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"[ABSTRAKLatar Belakang. Malnutrisi merupakan salah satu masalah kesehatan utama yang banyak dijumpai terutama di negara berkembang. Malnutrisi pada pasien gagal jantung diketahui berhubungan dengan luaran klinis yang lebih buruk, meliputi peningkatan lama perawatan, readmisi dan mortalitas. Pada pasien gagal jantung dekompensasi akut (GJDA), perburukan fungsi ginjal (PFG) selama perawatan diduga merupakan komorbid yang memberikan dampak luaran klinis yang lebih buruk tersebut. Namun sampai saat ini belum diketahui bagaimana hubungan antara status malnutrisi dengan terjadinya PFG pada pasien GJDA. Oleh karena itu, penelitian ini bertujuan untuk mengetahui hubungan antara status malnutrisi dengan terjadinya PFG pada pasien GJDA, sekaligus untuk menilai besarnya pengaruh malnutrisi terhadap luaran klinis tersebut.Metode. Studi kohort prospektif dilakukan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK). Kejadian PFG didefinisikan sebagai peningkatan nilai kreatinin > 0,3 mg/dL atau > 25% dibandingkan kreatinin saat masuk rawat. Karakteristik dasar, pemeriksaan klinis awal, status antropometri dan data laboratorium diambil pada saat admisi. Pasien dibagi berdasarkan nilai NRI menjadi kelompok malnutrisi (NRI < 97,5) dan tidak malnutrisi (NRI > 97,5). Kemudian pemeriksaan serial kreatinin dilakukan dengan interval setiap 3 hari selama pasien menjalani perawatan di RS. Data kemudian diolah dengan analisis bivariat dan multivariat untuk mengetahui hubungan antara malnutrisi dengan PFG, lama perawatan, dan mortalitas.Hasil Penelitian. Sebanyak 265 pasien GJDA diikutsertakan dalam penelitian ini, dengan proporsi kelompok malnutrisi sebesar 50,2%. Pada kelompok malnutrisi PFG terjadi pada 31,6% pasien, sedangkan pada kelompok tidak malnutrisi sebesar 26,5% pasien. Tidak didapatkan hubungan yang bermakna antara malnutrisi dengan kejadian PFG, namun terdapat kecenderungan peningkatan risiko PFG pada pasien GJDA yang disertai malnutrisi (OR 1,279; 95%IK 0,751-2,178; p=0,364). Malnutrisi ditemukan memiliki pengaruh yang signifikan terhadap tingginya lama rawat (HR 6,254; 95%IK 4,614-8,477; p<0,001) serta kematian pada pasien GJDA.Kesimpulan. Penelitian prospektif ini tidak menemukan hubungan yang bermakna antara malnutrisi dengan PFG, namun didapatkan kecenderungan bahwa malnutrisi akan semakin meningkatkan risiko terjadinya PFG pada pasien GJDA. Pada pasien GJDA di RSJPDHK ditemukan proporsi malnutrisi yang sangat besar, dan malnutrisi pada kelompok ini memberikan kontribusi yang signifikan terhadap tingginya lama perawatan serta kematian.

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ABSTRACTBackground. Malnutrition is the leading cause of disease burden especially in developing countries. Malnutrition in heart failure patients is associated with longer length of stay (LOS), higher readmission and mortality rates. Worsening renal function (WRF) has also been shown to contribute to the worsened outcomes in patients with acute decompensated heart failure (ADHF) patients. It is not known, however, whether malnutrition contributed to the worse outcomes in ADHF patient through the WRF. Accordingly, this study sought to investigate the association between malnutrition and WRF in ADHF patients.Methods. A prospective cohort study was conducted in National Cardiovascular Center Harapan Kita (NCCHK) to all patients admitted with ADHF. WRF was defined as the occurrence, at any time during the hospitalization, of > 0,3 mg/dL or > 25% increase in serum creatinine from admission. Baseline and clinical characteristics, anthropometry status, and laboratory data were collected during hospital admission. Subjects were divided based on NRI into malnutrition (NRI < 97,5) and no malnutrition group (NRI > 97,5). Serial serum creatinine was evaluated within 3 days interval during hospitalization. Statistical analysis was done using bivariate and multivariate analysis to determine the association between malnutrition with WRF, LOS and mortality rates.Results. Two hundred and sixty-five ADHF patients were included in this cohort study. Of those subjects, 50,2% were on malnutrition group. WRF occured in 31,6% patients of malnutrition group and 26,5% patients of no malnutrition group. Although there was an increased probability of WRF occurence in ADHF patients with malnutrition (OR 1,279; 95%CI 0,751-2,178; p=0,364), but this increased probability was not statistically significant. Malnutrition was found significantly prolonged the LOS (HR 6,254; 95%CI 4,614-8,477; p<0,001) and increased mortality rates in ADHF patients.Conclusion. This prospective study demonstrated there was no significant association between malnutrition and WRF, but there was an increased probability of WRF occurrences in ADHF patients with malnutrition. Nevertheless, we found high burden of malnutrition in ADHF patients in NCCHK, and this burden contributed significantly to longer LOS and higher mortality rates in this population., Background. Malnutrition is the leading cause of disease burden especially in developing countries. Malnutrition in heart failure patients is associated with longer length of stay (LOS), higher readmission and mortality rates. Worsening renal function (WRF) has also been shown to contribute to the worsened outcomes in patients with acute decompensated heart failure (ADHF) patients. It is not known, however, whether malnutrition contributed to the worse outcomes in ADHF patient through the WRF. Accordingly, this study sought to investigate the association between malnutrition and WRF in ADHF patients.Methods. A prospective cohort study was conducted in National Cardiovascular Center Harapan Kita (NCCHK) to all patients admitted with ADHF. WRF was defined as the occurrence, at any time during the hospitalization, of > 0,3 mg/dL or > 25% increase in serum creatinine from admission. Baseline and clinical characteristics, anthropometry status, and laboratory data were collected during hospital admission. Subjects were divided based on NRI into malnutrition (NRI < 97,5) and no malnutrition group (NRI > 97,5). Serial serum creatinine was evaluated within 3 days interval during hospitalization. Statistical analysis was done using bivariate and multivariate analysis to determine the association between malnutrition with WRF, LOS and mortality rates.Results. Two hundred and sixty-five ADHF patients were included in this cohort study. Of those subjects, 50,2% were on malnutrition group. WRF occured in 31,6% patients of malnutrition group and 26,5% patients of no malnutrition group. Although there was an increased probability of WRF occurence in ADHF patients with malnutrition (OR 1,279; 95%CI 0,751-2,178; p=0,364), but this increased probability was not statistically significant. Malnutrition was found significantly prolonged the LOS (HR 6,254; 95%CI 4,614-8,477; p<0,001) and increased mortality rates in ADHF patients.Conclusion. This prospective study demonstrated there was no significant association between malnutrition and WRF, but there was an increased probability of WRF occurrences in ADHF patients with malnutrition. Nevertheless, we found high burden of malnutrition in ADHF patients in NCCHK, and this burden contributed significantly to longer LOS and higher mortality rates in this population.]"

"[ABSTRAKLatar Belakang. Perburukan fungsi ginjal berkaitan dengan luaran klinis yang lebih buruk pada pasien gagal jantung dekompensasi akut. Karakteristik klinis pada saat pasien masuk ke unit gawat darurat (UGD) dapat menolong untuk identifikasi pasien yang berisiko terhadap kejadian perburukan fungsi ginjal. Tujuan penelitian ini adalah membuat sistem skor untuk mempermudah identifikasi pasien yang berisiko terhadap perburukan fungsi ginjal pada gagal jantung dekompensasi akut.Metode. Studi kohort retrospektif dilakukan terhadap 614 pasien yang menjalani perawatan karenan gagal jantung dekompensasi akut. Perburukan fungsi ginjal didefinisikan sebagai peningkatan nilai kreatinin serum ≥ 0.3 mg/dL kapanpun selama perawatan atau ≥ 25% dari awal masuk perawatan.Hasil. Perburukan fungsi ginjal terjadi pada hampir 26% pasien. Prediktor independen terhadap kejadian perburukan fungsi ginjal yang didapat melalui analisis dengan logistik regresi backward selection adalah usia > 75 tahun (p < 0.0001); perempuan (p = 0.034); riwayat hipertensi (p = 0.001); anemia (p = 0.005); dan serum Creatinin saat masuk di UGD > 2.5 mg/dL (p = 0.013). Sistem skor dibuat dari model akhir tersebut. Dilakukan validasi internal dengan metode bootstrap didapatkan hasil optimisme yang baik (0.01088808).Kesimpulan. Sistem skor baru dapat memprediksi kejadian perburukan fungsi ginjal pada pasien gagal jantung dekompensasi akut yang menjalani rawat inap.

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ABSTRACTBackground. Worsening renal function (WRF) is associated with worse outcomes among patients who are hospitalized with acute decompensated heart failure (ADHF). Clinical characteristics at admission may help identify patients at increased risk of WRF. The aim of this study was to create in admission scoring system to simplify identification patients at risk of WRF in ADHF setting.Methods. A retrospective data of 614 patients admitted with ADHF was analyzed. By the definition WRF occurred when serum Creatinin increased at anytime during hospitalization by ≥ 0.3 mg/dL or by ≥ 25% from admission.Results. Worsening renal function developed in near 26% patients. The independent predictors of WRF analyzed with backward selection logistic regression were: age > 75 years old (p < 0.0001), female (p = 0.034); history of hypertension (p = 0.001); anemia (p = 0.005); and in admission serum Creatinin (p = 0.013). A scoring system was generated from this final model. An internal validation with bootstrap method showed good optimism (0.01088808).Conclusion. A new scoring system could predict in-hospital worsening renal function among patients hospitalized with acute decompensated heart failure., Background. Worsening renal function (WRF) is associated with worse outcomesamong patients who are hospitalized with acute decompensated heart failure(ADHF). Clinical characteristics at admission may help identify patients at incresedrisk of WRF. The aim of this study was to create in admission scoring system tosimplify identification patients at risk of WRF in ADHF setting.Methods. A retrospective data of 614 patients admitted with ADHF was analyzed.By the definition WRF occurred when serum Creatinin increased at anytime duringhospitalization by ≥ 0.3 mg/dL or by ≥ 25% from admission.Results. Worsening renal function developed in near 26% patients. Theindependent predictors of WRF analyzed with backward selection logisticregression were: age > 75 years old (p < 0.0001), female (p = 0.034); history ofhypertension (p = 0.001); anemia (p = 0.005); and in admission serum Creatinin (p= 0.013). A scoring system was generated from this final model. An internalvalidation with bootstrap method showed good optimism (0.01088808).Conclusion. A new scoring system could predict in-hospital worsening renal function among patients hospitalized with acute decompensated heart failure.]"

"Penyakit Jantung Koroner (PJK) merupakan salah satu penyakit tidak menular yang ada kaitannya dengan faktor gizi serta memiliki kontribusi besar dalam tingkat mortalitas di Indonesia. Melalui penelitian dengan disain studi cross sectional diharapkan dapat diketahui hubungan antara karakteristik demografi (status migrasi dan lokasi tinggal), asupan makanan (asupan energi, karbohidrat, lemak, kolesterol, serat dan asupan gorengan per hari), aktivitas harian (tingkat aktivitas fisik dan waktu tempuh) dan status gizi (Indeks Massa Tubuh dan lingkar perut) dengan tingkat risiko Penyakit Jantung Koroner (PJK) pada karyawan laki-laki berusia 30 tahun ke atas di Perusahaan Alat Berat, Cikarang. Data diambil dengan metode wawancara untuk karakteristik demografi. Asupan makanan diketahui dengan wawancara menggunakan semi-kuantitatif FFQ, dan aktivitas fisik dengan wawancara menggunakan adaptasi kuesioner GPAQ versi 2. Tingkat risiko PJK diukur dengan metode skor Framingham data diperoleh dari hasil medical check-up bersama dengan data status gizi. Hasil penelitian menunjukkan bahwa rata-rata tingkat risiko PJK sebesar 12% dan masuk dalam kategori tingkat risiko sedang. Hubungan tingkat risiko penyakit jantung ditemukan bermakna secara statistik dengan status migrasi (p = 0,007), lokasi tinggal (p = 0,013), asupan gorengan per hari (p = 0,016), waktu tempuh (p = 0,036), IMT (p = 0,031) dan lingkar perut (p = 0,024).

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Coronary Heart Disease (CHD) is one of non-communicable disease related to nutrition factors and contribute to high rate mortality in Indonesia. This research using cross-sectional study and aims to know the association between demographic characteristic (migration status and household location), food consumption (consumption of calorie, carbohydrate, fat, cholesterol, fiber and fried foods), daily activity (physical activity level and travel duration), nutritional status (BMI and waist circumference) with risk of coronary heart disease which defined by Framingham Score in male employee of Heavy Equipment Company, Cikarang. Data collected by interview method in order to know demographic characteristic and also to know daily food consumptions using semi-quantitative FFQ and level of physical activity using adopted GPAQ version 2. Risk of CHD and nutritional status known from respondent medical check-up status. The results of this research show that mean of CHD risk is 12% and it classified as moderate risk of CHD. This research find out that there are significant statistical association between risk of CHD with migration status (p = 0,007), home location (p = 0,013), daily consumption of fried foods (p = 0,016), travel time (p = 0,036), BMI (p = 0,031) and waist circumference (p = 0,024)."

"Latar belakang: Kekurangan gizi merupakan penyebab umum morbiditas pada anak dengan penyakit jantung bawaan (PJB). Data dari negara berkembang memperlihatkan prevalensi malnutrisi penderita dengan PJB sebelum dioperasi mencapai 45%. Penelitian ini bertujuan untuk mengetahui profil anhropometrik dan prevalensi kekurangan gizi pada anak dengan PJB dengan melakukan pengukuran anthropometrik.Metode: Penelitian ini merupakan penelitian dengan rancang bangun cross sectional pada anak berusia 0-2 tahun dengan PJB di RSCM. Pengukuran antropometri (berat badan, panjang badan, lingkar kepala) dilakukan pada seluruh pasien. Kekurangan gizi, failure to thrive/FTT, perawakan pendek, mikrosefali dinilai dengan menggunakan rekomendasi WHO tahun 2006, berupa perhitungan z-skor BB/PB, BB/U di 2 titik, PB/U dan LK/U < -2 SD.Hasil: Total subyek dalam penelitian ini berjumlah 95 orang, 73 orang dengan asianotik dan 22 orang dengan PJB sianotik. Prevalensi kekurangan gizi sebesar 51,1% dengan 22,3% diantaranya adalah gizi buruk. FTT terdapat pada 64,9%, perawakan pendek pada 49,5% dan mikrosefali pada 37% pasien. FTT ditemukan lebih banyak pada pasien dengan lesi asianotik (72,2%) dibandingkan dengan lesi sianotik (42,9). Pada lesi asianotik, berat badan lebih dipengaruhi daripada panjang badan (72,2% dengan 49,3%). Pasien dengan lesi sianotik, berat dan panjang badan akan dipengaruhi secara seimbang (42,9% dengan 54.5%). Konsultasi diet diberikan kepada pasien dengan kekurangan gizi. Terapi obat-obatan, intervensi transkateter atau bedah diindikasikan pada pasien tertentu.Kesimpulan: Prevalensi FTT lebih tinggi dibandingkan dengan kekurangan gizi pada anak dengan kelainan jantung kongenital. FTT ditemukan lebih banyak pada pasien dengan lesi asianotik. Pada lesi asianotik, berat badan lebih dipengaruhi daripada panjang badan. Pada lesi asianotik, berat badan lebih dipengaruhi daripada panjang badan.

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AbstractBackground: Undernutrition is a common cause of morbidity in children with CHD. Previous data from developing country showed prevalence of preoperative undernutrition in children with CHD was up to 45%. The aim of this study are to determine the anthropometric profi les and prevalence of undernutrition in children with CHD by using the anthropometric measurement.Methods: A cross-sectional study was carried out in children aged 0-2 years old with CHD in Cipto Mangunkusumo hospital. All patients underwent an anthropometric evaluation (weight, length and head circumference) at presentation. Undernutrition, failure to thrive /FTT, short stature and microcephaly were determined according to WHO, weight-forlength, weight-for-age at 2 points, length-for-age, head circumference-for-age z-score < -2SD accordingly.Results: We had total of 95 patients, 73 patients with acyanotic and 22 patients with cyanotic lesions. Prevalence of undernutrition in CHD was 51.1%, with 22.3% severe undernutrition. FTT was found in 64.9%, short stature in 49.5% and microcephaly in 37% patients. FTT was found higher in acyanotic (72.2%) compared to cyanotic lesions (42.9%). In acyanotic, weight was affected more than length (72.2% vs 49.3%). In cyanotic, weight and length affected equally (42.9% vs 54.5%). Diet counseling were done in patients with undernutrition. Medicines, transcatheter or surgery intervention were indicated in selected patients.Conclusions: Prevalence of FTT was higher than undernutrition in children with CHD. FTT was found higher in acyanotic lesions. In acyanotic, weight was affected more than length. In cyanotic, weight and length affected equally. "

"Lima puluh persen penderita gagal jantung merupakan gagal jantung dengan fraksi ejeksi yang normal (HFPEF). Morbiditas dan mortalitas HFPEF belumlah jelas. Latihan olahraga telah menjadi rekomendasi pertama dalam beberapa panduan klinis, namun belum pada HFPEF. Strain longitudinal apikal 4 ruangan dapat digunakan sebagai nilai prognostik. Perbaikan fungsi longitudinal intrinsik ventrikel kiri menggunakan strain longitudinal apikal empat ruangan akibat latihan olahraga belumlah diketahui. Kuasi eksperimental menggunakan 30 sampel konsekutif HFPEF, dilakukan program latihan olahraga tersupervisi. Program latihan olahraga dilakukan selama satu bulan. Dilakukan pemeriksaan ekokardiografi, 6MWT, kuesioner MLWHF dan WHO. Terdapat perbedaan yang signifikan dalam 6MWT, nilai skoring MLWHF dan WHO5 sebelum dan sesudah latihan olahraga. Didapatkan nilai strain longitudinal sebesar -16,20% (-10,7% sampai dengan -17,81%). Strain longitudinal apikal 4 ruangan mengalami perbaikan pada minggu ke 2 dan ke 4 latihan olahraga (sebelum latihan olahraga LS = -16,20 [-10,70 to -17,81]; minggu ke dua latihan olah raga LS = -18,00±2,69 dan minggu ke 4 latihan olahraga LS = -21,86±1,79) dan terdapat perbedaan yang signifikan (p < 0,001). Terdapat perbaikan fungsi intrinsik longitudinal ventrikel kiri sebelum dengan sesudah diberikan program latihan olahraga pada penderita gagal jantung dengan fraksi ejeksi yang normal.

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Fifty percent of patients with heart failure are heart failure with preserved ejection fraction (HFPEF). Morbidity and mortality of HFPEF is unclear. Exercise has become the first recommendation in several clinical guidelines, but not yet in HFPEF. Apical 4 chamber longitudinal strain can be used as a prognostic value. But the improvement of longitudinal intrinsic left ventricular function using apical 4 chamber longitudinal strain due to exercise training is not yet known. Quasi- experimental study using thirty consecutive sample of HFPEF. Exercise training program was conducted for a month. Echocardiography, 6MWT, MLWHF and WHO questionnaire was performed before and after exercise. There was significant differences in the 6MWT, the value of MLWHF and WHO5 score before and after exercise. Longitudinal strain values obtained by -16.20 % (-10.7% to -17.81%). Four chamber longitudinal strain was improved at weeks 2 and 4 of exercise (before exercise LS = -16.20[-10.70 to -17.81]; the second week of exercise training LS = -18.00±2,69 and week 4 exercise LS = -21.86 ± 1.79) and there were significant differences (p < 0.001). There was an improvement in the longitudinal intrinsic left ventricular function before and after exercise training in patients with heart failure with preserved ejection fraction."

"[ABSTRAKLatar belakang. Pada stenosis mitral sering timbul komplikasi hipertensi pulmoner dan disfungsi ventikel kanan. Belum ada penelitian yang menghubungkan antara resistensi vaskular paru sebelum operasi dengan fungsi jantung kanan saat pasca operasi serta perubahannya pasca operasi stenosis mitral rematik.Metode. Studi ini merupakan studi kohort prospektif pada 31 pasien stenosis mitral rematik yang menjalani operasi katup mitral di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita sejak April 2014 sampai Maret 2015. Pasien menjalani pemeriksaan ekokardiografi sebelum operasi, sebelum pulang perawatan pasca operasi serta saat follow up mid term di poliklinik. Dilakukan analisa statistik untuk melihat hubungan antara resistensi vaskular paru (RVP) pra operasi dengan strain longitudinal ventrikel kanan saat follow up mid term serta perubahan strain longitudinal ventrikel kanan pasca operasi (delta strain).Hasil. Tidak terdapat korelasi antara RVP pra operasi dengan strain longitudinal speckle tracking ventrikel kanan saat follow up mid term pasca operasi (r 0,199 p 0,264) serta dengan perubahan strain longitudinal ventrikel kanan pasca operasi atau delta strain (r 0,174 p 0,350).Kesimpulan. Resistensi vaskular paru pra operasi tidak berhubungan dengan strain longitudinal speckle tracking ventrikel kanan saat follow up mid term pasca operasi serta dengan perubahan strain longitudinal ventrikel kanan pasca operasi atau delta strain.

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ABSTRACTBackground. In MS right ventikel (RV) dysfunction and pulmonary hypertension often occur as complication. There is no research that connects the pulmonary vascular resistance before surgery with RV function and its changes in the case of rheumatic mitral stenosis who underwent mitral valve surgery.Methods. This study is a prospective cohort study which involves 31 patients with rheumatic mitral stenosis who underwent surgery at National Cardiovaskular Center Harapan Kita Hospital from April 2014 to March 2015. Patients underwent echocardiography before surgery, after surgery pre-hospital discharge and mid-term follow-up at clinic. Statistical analysis was performed to see the relationship between preoperative pulmonary vascular resistance (PVR) with RV function at mid term follow up, which is assessed using echocardiographic parameters right ventricular longitudinal speckle strain, and also with right ventricle longitudinal speckle strain postoperative changes (delta strain).Results. There is no correlation between pre operative PVR with RV longitudinal speckle strain at mid term follow-up (r 0,199 p 0,264), and post operative changes or delta strain (r 0.174 p 0.350).Conclusion. RVP before surgery is not associated with right ventricle longitudinal speckle strain at follow up mid term and post operative changes or delta strain., Background. Acute rheumatic fever and rheumatic heart disease is still regarded as animportant public health problem especially in developing countries. Mitral stenosis (MS) is asequale of rheumatic fever which are most commonly found. In MS right ventikel (RV)dysfunction and pulmonary hypertension often occur as complication. The right ventricle hasa smaller muscle mass so it is more sensitive to changes in pressure loads. There is noresearch that connects the pulmonary vaskular resistance before surgery with RV functionand also changes in the case of rheumatic mitral stenosis who underwent mitral valvesurgery.Methods. This study is a prospective cohort study which involves 31 patients with rheumaticmitral stenosis who underwent surgery at National Cardiovaskular Center Harapan Kita Hospital from April 2014 to March 2015. Patients underwent echocardiography before surgery, after surgery pre-hospital discharge and mid-term follow-up at clinic. Statisticalanalysis was performed to see changes in RV function with longitudinal speckle strain, aftersurgery pre-hospital discharge and mid-term follow-up at clinic. Analysis also performed tosee the relationship between preoperative pulmonary vascular resistance (PVR) with RVfunction at mid term follow up, which is assessed using echocardiographic parameters rightventricular longitudinal speckle strain, and also with right ventricle longitudinal specklestrain postoperative changes (delta strain). Results. Right ventricular function after surgery seen with longitudinal speckle strainimproved from -12.94 ± 3.63 preoperatively into -13.06 ± 3.63 after surgery pre hospitaldischarge, and -15.25 ± 3.75 at follow-up evaluation (p 0.007). There is no correlationbetween pre operative PVR with longitudinal speckle strain at mid term follow-up (r 0,199 p0,264), and RV longitudinal speckle strain post operative changes or delta strain (r 0.174 p0.350). Conclusion. After mitral valve surgery, right ventricle longitudinal speckle strain improves.RVP before surgery is not associated with right ventricle longitudinal speckle strain at follow up mid term and right ventricle longitudinal speckle strain post operative changes or deltastrain. ]"

"The major cause of mortalities in Indonesia shifs to Non Communicable risk faktors that related to physiological factors (intermediate risk factors) i.e. hypertension, obesity, and central obesity, diabetes...."

"[ABSTRAKLatar belakang : Kekakuan arteri berkaitan dengan peningkatan risiko kejadian kardiovaskular. Variabilitas tekanan darah dengan menggunakan ambulatory blood pressure monitoring telah terbukti sebagai prediktor prognosis kardiovaskular dan dapat menggambarkan kekakuan arteri. Penelitian ini bertujuan untuk menyelidiki hubungan variasi tekanan darah dengan menggunakan home blood pressure monitoring dengan pemeriksaan pulse wave velocity sebagai penilaian kekakuan arteri.Metode : Penelitian potong-lintang dilakukan terhadap 57 subyek hipertensi yang belum terobati berusia 30-50 tahun. Subyek menjalani pemeriksaan PWV dan dilakukan monitoring tekanan darah menggunakan HBPM sebanyak 3 hari (setiap pagi dan malam, masing-masing dua kali pengukuran). Dilakukan juga penilaian terhadap variabel perancu (obesitas, diabetes, dislipidemia, penurunan fungsi ginjal).Hasil : Sebanyak 21% subyek obesitas, 8,7% mengidap diabetes melitus, 60% mengalami dislipedemia, 14% merokok, tidak ada yang mengalami perburukan fungsi ginjal. Tidak ada hubungan antara obesitas, dislipidemia, merokok, jenis kelamin, merokok dengan kekakuan arteri. Diabetes melitus memliki hubungan yang signifikan dengan kekakuan arteri (p=0,01). Ada perbedaan antar pengukuran tekanan sistolik berdasarkan pengelompokan hari dan waktu, sebaliknya tidak ada perbedaan antar pengukuran tekanan diastolik. Terdapat korelasi antara kekakuan arteri dengan rata-rata tekanan darah diastolik (p=0,028), rata-rata tekanan darah diastolik pagi (p=0,015), koefisien variasi diastolik (p=0,030), koefisien variasi diastolik pagi (p=0,015).Kesimpulan : Tidak terdapat hubungan variabilitas tekanan darah sistolik terhadap kekakuan arteri namun terdapat kecenderungan hubungan yang positif. Terdapat hubungan berbanding terbalik yang signifikan antara variabilitas tekanan darah diastolik dengan kekakuan arteri.

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ABSTRACTBackground : Arterial stiffness is related to higher risk of cardiovascular events. Blood pressure variability using ambulatory blood pressure monitoring has proven as a cardiovascular prognosis predictor and also serves as predictor of arterial stiffness. The study aims to prove the correlation between blood pressure variability measurement using home blood pressure monitoring and arterial stiffness measurement using pulse wave velocityMethods : A cross-sectional study was conducted to 57 subjects with native hypertension between 30-50 years old. Subjects underwent PWV measurement and was monitored for their blood pressure using HBPM for three consecutive days (morning and night BP each repeated two times). Subjects also screened for related confoundings i.e., diabetes, obesity, dyslipidemia, renal function disturbance. Results : As many as 21% subjects is obese, 8.7% had diabetes melitus, 60% had dyslipidemia, 14% is smoker. There is no subjects with renal function disturbance. There is no correlation between obesity, dyslipidemia, smoking habit, and sex to arterial stiffness, whereas diabetes melitus has a strong correlation to arterial stiffness (p=0,01). There was a significant difference between sytolic blood pressure measurement at each group of blood pressure based on day and time, but no difference found between diastolic blood pressure. There is significant correlation between arterial stiffness and mean diastolic pressure, mean morning diastolic pressure, variance coefficient of diastolic pressure, variance coefficient of morning blood pressure.Conclusion : We conclude that HBPM is reliable in measuring blood pressure variability. There is no significant relation of systolic blood pressure variability to arterial stiffness, but there is a tendency of positive correlation. While there is a significant negative correlation between diastolic pressure to arterial stiffness., Background : Arterial stiffness is related to higher risk of cardiovascular events.Blood pressure variability using ambulatory blood pressure monitoring has proven asa cardiovascular prognosis predictor and also serves as predictor of arterial stiffness.The study aims to prove the correlation between blood pressure variabilitymeasurement using home blood pressure monitoring and arterial stiffnessmeasurement using pulse wave velocity Methods : A cross-sectional study was conducted to 57 subjects with nativehypertension between 30-50 years old. Subjects underwent PWV measurement andwas monitored for their blood pressure using HBPM for three consecutive days(morning and night BP each repeated two times). Subjects also screened for relatedconfoundings i.e., diabetes, obesity, dyslipidemia, renal function disturbance. Results : As many as 21% subjects is obese, 8.7% had diabetes melitus, 60% haddyslipidemia, 14% is smoker. There is no subjects with renal function disturbance.There is no correlation between obesity, dyslipidemia, smoking habit, and sex toarterial stiffness, whereas diabetes melitus has a strong correlation to arterial stiffness(p=0,01). There was a significant difference between sytolic blood pressuremeasurement at each group of blood pressure based on day and time, but nodifference found between diastolic blood pressure. There is significant correlationbetween arterial stiffness and mean diastolic pressure, mean morning diastolicpressure, variance coefficient of diastolic pressure, variance coefficient of morningblood pressure.Conclusion : We conclude that HBPM is reliable in measuring blood pressurevariability. There is no significant relation of systolic blood pressure variability toarterial stiffness, but there is a tendency of positive correlation. While there is a significant negative correlation between diastolic pressure to arterial stiffness. ]"