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"Latar Belakang : Kelelahan umum merupakan salah satu faktor risiko untuk terjadi kecelakaan kerja. Peningkatan tekanan darah sering disertai dengan kondisi lelah pada seseorang. Penelitian ini bertujuan untuk mengetahui hubungan perubahan tekanan darah (sistolik, diastolik,MAP) dengan timbulnya kelelahan umum dan faktor-faktor yang berhubungan pada operator heavy dump truck di Binungan yaitu usia, status perkawinan, status gizi, kebiasaan olah raga, kebiasaan merokok, shift kerja, lama kerja,dan stres kerja. Metode : Penelitian ini menggunakan desain cross sectional dengan sampel sebanyak 125 responden yang dipilih secara propotional random. Pengumpulan data dilakukan dengan wawancara, data medical check up dan kuesioner. Pengukuran kelelahan dan tekanan darah menggunakan tensimeter dan waktu reaksi L77 Lakassidaya yang diukur sebelum dan sesudah bekerja. Analisis data menggunakan uji regresi linear untuk variabel numerik dan uji regresi logistik untuk variabel katagorik. Hasil : Prevalensi kelelahan umum operator sebelum kerja sebesar 20% dan sesudah kerja 22.4% dengan tingkat kelelahan ringan. Faktor yang berhubungan dengan kelelahan pada operator yaitu masa kerja > 3 tahun (r = 0.268) dengan nilai adjusted R square sebesar 6.4%. Faktor-faktor lain yang diteliti tidak berhubungan dengan kelelahan umum. Kesimpulan : Perubahan tekanan darah tidak berhubungan dengan kelelahan umum. Faktor yang berhubungan dengan kelelahan umum adalah masa kerja.

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Background : Increased blood pressure is often associated with general fatigue which one of risk factors for accidents in the workplace. The aim of this study is to determine the relationship blood pressure (systolic, diastolic, and MAP) with general fatigue and related factors related such as age, marital status, nutritional status, exercise, smoke, shift work, working periode, and stres.

Methodology: this study used a cross-sectional design with 125 respondents selected by proportional random sampling. Data collected through interviews, medical check-up data and questionnaires. Fatigue and blood pressure measurement using a sphygmomanometer and Lakassidaya L77 reaction time measured before and after work. Analysis data using linear regression test for numerical variables and logistic regression for catagorical variables.

Result : The prevalence of general fatigue in operators before work is 20% and 22.4% after working with mild fatigue level. Factors that related to fatigue is working period > 3 years with adjusted R-square value of 6.4% (r =0.268). Other factors are not associated with general fatigue.

Conclusions: Blood pressure are not associated with general fatigue. Working periode is associated with general fatigue."

"ABSTRAKIsometric Handgrip Exercise merupakan salah satu terapi non farmakologis yang dikembangkan untuk menurunkan tekanan darah pasien hipertensi. Penelitian ini bertujuan untuk mengidentifikasi pengaruh isometric handgrip exercise terhadap perubahan tekanan darah pasien hipertensi. Desain penelitian quasi experiment dengan pendekatan control group pretest posttest design pada 44 responden meliputi kelompok kontrol dan kelompok intervensi. Kelompok intervensi mendapatkan latihan handgrip selama 3 menit, sekali sehari dan dilakukan selama 5 hari. Kedua kelompok dilakukan pengukuran tekanan darah sebelum dan setelah latihan pada hari 1 dan ke 5. Hasil penelitian menunjukkan bahwa ada pengaruh isometric handgrip exercise (IHG) terhadap perubahan tekanan darah pasien hipertensi. kesimpulan penelitian ini adalah isometric handgrip exercise secara bermakna dapat menurunkan tekanan darah sistolik dan tekanan darah diastolik. Hasil penelitian ini diharapakan menjadi dasar isometric handgrip exercise (IHG) sebagai intervensi keperawatan yang mandiri dan inovatif pada asuhan keperawatan klien dengan hipertensi

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ABSTRACTAn Isometric Handgrip Exercise is one of the non-pharmacological therapies that is developed to lower blood pressure in hypertensive patients. The aim of the study was to identify the effect of isometric handgrip exercise on changes in blood pressure in hypertensive patients. A Quasi experimental research design approach pretest posttest control group design was employed with 44 respondents included control and intervention groups. The intervention group got handgrip exercise for 3 minutes, once a day and performed for 5 days. Both groups performed measurements of blood pressure before and after exercise on days 1 and 5. The results showed that there is influence of isometric handgrip exercise on changes in blood pressure in hypertensive patients. Conclusion of this study is the isometric handgrip exercise (IHG) can significantly lower systolic blood pressure and diastolic blood pressure. The result of this study recommended that isometric handgrip exercise (IHG) can bean independen and innovative therapeutic nursing intervension in nursing care of patients with hypertension."

"Latar belakang. Stenosis mitral masih menjadi masalah kesehatan di negara berkembang dengan hipertensi pulmoner sebagai salah satu komplikasinya. Disfungsi endothelium berperan penting pada hipertensi pulmoner dimana terdapat peningkatan produksi mediator vasoaktif. Endotelin-1 merupakan vasokonstriktor yang kuat dan berperan penting dalam hipertensi pulmoner. Metode. Penelitian ini merupakan studi kohort pada 32 pasien stenosis mitral bermakna dengan hipertensi pulmoner sedang-berat yang menjalani pembedahan katup mitral di Pusat Jantung Nasional Harapan Kita dari bulan April hingga November 2014. Dilakukan analisa statistik untuk mencari hubungan antara kadar endotelin-1 dengan tekanan sistolik arteri pulmoner pasca operasi. Hasil. Terdapat korelasi antara kadar endotelin-1 pre operasi dengan tekanan sistolik arteri pulmoner pasca operasi (r 0,387 dengan p 0,029). Analisa regresi linear antara kadar endotelin-1 pre operasi dengan tekanan sistolik arteri pulmoner pasca operasi (adjusted analysis sesuai usia, jenis kelamin, hipertensi, diabetes melitus, dislipidemia, atrial fibrilasi dan waktu cross clamp aorta dan penggunaan mesin cardiopulmonay bypass menunjukan nilai koefisien β 11,4 dengan IK 95% 2,9-19,9 dan nilai p 0,011. Analisa regresi linear antara kadar endotelin-1 pasca operasi dengan tekanan sistolik arteri pulmoner pasca operasi (adjusted analysis) menunjukan nilai koefisien β 4,3 dengan IK 95% -5,4-13,9 dan nilai p 0,367. Analisa regresi linear antara perubahan kadar endotelin-1 pre dan pasca operasi dengan tekanan sistolik arteri pulmoner pasca operasi (adjusted analysis) mendapatkan nilai koefisien β 12,5 dengan IK 95% 0,5-24,4 dan p 0,041. Kesimpulan. Kadar endotelin-1 pre operasi berhubungan dengan tekanan sistolik arteri pulmoner pasca operasi mitral pada pasien mitral stenosis dengan hipertensi pulmoner.

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Background. Mitral stenosis is still the major health problem in developing countries with pulmonary hypertension as one of the complications. Endothelial dysfunction play significant role in pulmonary hypertension where the production of vasoactive mediators increase. Endothelin-1 is a very strong vasoconstrictor which play role in pulmonary hypertension.

Methods. A cohort study in 32 patients with significant mitral stenosis complicated with moderate-severe pulmonary hypertension who underwent mitral valve surgery in National Cardiovascular Center Harapan Kita from April to November 2014. Statistical analysis is done to explore the correlation between endothelin-1 level and systolic pulmonary arterial pressure post surgery.

Results. There was correlation between endothelin-1 pre surgery with systolic pulmonary arterypressure after surgery (r 0,387 and p value 0,029). Linear regression analysis of the endothelin-1 level pre surgery with systolic pulmonary artery pressure post surgery (adjusted analysis to age, sex, hypertension, diabetes mellitus, dyslipidemia atrial fibrillation, aortic cross clamp time and cardio-pulmonary bypass time) with β coefficient 11,4 with 95% confidence interval 2,9-19,9 and p 0,011. Linear regression analysis between endothelin-1 level post surgery with systolic pulmonary artery pressure (adjusted analysis) showed β coefficient 4,3 with 95% confidence interval -5,4-13,9 and p 0,367. Linear regression analysis between the difference of endothelin-1 level post and pre surgery and systolic pulmonary artery pressure post surgery (adjusted analysis) showed β coefficient 4,3 with 95% confidence interval 0,5-24,4 and p 0,041.

Conclusion. Endothelin-1 level pre surgery is correlated with systolic pulmonary artery pressure post mitral valve surgery in mitral stenosis patients with pulmonary hypertension."

"Pendahuluan: Hipertensi, hiperurisemia, DM tipe 2, obesitas dan dislipidemia merupakan faktor risiko stroke yang dapat dimodifikasi. Selain disfagia yang dialami pasien, faktor risiko stroke perlu dipertimbangkan juga dalam memberikan nutrisi untuk mencegah serangan ulang stroke.Presentasi kasus: Empat kasus stroke hemoragik dengan hipertensi yang membutuhkan tatalaksana nutrisi selama perawatan di RSUT. Kasus pertama seorang laki-laki berusia 60 tahun, dengan hiperurisemia. Kasus kedua seorang perempuan berusia 56 tahun, dengan DM tipe 2 dan dislipidemia. Kasus ketiga seorang perempuan berusia 49 tahun, dengan obes II dan kasus keempat seorang laki-laki berusia 65 tahun, dengan dislipidemia dan stroke berulang.Kesimpulan: Tatalaksana nutrisi yang diberikan dapat membantu pengobatan pasien dan meningkatkan kapasitas fungsional pasien.

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Background: Hypertension, hyperuricemia, type 2 diabetes, obesity and dyslipidemia are risk factors for stroke that can be modified. Besides dysphagia, experienced by patient, other stroke risk factors need to be considered in providing nutrition to prevent repeated strokes attacks.Case presentation: Four patients of hemorrhagic stroke with hypertension required nutritional support during treatment in RSUT. The first patient was male, aged 60 years, with hyperuricemia. The second patient was female, aged 56 years, with type 2 diabetes and dyslipidemia. The third patient was female, aged 49 years, with obesity grade II and fourth patient was male, aged 65 years, with dyslipidemia and recurrent strokes.Conclusion: Given nutritional support could help the patient treatment process and improve the patient's functional capacity."

"Hipertensi adalah suatu kondisi dimana terjadi peningkatan tekanan darah yang mengakibatkan berbagai penyakit yang penyebabnya multifaktorial. Riset ini bertujuan untuk mengamati dan mengidentifikasi prevalensi hipertensi dengan hubungannya dengan faktor-faktor terkait, yaitu demografi (usia, jenis kelamin, tingkat pendidikan dan pekerjaan) dan gaya hidup (merokok, aktivitas fisik, konsumsi alkohol, BMI) dengan menggunakan desain cross-sectional pada penduduk yang tinggal di Kelurahan Kayu Putih, Jakarta Timur. Hasil yang didapatkan adalah prevalensi hipertensi sebesar 25,1% di antara 432 responden dengan proporsi wanita lebih banyak yang mengalami hipertensi dibandingkan dengan laki-laki (p = 0,045).

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Hypertension is a condition where there is blood pressure elevation resulting risks of having several diseases which the causes are multifactorial. This study aims to observe and identify the prevalence of hypertension and its relation to several factors, which are demographic (age, gender, level of education and occupation) and lifestyle (smoking, physical activity, alcohol consumption, BMI) by using cross-sectional study to people who live in Kelurahan Kayu Putih, East Jakarta. The result shows that prevalence of hypertension is 25.1% among 432 respondents, with females are more likely to have hypertension compared to male (p=0.045)."

"Hipertensi merupakan salah satu isu penyebab dari penyakit kardiovaskuler dengan prevalensi yang tinggi. Berdasarkan data dari Dinas Kesehatan Kota Sukabumi, diketahui Puskesmas Benteng merupakan puskesmas dengan prevalensi hipertensi tertinggi (16,8 %) tahun 2014 di Kota Sukabumi. Tujuan dari penelitian ini yaitu untuk mengetahui faktor-faktor yang berhubungan dengan kejadian hipertensi di Puskesmas Benteng Kota Sukabumi. Jenis penelitian yang digunakan dalam penelitian ini adalah analitik korelatif dengan desain cross sectional. Jumlah sampel sebanyak 195 responden. Alat pengumpulan data yang digunakan yaitu pemeriksaan fisik (tekanan darah, berat badan dan tinggi badan) dan isian kuesioner. Pengukuran faktor stress menggunakan Perceived Stress Scale. Hasil penelitian menunjukkan bahwa faktor-faktor risiko yang memiliki hubungan bermakna dengan kejadian hipertensi yaitu umur, obesitas, olahraga, kebiasaan mengonsumsi makanan berasa asin, kebiasaan mengonsumsi makanan berlemak, dan merokok. Penelitian ini menyarankan kepada perawat sebagai salah satu promotor kesehatan untuk berperan dalam mempromosikan gaya hidup sehat kepada masyarakat terkait dengan hipertensi dan menjamin keberlanjutan sistem deteksi dini hipertensi dan komplikasinya.

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Hypertension is one of the issues that causes of cardiovascular disease with high prevalence. Based on data from the Health Department Sukabumi, Benteng Public Health Center is known as the highest prevalence of hypertension (16.8%)2014 in Sukabumi. The aimed of this study was to determine the factors associated with hypertension in the Benteng Health Center Fort Sukabumi. The type of research which used was correlative analytic with cross sectional design. The total sample was 195 respondents. Data collection tools in this study were the form of physical examination (blood pressure, weight and height) and a questionnaire. Stress measurement which used wa the Perceived Stress Scale. The results showed that the risk factors that have a significant relationship with the occurrence of hypertension such as age, obesity, exercise, habit of eating salty foods, fatty foods eating habits, and smoking. This study suggests the nurse to promote healthy lifestyles to the public associated with hypertension and ensure the sustainability of the system of early detection of hypertension and its complications."

"Deteksi dini hipertensi yang baik dapat mencegah terjadinya hipertensi dan komplikasinya. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan perilaku deteksi dini hipertensi pada orang dewasa di Posbindu PTM Kota Depok Jawa Barat. Penelitian ini menggunakan desain cross sectional dengan sampel penelitian 110 responden dewasayang diambil secara proporsional random sampling. Hasil penelitian menunjukkan, dengan α< 0,05, ada hubungan antara usia, persepsi terhadap hipertensi, dukungan keluarga dan dukungan lingkungan dengan perilaku deteksi dini hipertensi di Posbindu PTM. Dukungan lingkungan merupakan faktor yang paling dominan berhubungan dengan perilaku deteksi dini hipertensi setelah dikontrol variabel usia, persepsi dan dukungan keluarga. Pemberdayaan sumber-sumber yang ada di masyarakat sangat diperlukan dalam meningkatkan perilaku deteksi dini hipertensi di Posbindu PTM.

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Early detection of hypertension can prevent the prevalence of hypertension and its complications. The purpose of this study was to identify the factors associated with the behavior of early detection of hypertension in adults in Posbindu PTM Depok, West Java. This study used cross sectional design with a total samples of 110 adults, who were taken randomly using proportional random sampling.

The result showed that age, perception on hypertension, family support and environmental support were related to the behavior of early detection of hypertension in Posbindu PTM (α< 0,05). Environmental support is the dominant factor associated with the behavior of early detection of hypertension in adults after being controlled by age, perceptions and family support variables. Empowerment of existing resources in the community is needed to improve the behavior of early detection of hypertension in Posbindu PTM."

"[ABSTRAKPrevalensi dan mortalitas gagal ginjal kronis pada masyarakat urban di indonesia mengalamipeningkatan dari tahun ke tahun. Penulisan karya ilmiah ini bertujuan untuk menganalisis asuhankeperawatan dengan pendekatan Keperawatan Kesehatan Masyarakat Perkotaan pada areaKeperawatan Medikal Bedah pada klien dengan gagal ginjal kronis dengan komplikasi hipertensi.Perawat dalam melakukan asuhan keperawatan melakukan tindakan preventif baik primer,sekunder, ataupun tersier. Masalah keperawatan yang ditemukan meliputi kelebihan volumecairan, penurunan curah jantung, nyeri akut, dan risiko perubahan nutrisi kurang dari kebutuhantubuh. Manajemen keperawatan terkait hipertensi yang dilakukan meliputi modifikasi gaya hidupmelalui diet, teknik relaksasi, dan aktivitas. Setelah dilakukan asuhan keperawatan pada pasiengagal ginjal kronis, terdapat penurunan nilai tekanan darah pasien meskipun belum mencapaitarget yang dianjurkan. Perawat dapat memberikan asuhan keperawatan menggunakan pendekatankeperawatan kesehatan masyarakat perkotaan untuk dapat memperkirakan perilaku berisiko terkaitkomplikasi yang dapat terjadi, seperti hipertensi dan penyakit kardiovaskular lainnya, serta tingkatkepatuhan terhadap terapi yang diberikan. Asuhan keperawatan tersebut dilakukan gunamendukung upaya pencegahan komplikasi dan peningkatan kualitas hidup pasien dengan gagalginjal kronis.

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ABSTRACTThe prevalence and mortality of chronic renal failure in urban society in Indonesia has increasedfrom year to year. This paper aimed to analyze the nursing care with the approach of the UrbanPublic Health Nursing in the Medical Surgical Nursing setting in clients with chronic renal failurewith complication of hypertension. Nurses performed preventive action both primary, secondary,or tertiary. Various nursing problems were revealed including fluid volume excess, decreasedcardiac output, acute pain, and risk for imbalanced nutrition: less than body. The application ofnursing management related hypertension included lifestyle modification, diet, relaxationtechniques, and activity. The result of implementation of nursing intervention to the patients,showed that there was a decrease in the patient's blood pressure despite not reaching therecommended targets. Nurses can provide nursing care using urban nursing health care approachto be able to estimate the risk behaviors of patients related complication that can happen, likehypertension,and other cardiovascular disease and the level of adherence to therapy. The nursingcare is done in order to support efforts to prevent complications and improve the quality of life ofpatients with chronic renal failure.;The prevalence and mortality of chronic renal failure in urban society in Indonesia has increasedfrom year to year. This paper aimed to analyze the nursing care with the approach of the UrbanPublic Health Nursing in the Medical Surgical Nursing setting in clients with chronic renal failurewith complication of hypertension. Nurses performed preventive action both primary, secondary,or tertiary. Various nursing problems were revealed including fluid volume excess, decreasedcardiac output, acute pain, and risk for imbalanced nutrition: less than body. The application ofnursing management related hypertension included lifestyle modification, diet, relaxationtechniques, and activity. The result of implementation of nursing intervention to the patients,showed that there was a decrease in the patient's blood pressure despite not reaching therecommended targets. Nurses can provide nursing care using urban nursing health care approachto be able to estimate the risk behaviors of patients related complication that can happen, likehypertension,and other cardiovascular disease and the level of adherence to therapy. The nursingcare is done in order to support efforts to prevent complications and improve the quality of life ofpatients with chronic renal failure., The prevalence and mortality of chronic renal failure in urban society in Indonesia has increasedfrom year to year. This paper aimed to analyze the nursing care with the approach of the UrbanPublic Health Nursing in the Medical Surgical Nursing setting in clients with chronic renal failurewith complication of hypertension. Nurses performed preventive action both primary, secondary,or tertiary. Various nursing problems were revealed including fluid volume excess, decreasedcardiac output, acute pain, and risk for imbalanced nutrition: less than body. The application ofnursing management related hypertension included lifestyle modification, diet, relaxationtechniques, and activity. The result of implementation of nursing intervention to the patients,showed that there was a decrease in the patient's blood pressure despite not reaching therecommended targets. Nurses can provide nursing care using urban nursing health care approachto be able to estimate the risk behaviors of patients related complication that can happen, likehypertension,and other cardiovascular disease and the level of adherence to therapy. The nursingcare is done in order to support efforts to prevent complications and improve the quality of life ofpatients with chronic renal failure.]"

"[ABSTRAKLatar belakang. Patogenesis dari pre-diabetes terhadap vascular sudah terjadi sejak awal sebelum ada manifestasi klinis sehingga sudah seharusnya ditatalaksana sejak awal untuk mencegah komplikasi lanjut. Metformin sebagai terapi antihiperglikemik oral memiliki efek pleiotropik yang dapat memperbaiki disfungsi endotel pada keadaan resistensi insulin. Metode. Penelitian ini merupakan suatu studi longitudinal observasi-intervensi non randomisasi. Observasi dilakukan pada 62 pasien hipertensi dan IGT di Pusat Jantung Nasional Harapan Kita dari bulan Agustus 2014 hingga bulan Januari 2015. Pasien dibagi menjadi tiga kelompok yaitu plasebo (n=18 orang), kelompok metformin 1x500 mg (n=21 orang) dan kelompok metformin 2x500 mg (n=23 orang). Pemeriksaan FMD diambil dua kali (0 dan 3 bulan). Dilakukan analisis statistik untuk menilai efek pemberian Metformin yang dinilai dengan delta FMD dan melihat perbandingan efektifitas dosis 1x500 mg dibandingkan dengan dosis 2x500 mg.Hasil. Tidak terdapat perbedaan bermakna pada data dasar ketiga kelompok dalam hal umur, jenis kelamin dan terapi hipertensi yang diberikan. Nilai delta FMD menunjukkan peningkatan yang signifikan pada kelompok Metformin 2x500 mg (p <0,001). Analisa regresi linear (adjusted analysis; sesuai usia, jenis kelamin, riwayat merokok dan BMI) menunjukkan koefisiensi 0,89 dengan nilai p 0,394 pada kelompok metformin 1x500 mg dan koefisien 7,88 dengan nilai p <0,001 pada kelompok metformin 2x500 mg.Kesimpulan. Pemberian Metformin 2x500 mg pada subjek pre-diabetes dengan hipertensi dapat memperbaiki fungsi endothel pembuluh darah yang ditandai dengan perbaikan nilai FMD setelah 3 bulan.

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ABSTRACTBackground : The vascular effect of insulin resistance had been known to cause serious damage on endothelial function, especially nitric oxide (NO) system, that may cause an earlier onset of cardiovascular disease.Objective : To explore the pleiotropic effect of Metformin on improving endothelial function.Method and Results : A quasi experimental study of 62 hypertensive and pre-diabetic (IGT) patients showed a significant improvement of Flow Mediated Dilatation (FMD) within 3 months in those who received added theraphy of Metformin 500 mg twice daily (n=23) on their routine anti-hypertensive drugs (p<0,001). It also showed a moderate correlation between improvement of FMD that reflects the endothelial function with good achivement of targeted blood pressure (R 0,421). Linear regression analysis (adjusted analysis to confounder factors such as age, sex, BMI, history of smoking, aspilet added therapy, anti-hypertensive drugs) showed Metformin as the only factor that influenced the improvement FMD (OR 7,88; p<0,001).Conclusion : This study showed that Metformin 2x500 mg as an add-on therapy in hypertensive pre-diabetic subject plays a positive role in improving the endothelial function as seen on the FMD measurement, Background : The vascular effect of insulin resistance had been known to cause serious damage on endothelial function, especially nitric oxide (NO) system, that may cause an earlier onset of cardiovascular disease.Objective : To explore the pleiotropic effect of Metformin on improving endothelial function.Method and Results : A quasi experimental study of 62 hypertensive and pre-diabetic (IGT) patients showed a significant improvement of Flow Mediated Dilatation (FMD) within 3 months in those who received added theraphy of Metformin 500 mg twice daily (n=23) on their routine anti-hypertensive drugs (p<0,001). It also showed a moderate correlation between improvement of FMD that reflects the endothelial function with good achivement of targeted blood pressure (R 0,421). Linear regression analysis (adjusted analysis to confounder factors such as age, sex, BMI, history of smoking, aspilet added therapy, anti-hypertensive drugs) showed Metformin as the only factor that influenced the improvement FMD (OR 7,88; p<0,001).Conclusion : This study showed that Metformin 2x500 mg as an add-on therapy in hypertensive pre-diabetic subject plays a positive role in improving the endothelial function as seen on the FMD measurement]"