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ABSTRAK
Latar belakang: disglikemia adalah keadaan intoleransi glukosa berupa peningkatan kadar gula darah yang berhubungan dengan risiko penyakit kardiovaskular. Seiring dengan waktu, pada akhirnya diabetes akan menimbulkan kerusakan pada target organ, salah satu yang penting adalah pada sistem organ kardiovaskular, dapat berupa penyakit jantung koroner, kardiomiopati diabetes, penyakit serebrovaskuler, dan penyakit arteri perifer. Diabetes juga meningkatkan risiko terjadinya gagal jantung. Pada kardiomiopati diabetes, proses fibrosis yang masih reversibel sudah mulai terjadi bahkan ketika penderita masih asimtomatik. Pemeriksaan baku emas untuk mendeteksi terjadinya fibrosis miokard secara dini adalah pemeriksaan histopatologi jaringan miokardium melalui biopsi. Akan tetapi pemeriksaan ini sangat invasif dan tidak nyaman bagi subjek. Pemeriksaan yang kemudian berkembang adalah pencitraan menggunakan Cardiac Magnetic Resonance Imaging (CMRI). Akan tetapi pemeriksaan ini cukup mahal, dan tidak tersedia pada semua fasilitas kesehatan. Sementara itu, ST2 adalah penanda enzim jantung yang menggambarkan derajat proses fibrosis yang sedang terjadi pada miokard, terutama pada keadaan gagal jantung. Pemeriksaan menggunakan penanda enzim dapat menjadi alternatif dengan keuntungan lebih murah, dapat terjangkau luas dan mudah tersedia. Tujuan: Mengetahui hubungan antara kadar ST2 serum dengan fibrosis miokard interstisial pada penderita disglikemia. Metode: Pasien disglikemia yang lolos kriteria eksklusi berupa komorbid kardiovaskular akan menjalani pemeriksaan kadar ST2 serum dan T1 relaxation time menggunakan Cardiac MRI. Selanjutnya dilakukan analisis hubungan antara kadar ST2 serum dan T1 relaxation time. Hasil penelitian: Sebanyak 34 pasien diikutsertakan ke dalam penelitian ini. Didapatkan kisaran nilai kadar ST2 serum antara 12.40-53.22 ng/dL (median 19.95 ng/dL). Rerata nilai T1 relaxation time didapatkan sebesar 443.39 ± 113.35 ms. Terdapat korelasi bermakna antara kadar ST2 serum dengan fibrosis diffuse miokardium (Spearman correlation r = -0,547, p < 0.01). Pada analisa multivariat hubungan antara kadar ST2 serum dan T1 relaxation time tidak dipengaruhi oleh faktor perancu yang telah ditetapkan (r = -0,44, p = 0,033). Kesimpulan: Hasil penelitian ini menunjukkan kadar ST2 serum berkolerasi dengan fibrosis diffuse miokardium pada populasi disglikemia.ABSTRACT
Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.;Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.;Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.;Background: disglycemia is a state of glucose intolerance include increased blood sugar levels associated with risk of cardiovascular disease. Over time, eventually diabetes will cause damage to the target organ, especially the cardiovascular system, which include coronary heart disease, diabetic cardiomyopathy, diabetes, cerebrovascular disease, and peripheral arterial disease. Diabetes also increases the risk of heart failure. The clinical appearance of the disease is wide ranging from asymptomatic to symptomatic heart failure. Gold standard examination to detect the occurrence of early myocardial fibrosis is histopathological examination of myocardial tissue via biopsy. However, these tests are very invasive and uncomfortable for the subject. Examination which later evolved is imaging using cardiac magnetic resonance imaging (CMRI). However, these tests are quite expensive, and not available at all health facilities. Meanwhile, ST2 is a cardiac enzyme marker that describes the degree of fibrosis process in the myocardium, especially in the state of heart failure. Examination using enzyme markers can be a cheaper alternative, widely accessible and readily available. Aim: Knowing the relationship between serum levels of ST2 with myocardial interstitial fibrosis in disglycemic patients. Methods: Disglycemic patients who passed from the exclusion criteria (cardiovascular comorbid), will undergo a serum ST2 levels and T1 relaxation time using cardiac MRI. Then we analyzed the relationship between serum levels of ST2 and T1 relaxation time. Results: A total of 34 patients were included in this study. The range values of serum ST2 levels were between 12.40-53.22 ng/dL (median 19.95 ng/dL). The mean value of T1 relaxation time were 443.39 ± 113.35 ms. There is a significant correlation between serum levels of ST2 with diffuse myocardial fibrosis (Spearman correlation r = -0.547, p <0:01). Multivariate analysis showed the relationship between serum levels of ST2 and T1 relaxation time is not influenced by confounding factors (r = -0.44, p = 0.033). Conclusion: ST2 serum levels correlates with diffuse myocardial fibrosis on disglycemic population.

Abstrak :
ABSTRAK
Latar belakang. Pada pasien SA fraksi ejeksi ventrikel kiri dapat normal bahkan supra normal untuk jangka waktu yang lama walaupun proses remodeling ventrikel kiri sudah mulai terjadi.. Ekokardiografi speckle tracking dua dimensi (EST) mempunyai kelebihan untuk digunakan dalam menilai penurunan fungsi kontraktilitas miokard subklinis, dimana keadaan tersebut dapat mempengaruhi prognosis pasien SA. sST2 merupakan biomarker yang relatif baru, dapat meningkat pada regangan otot jantung (myocardial stretch), fibrosis, inflamasi, dan injuri miokard, apakah berhubungan dengan disfungsi dini ventrikel kiri masih belum diketahui. Tujuan. Mengetahui korelasi sST2 terhadap nilai GLS EST pada pasien SA berat dengan FEVK normal Metode. Merupakan studi potong lintang. Evaluasi dilakukan pada 29 pasien stenosis aorta berat dengan fraksi ejeksi normal yang datang ke poliklinik RS Jantung Harapan Kita periode Februari 2015 sampai November 2015. Dilakukan pengambilan figur ekokardiografi untuk menilai severitas SA dan untuk perhitungan nilai global longitudinal strain speckle tracking kemudian dilakukan pengambilan sampel darah di laboratorium RS Jantung Harapan Kita untuk menilai sST2. Hasil Penelitian. Dua puluh sembilan subjek ikut dalam penelitian ini dengan rerata usia adalah 59.7±12.1 tahun. Fungsi intrinsik ventrikel kiri pasien SA berat pada penelitian ini mengalami penurunan dengan nilai rerata GLS -11±4.5%. Hasil uji korelasi menunjukan terdapat korelasi positif dengan kekuatan korelasi sedang yang bermakna (r=0.429, p=0.02). Analisis multivariat tetap menunjukkan adanya hubungan antara kadar sST2 dengan nilai GLS EST (r=0,282 p=0.036). Kesimpulan. Terdapat korelasi sST2 dengan global longitudinal strain speckle tracking pada pasien SA berat dengan fraksi ejeksi normal.ABSTRACT
Background. In severe aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically normal or supranormal, whereas Global Longitudinal Strain providing comprehensive information on LV myocardial contractility and is superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation, and myocardial injury. Whether sST2 is increased in relation to the subclinical LV dysfunction assessed by GLS in AS is unknown. Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe Methods. This is a correlation study with cross sectional design. The subject was aortic stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A comprehensive transthoracic echocardiography was performed to evaluate severity of aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line subsequent GLS analysis. sST2 measurements were drawn after echocardiography. Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1 years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%. A Pearson correlate revealed significant positive correlation between sST2 and GLS (r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still showed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation between sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe aortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically normal or supranormal, whereas Global Longitudinal Strain providing comprehensive information on LV myocardial contractility and is superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation, and myocardial injury. Whether sST2 is increased in relation to the subclinical LV dysfunction assessed by GLS in AS is unknown. Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe Methods. This is a correlation study with cross sectional design. The subject was aortic stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A comprehensive transthoracic echocardiography was performed to evaluate severity of aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line subsequent GLS analysis. sST2 measurements were drawn after echocardiography. Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1 years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%. A Pearson correlate revealed significant positive correlation between sST2 and GLS (r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still showed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation between sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe aortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically normal or supranormal, whereas Global Longitudinal Strain providing comprehensive information on LV myocardial contractility and is superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation, and myocardial injury. Whether sST2 is increased in relation to the subclinical LV dysfunction assessed by GLS in AS is unknown. Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe Methods. This is a correlation study with cross sectional design. The subject was aortic stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A comprehensive transthoracic echocardiography was performed to evaluate severity of aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line subsequent GLS analysis. sST2 measurements were drawn after echocardiography. Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1 years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%. A Pearson correlate revealed significant positive correlation between sST2 and GLS (r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still showed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation between sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe aortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically normal or supranormal, whereas Global Longitudinal Strain providing comprehensive information on LV myocardial contractility and is superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation, and myocardial injury. Whether sST2 is increased in relation to the subclinical LV dysfunction assessed by GLS in AS is unknown. Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe Methods. This is a correlation study with cross sectional design. The subject was aortic stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A comprehensive transthoracic echocardiography was performed to evaluate severity of aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line subsequent GLS analysis. sST2 measurements were drawn after echocardiography. Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1 years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%. A Pearson correlate revealed significant positive correlation between sST2 and GLS (r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still showed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation between sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe aortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at the ventricular chamber is typically normal or supranormal, whereas Global Longitudinal Strain providing comprehensive information on LV myocardial contractility and is superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation, and myocardial injury. Whether sST2 is increased in relation to the subclinical LV dysfunction assessed by GLS in AS is unknown. Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe Methods. This is a correlation study with cross sectional design. The subject was aortic stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A comprehensive transthoracic echocardiography was performed to evaluate severity of aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line subsequent GLS analysis. sST2 measurements were drawn after echocardiography. Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1 years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%. A Pearson correlate revealed significant positive correlation between sST2 and GLS (r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still showed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation between sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe aortic stenosis with preserved EF.

Abstrak :
ABSTRAK
Latar Belakang : Hipertensi merupakan faktor resiko utama penyakit kardiovaskular, terutama sindrom koroner akut dan stroke. Peningkatan konsumsi garam berhubungan dengan kenaikan tekanan darah. Beberapa studi randomized-controlled trial (RCT) menyatakan bahwa konsumsi rendah garam dapat menurunkan tekanan darah pada populasi dewasa dengan atau tanpa hipertensi. Variabilitas tekanan darah selama 24 jam bersifat dinamis. Peningkatan darah nokturnal memiliki makna klinis yang cukup besar, merupakan salah satu prediktor dari penyebab kerusakan target organ, terutama kejadian kardiovaskular dan stroke. Asupan garam dapat mempengaruhi variasi tekanan darah 24 jam, yang dalam hal ini dapat juga berpengaruh pada hipertensi nokturnal. Obat penyekat EKA merupakan obat hipertensi lini pertama yang sering digunakan, terutama pada usia muda dan hipertensi yang disertai sindrom metabolik, mengingat peranan Sistem Renin Angiotensin memiliki peranan yang sangat penting dalam patofisiologi hipertensi. Asupan garam juga memiliki peranan pada patofisiologi terjadinya hipertensi dalam sistem Renin Angiotensin. Sedikit studi yang meneliti perpaduan obat penyekat EKA dengan asupan rendah garam dalam menrunkan kejadian hipertensi. Oleh karena itu, Menarik untuk diteliti pengaruh asupan garam dengan tekanan darah nokturnal pada pasien yang mengkonsumsi obat penyekat EKA. Tujuan : Menilai pengaruh asupan garam dengan tekanan darah nokturnal pada pasien hipertensi yang mendapatkan terapi penyekat EKA. Metode : Pasien poliklinik berusia 30 ? 50 tahun yang terdiagnosis hipertensi dan belum pernah mendapatkan anti-hipertensi sebelumnya, dibagi menjadi 2 kelompok (asupan rendah garam (Na <15 g/hari) dan asupan tinggi garam ≥15 g/hari). Kedua kelompok akan diberikan lisinopril dan dilakukan pemeriksaan natrium urin 24 jam dan home blood pressure monitoring.. Hasil Penelitian : Sebanyak 80 pasien hipertensi pasien hipertensi yang belum mendapatkan terapi diikutsetakan dalam penelitian ini, yang terdiri dari 37 pasien kelompok rendah garam dan 43 pasien kelompok tinggi garam. Kelompok pasien dengan asupan rendah garam memliki delta penurunan darah nokturnal sistolik (p<0,001), diastolic (p<0,001), dan rerata arteri (p<0,001) yang lebih besar dibandingkan pada kelompok asupan tinggi garam. Rerata asupan garam pada penelitian ini sebesar 16,77 gram/hari. Pada analisa multivariat didapatkan delta penurunan tekanan darah tidak dipengaruhi oleh usia, jenis kelamin, dislipidemia, IMT, dan durasi tidur. Kesimpulan : Penelitian ini membuktikan asupan rendah garam dapat mempengaruhi efektivitas terapi penyekat EKA dalam menurunkan tekanan darah nokturnal. ABSTRACT
Background : Hypertension is one of important risk factor of cardiovascular disease, especially acute coronary syndrome and stroke. High salt intake correlates to high blood pressure. Some Randomized-Controlled-Trials stated that low salt intake may decrease blood pressure in adult population with or without hypertension. Blood pressure variation in 24 hours is not static but dynamically changes. Increasing nocturnal blood pressure has significantly impacts, and become one of predictor of target organ damage, especially cardiovascular events and stroke. Salt intake may interferes both 24 hours blood pressure variation and nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first drug of choice anti-hypertensive therapy, especially in young age and associated with metabolic syndrome, due to important role of Renin Angiotensin Aldosterone System in pathophysiology of hypertension, whereas salt intake also has role in that system. Only few of studies that had proved combination of ACE Inhibitors and low salt intake in decreasing blood pressure in hypertension population. Therefore, it is so important to know the impact of low salt intake to nocturnal blood pressure in hypertension patient treated with ACE Inhibitors. Objectives : To know impact of low salt intake to nocturnal blood pressure in hypertension patient treated with ACE Inhibitors. Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreated hypertension, divided into two groups (low salt intake (Na <15 grams/day) and high salt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg and underwent 24-hours sodium urine collection and home blood pressure monitoring periodically. Results : There are 80 ambulatory patients diagnosed as untreated hypertension, consist of 37 patients in low salt intake group and 43 patients in high salt intake group. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic (p<0.001), and mean arterial (p<0.001) blood pressure compared with high salt intake group. Mean salt intake in this study was 16.77 grams/day. Multivariate analyzes showed that the difference of decreasing nocturnal blood pressure was not interfered by age, sex, dyslipidemia, BMI, and sleep duration. Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.;Background : Hypertension is one of important risk factor of cardiovascular disease, especially acute coronary syndrome and stroke. High salt intake correlates to high blood pressure. Some Randomized-Controlled-Trials stated that low salt intake may decrease blood pressure in adult population with or without hypertension. Blood pressure variation in 24 hours is not static but dynamically changes. Increasing nocturnal blood pressure has significantly impacts, and become one of predictor of target organ damage, especially cardiovascular events and stroke. Salt intake may interferes both 24 hours blood pressure variation and nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first drug of choice anti-hypertensive therapy, especially in young age and associated with metabolic syndrome, due to important role of Renin Angiotensin Aldosterone System in pathophysiology of hypertension, whereas salt intake also has role in that system. Only few of studies that had proved combination of ACE Inhibitors and low salt intake in decreasing blood pressure in hypertension population. Therefore, it is so important to know the impact of low salt intake to nocturnal blood pressure in hypertension patient treated with ACE Inhibitors. Objectives : To know impact of low salt intake to nocturnal blood pressure in hypertension patient treated with ACE Inhibitors. Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreated hypertension, divided into two groups (low salt intake (Na <15 grams/day) and high salt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg and underwent 24-hours sodium urine collection and home blood pressure monitoring periodically. Results : There are 80 ambulatory patients diagnosed as untreated hypertension, consist of 37 patients in low salt intake group and 43 patients in high salt intake group. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic (p<0.001), and mean arterial (p<0.001) blood pressure compared with high salt intake group. Mean salt intake in this study was 16.77 grams/day. Multivariate analyzes showed that the difference of decreasing nocturnal blood pressure was not interfered by age, sex, dyslipidemia, BMI, and sleep duration. Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.;Background : Hypertension is one of important risk factor of cardiovascular disease, especially acute coronary syndrome and stroke. High salt intake correlates to high blood pressure. Some Randomized-Controlled-Trials stated that low salt intake may decrease blood pressure in adult population with or without hypertension. Blood pressure variation in 24 hours is not static but dynamically changes. Increasing nocturnal blood pressure has significantly impacts, and become one of predictor of target organ damage, especially cardiovascular events and stroke. Salt intake may interferes both 24 hours blood pressure variation and nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first drug of choice anti-hypertensive therapy, especially in young age and associated with metabolic syndrome, due to important role of Renin Angiotensin Aldosterone System in pathophysiology of hypertension, whereas salt intake also has role in that system. Only few of studies that had proved combination of ACE Inhibitors and low salt intake in decreasing blood pressure in hypertension population. Therefore, it is so important to know the impact of low salt intake to nocturnal blood pressure in hypertension patient treated with ACE Inhibitors. Objectives : To know impact of low salt intake to nocturnal blood pressure in hypertension patient treated with ACE Inhibitors. Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreated hypertension, divided into two groups (low salt intake (Na <15 grams/day) and high salt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg and underwent 24-hours sodium urine collection and home blood pressure monitoring periodically. Results : There are 80 ambulatory patients diagnosed as untreated hypertension, consist of 37 patients in low salt intake group and 43 patients in high salt intake group. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic (p<0.001), and mean arterial (p<0.001) blood pressure compared with high salt intake group. Mean salt intake in this study was 16.77 grams/day. Multivariate analyzes showed that the difference of decreasing nocturnal blood pressure was not interfered by age, sex, dyslipidemia, BMI, and sleep duration. Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.