjukkan proporsi kadar sVCAM-1 tinggi sebesar 81,5 % dan MAU 27,7 %. Kadar sVCAM-1 tinggi dan MAU lebih banyak dijumpai pada subyek tua, lelaki, hipertensi tak terkendali, lama sakit > 10 tahun dan obese. Dari hasil analisis multivariat derigail regresi rr ultipel, Adak didapatkan korelasi -yang bermakna antara kadar sVCAM-1 dengangender dan lama sakit namun didapatkan korelasi yang bermakna antara kadar sVCAM-1 dengan usia, MAP dan K-LDL. Hubungan tersebut dapat digambarkan melalui suatu persamaan yaitu kadar sVCAM-1 = 175 + 9,7 x usia (tahun) + 5,9 x MAP (mmHg) -- 2,9 x kadar K-LDL (rngldL) dengan nilai R2 adjusted sebesar 23,1 %. Tidak didapatkan korelasi yang bermakna antara MAU dengan usia, gender, MAP. 1MT, lama sakit dan K-LDL.Tidak didapatkan korelasi yang bermakna antara kadar sVCAM-1 dan rasio A 1 K.KESIMPULAN: Berdasarkan hasil penelitian ini didapatkan proporsi kadar sVCAM-1 tinggi 81,5 % dan MAU 27,7 %. Hal ini menunjukkan bahwa pada penderita hipertensi primer telah terjadi disfungsi endotel. Dari analisis multivariat menunjukkan kadar sVCAM-1 berkorelasi dengan usia, MAP dan K-LDL, sedangkan MAU tidak berkorelasi dengan variabel tersebut. Kadar sVCAM-1 tidak berkorelasi dengan MAU.

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Hypertension is a health problem which contributes in the increase morbidity and mortality of stroke, heart failure, and renal failure. The morbidity and mortality of hypertension were influenced by various risk factors, the height of blood pressure and the lenght of illness. The mechanism of hypertension up to now remains unclear. Recently, endothelial dysfunction has been associated with hypertension. The aims of this study were to obtain the level of sVCAM-1 and microalbuminuria (MAU) in primary hypertension, to analyse the relationship between sVCAM-1 level and MAU, to analyse the influences of age, gender, obesity, control of hypertension, length of illness, and the level of LDL cholesterol on sVCAM-1 level and MAU.

Sixty five non diabetic subjects with hs-CRP level < 5 mg/L and protein urine < 3 + were enrolled in this cross sectional study. The level of sVCAM-1 were performed on all subjects by ELISA using reagents from R&D system, while MAU was determined by calculated the albumin : creatinine ratio in the urine. The level of LDL cholesterol was performed by homogenous enzymatic assay.

The results indicated that the proportion of increase of sVCAM-1 level was 81.5% and MAU was 27.7% in primary hypertension. Increase of sVCAM-1 level and MAU were found more frequently in older subjects, male, uncontrolled hypertension, length of illness more than 10 years, and obese subject. The results of multivariate analysis with multiple regression showed that sVCAM-1 level significantly correlated with age, mean arterial pressure (MAP), and LDL cholesterol level, but did not correlate with gender, and length of illness. The relationship could be formulated as: sVCAM-1 level = 175 + 9.7 x age (years) + 5.9 x MAP ( mm Hg) -- 2.9 x LDL cholesterol level (mgldL) with R2 adjusted 23.1%. There were no correlation between MAU with age, gender, MAP, obesity, ienght of illness, and LDL cholesterol level. The level of sVCAM-1 did not correlate with albumin:creatinine urine ratio (MAU).

Based on high proportion of increased sVCAM-1 and MAU, it is concluded that endothelial dysfunction occur in primary hypertension. The level of sVCAM-1 significantly correlates with age, MAP, and LDL cholesterol level, while MAU does not correlate with these variables. There is no correlation between sVCAM-1 level and MAU."

"Slow deep breathing (SDB) adalah tindakan nonfarmakologis untuk menurunkan tekanan darah pasien hipertensi primer. Penelitian ini bertujuan untuk mengetahui efektifitas SDB terhadap penurunan tekanan darah pasien hipertensi primer. Metode penelitian ini menggunakan desain Randomized Clinical Trial dengan pretest dan post test control group. Sampelnya 142 responden, meliputi 33 responden kelompok rendah garam (RG), 37 responden kelompok SDB, 39 responden kombinasi kelompok SDB dan RG; dan 33 responden kelompok kontrol. Sampel diambil dengan cara randomisasi. Hasil penelitian menunjukan penurunan tekanan darah secara bermakna terutama pada kelompok SDB. Tekanan darah sistolik menurun 28,59 mmHg (P value=0,002) dan tekanan darah diastolik 16,92 mmHg (P value=0,007). Analisis dengan uji Tukey diketahui tekanan darah sistolik yang berbeda secara bermakna yaitu antara SDB dan kelompok kontrol (P value=0,001). Tekanan darah diastolik yang berbeda secara bermakna, yaitu: RG dan SDB-RG (P value=0,046); RG dan kelompok kontrol (P value=0,003); SDB dan SDB-RG (P value=0,038) serta SDB dan kelompok kontrol (P value=0,005). Penelitian ini merekomendasikan penerapan SDB untuk membantu menurunkan prevalensi hipertensi sehingga meminimalkan komplikasi yang mungkin timbul.

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Slow deep breathing is a nonpharmacology therapy to reduce blood pressure in patients with primary hypertension. The purpose of this study was to determine the effectiveness of slow deep breathing exercise to reduce blood pressure in patients with primary hypertension in Atambua East Nusa Tenggara. The method of this research was a quantitative research: a randomized clinical trial design with pretest and post test control group. The sample was 142 respondents, which consisted of 33 respondents in the lower salt (RG) group, 37 respondents in the slow deep breathing (SDB) group, 39 respondents in the combination of SDB-RG group; and 33 respondents in the control group. The method of sampling used a randomization.

The results showed that there were differences in the reduction of systolic blood pressure in SDB group for 28.59 mm Hg and diastolic blood pressure for 16.92 mmHg. The result of Anova analysis showed that there was a significant decrease on average of systolic blood pressure (p = 0.002) and diastolic blood pressure (p = 0.007). Further analysis by Tuckey test of systolic blood pressure found that between SDB group and control group were significantly different, however the other groups was not significant. (P = 0.001). After undergoing further Tukey analysis we found that the systolic blood pressure of four groups has significant differences. The SDB and controlling groups have P value=0,001 differences. RG and the controlling groups have P value=0,003 differences. SDB and SDB-RG groups have P value=0,038 differences. And SDB and controlling groups have P value=0,005 differences. This research would like to suggest applied non-pharmacological actions particularly toward SDB groups in order to decrease the prevalence of hypertension. This will minimize consequences caused by this problem."