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Abstrak :
Latar Belakang : Keberhasilan pengobatan antihipertensi dipengaruhi banyak hal, salah satunya adalah faktor genetik, termasuk perbedaan ras dan aktivitas renin plasma (ARP). Perbedaan ras, berkaitan dengan ARP, mungkin dapat memberikan perbedaan respon terhadap obat antihipertensi. Aktivitas renan plasma dan perbandingan efektifitas obat antihipertensi (lisinopril dan amlodipin) pada ras melanesia di Provinsi Papua belum pernah diteliti. Tujuan : Mengukur aktivitas renin plasma dan membandingkan efektifitas obat lisinopril dan amlodipin pada pasien hipertensi ras melanesia untuk menurunkan tekanan darah. Metode : Pada awal penelitian, 68 subjek berhasil direkrut, dilakukan randomisasi dan dibagi ke dalam dua kelompok. Sebanyak 34 subjek mendapat lisinopril 5 mg dan 34 subjek mendapat amlodipine 2.5 mg. Tekanan darah, ARP dan karakteristik dasar lainnya diukur sebelum intervensi, dan kemudian di follow up tiap minggu. Subjek yang belum mencapai target tekanan darah akan diberikan peningkatan dosis obat, lisinopril 10 hingga 20 mg dan amlodipin 5 hingga 10 mg. Pada akhir penelitian (minggu keempat), tekanan darah diukur sebagai luaran klinis. Sebanyak 7 subjek drop out, 4 subjek pada kelompok lisinopril dan 3 subjek pada kelompok amlodipin. Hasil : Aktivitas renin plasma pada populasi penelitian ini 1.6 ng/ml/jam (normal). Karakteristik dasar klinis tidak berbeda antara kedua kelompok, termasuk rerata tekanan darah sebelum intervensi dan ARP. Pada kedua kelompok didapatkan penurunan tekanan darah yang signifikan setelah intervensi, baik pada tekanan darah sistolik (TDS), distolik (TDD) dan tekanan nadi (TN). Namun, pada penelitian ini, perbedaan respon penurunan tekanan darah antara kelompok lisinopril dan amlodipin tidak berbeda (TDS 24.6 ± 9.3 vs 25.9 ± 8.9 mmHg, p=0.56; TDD 13.3 ± 5.5 vs 11.4 ± 4.8 mmHg, p=0.15; TN 17.1 ± 5.6 vs 16.3 ± 5.0 mmHg, p=0.55). Kesimpulan : Aktivitas renin plasma pada pasien hipertensi ras melanesia normal dan pemberian lisinopril tidak menunjukkan perbedaan penurunan respon penurunan tekanan darah dibandingkan dengan amlodipin. ......Background: The success of antihypertensive treatment are influenced by many factors, one of which are genetic factors, including differences in race and plasma renin activity (PRA). Racial differences, regarding PRA, may give different response to antihypertensive drugs. Plasma renin activity and comparison of the effectiveness of antihypertensive medications (lisinopril and amlodipine) in the Melanesian race in the province of Papua have not been investigated. Objectives: To measure plasma renin activity and compare the effectiveness of lisinopril and amlodipine in melanesian hypertensive patients to reduce blood pressure. Methods: Sixty eight subjects were randomly assigned into 2 groups, those receiving lisinopril 5 mg (34 subjects) and amlodipine 2.5 mg (34 subjects). Blood pressure, PRA and other baseline characteristics were measured before the intervention, and then evaluated every week. Dose of lisinopril and amlodipine will be increased in subjects who have not achieved blood pressure target, 10 mg to 20 mg and 5 mg to 10 mg, respectively. At the end of the fourth week, blood pressure is measured as the main clinical outcome. Seven subjects were drop out, four from lisinopril group and three from amlodipin group. Results: Plasma renin activity in this study population was 1.6 ng/ml/h (normal). Baseline characteristics did not differ between two groups, including blood pressure and PRA before intervention. Significant decrease in blood pressure occurred in both group after the intervention, including systolic blood pressure (SBP) , diastolic (DBP) and mean arterial pressure (MAP). However, there are no differences in blood pressure reduction between lisinopril and amlodipine groups. (SBP 24.6 ± 9.3 vs 25.9 ± 8.9 mmHg, p=0.56; DBP 13.3 ± 5.5 vs 11.4 ± 4.8 mmHg, p=0.15; MAP 17.1 ± 5.6 vs 16.3 ± 5.0 mmHg, p=0.55). Conclusion: Plasma renin activity in melanesian hypertensive patients was normal and administration of lisinopril showed no difference in blood pressure reduction compared with amlodipine.

Abstrak :
ABSTRAK
Hipertensi pada remaja semakin meningkat dan menyebabkan peningkatan berbagai penyakit degeneratif lainnya ketika dewasa. Tujuan penelitian ini adalah untuk mengetahui faktor dominan yang paling berhubungan terhadap kejadian prehipertensi dan hipertensi pada remaja usia 15-18 tahun di SMA Negeri 3 Kisaran Kabupaten Asahan Sumatera Utara tahun 2016. Desain penelitian yang digunakan dalam penelitian ini adalah cross-sectional yang dilakukan pada 145 responden kelas X dan XI. Variabel dependen yang diteliti adalah hipertensi dan prehipertensi sedangkan variabel independen yang diteliti adalah jenis kelamin, riwayat hipertensi keluarga, status gizi, asupan energi, asupan lemak, asupan natrium, asupan serat, aktivitas fisik, kebiasaan merokok, keadaan stres dan durasi tidur. br>
Hasil penelitian menunjukkan bahwa prevalensi prehipertensi 42,1% dan hipertensi 12,4%. Berdasarkan hasil analisis bivariat terdapat perbedaan bermaknan antara prehipertensi dan hipertensi berdasarkan jenis kelamin (p value = 0,005), riwayat hipertensi keluarga (p value = 0,040), status gizi (p value = 0,012), asupan lemak (p value = 0,036), asupan natrium (p value = 0,031), asupan serat (p value = 0,010), aktivitas fisik (p value = 0,044), keadaan stres (p value = 0,043), dan durasi tidur (p value = 0,023). Sedangkan bedasarkan analisis multivariat, faktor dominan kejadian prehipertensi dan hipertensi adalah aktivitas fisik. Diperlukan penelitian lebih lanjut untuk meneliti hubungan kasualitas pada faktor-faktor tersebut dan untuk mencari apakah ada faktor dominan lain yang berhubungan dengan kejadian prehipertensi dan hipertensi pada remaja. Peneliti menyarankan agar siswa rutin melakukan pengukuran tekanan darah setidaknya sebulan sekali, aktif berolahraga paling sedikit tiga kali seminggu, memantau berat badan minimal sebulan sekali untuk memantau status gizi baik, dan menjaga asupan zat gizi dengan mengonsumsi makanan sesuai dengan pedoman gizi seimbang.

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ABSTRACT
Hypertension in adolescents has increased and led to an increase in various other degenerative diseases when adults. The purpose of this study was to determine the most dominant factor that related to the incidence of prehypertension and hypertension in adolescents aged 15-18 years old at SMA Negeri 3 Kisaran Asahan District North Sumatra in 2016. The study used cross-sectional design which was conducted on 145 respondents of 10th and 11th grader. The dependent variables in this study is hypertension and prehypertension, while independent variables were gender, family history of hypertension, nutritional status, energy intake, fat intake, sodium intake, fiber intake, physical activity, smoking, stress and sleep duration.

The results showed that the prevalence of prehypertension and hypertension were 42,1% and 12,4% respectively. Based on the bivariate analysis, there were significant differences between prehypertension and hyepertension based on sex (p value = 0,005), family history of hypertension (p value = 0,040), nutritional status (p value = 0,012), fat intake (p value = 0,036), sodium intake (p value = 0,031), fiber intake (p value = 0,010), physical activity (p value = 0,044), stress (p value = 0,043), and sleep duration (p value = 0,023). While based on the multiariate analysis, the dominant factor of prehypertension and hypertension was physical activity.

Further research is needed to examine the relationship of causality on these factors and to explore whether there other dominant factor of prehypertension and hypertension among adolescents. The author suggests that the students should routinely check the blood pressure measurements at least once a month, exercise at least three times a week, monitoring the body weight at least once a month to maintain good nutrional status, and keep the intake of nutritionts by eating foods according to balanced nutriotional guidelines.