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"Cardiovascular disease has become the first cause of death. Highest morbidity is found in the age, and among cardiovascular diseases, prevalence of hypertension is the highest. Many studies on the relationship between nutritional factors and hypertension have been done, but studies to observe determinants of hypertension in Indonesia are lacking. Therefore, there is an urgent need to elaborate information on various hypertension risk factors in the Indonesian elderly, which will allow the policy makers to provide appropriate intervention programs.

The primary purpose of this study was to investigate various determinants of hypertension in the Indonesian elderly with different nutritional status.

A cross sectional study was undertaken in Jakarta and 5 other cities with total sample of 1261 elderly using multistage random sampling. Subjects were recruited from elderly population in Jakarta, Padang, Bandung, Jogyakarta, Denpasar and Makasar. Data were collected through interview using structured questionnaires, anthropometrics measurements, biochemical blood and urine analysis, and blood pressure measurements. Daily nutrients intake was analyzed using WorldFood2 Dietary Assessment Program. Data were analyzed by using SPSS programs for Windows version 7.5; General Linear Model, Multiple linear regression and logistic regression analysis were performed to determine the predictive power of independent variables for outcome variables. Prevalence of hypertension found in the study was quite high, more than 50% of the study population for both men and women. This study showed significant differences of determinant and predictive factors of blood pressure between elderly with Body Mass Index (BMI) < 25 kg/m2 and BMI? 25 kg/m2. Prevalence of systolic and diastolic hypertension was higher in the elderly with BMI < 25 kg/lm2 than in the elderly with BMI 25 kg/m2. BMI was a significant determinant for diastolic blood pressure in elderly with BMI > 25 kg/m2. There was a positive association between blood pressure and Waist to hip ratio (WHR) irrespective of BMI value.

Plasma LDL cholesterol >160 mg/dl increased the risk of having systolic hypertension 1.5 to 2 times in the elderly with BMI < 25 kg/m2 after the age of 65 years and increased the risk of having diastolic hypertension 1.5 times. Plasma triglycerides > 200 mg/dl increased the risk of having systolic hypertension 1.7 and 2.5 times in elderly with BMI 25 kg/m2 and in elderly with BMI? 25 kg/m2 respectively, after the age of 65 years and increased the risk of having diastolic hypertension Ft, 1.7 times. Ratio of total cholesterol to HDL cholesterol > 5 increased the risk of having hypertension 1.8 times in elderly with BMI? 25 kg/m2. Plasma HDL cholesterol < 35 mg/dl in elderly with BMI < 25 kg/m2 increased the risk of hypertension approximately 2.4 times. In elderly with BMI < 25 kgmm2, monounsaturated fatty acid (MUFA) had negative correlation (protecting effect) with diastolic and systolic blood pressure. Saturated fatty acid (SFA) had positive correlation with diastolic blood pressure and systolic blood pressure. Cholesterol intake had positive correlation with diastolic blood pressure. Multivariate analyses in this study did not find significant correlation between energy intakes with blood pressure. Although no significant correlation was found between protein intakes with blood pressure, this study showed that arginine intake had protecting effect against hypertension. The study also showed that calcium and potassium intake had negative correlation with DBP and SBP respectively in elderly with BMI > 25 kg/m2. In elderly with BMI < 25 kg/m2 sodium intake had positive correlation with SBP. This study also demonstrated that sport index had negative correlation (protecting effect) with diastolic blood pressure.

Nutrition education to elderly group should emphasize healthy nutrients with protecting effect against hypertension and avoid nutrients with positive correlation to hypertension. Suggestion for sodium restriction especially in the elderly with BMI < 25 kg/m2, and proper physical/sport activity as a protecting factor against hypertension is very important for the elderly. Regular check of blood pressure and plasma lipid should be conducted and Public Health Centers equipped with appropriate laboratory facilities, for early detection of hypertensive risk factors. BMI category should be considered in hypertension program since there were differences of determinant factors of hypertension between different categories of BMI. Future studies should be directed on public health and nutrition intervention to the elderly community."

"Tujuan penelitian ini adalah untuk mengetahui determinan tekanan darah sistolik pada kelompok lanjut usia pria. Suatu studi dengan rancangan 'cross sectional' dilakukan di 4 kota besar di Indonesia dengan menggunakan inetoda 'multistage random sampling'. Jumlah responden 320 orang lanjut usia pria, yang merupakan sub-sampel dari 981 responden pada penelitian yang lebih besar. Pengumpulan data dilakukan dengan pengukuran antropometri, analisa biokimia darah, analisa asupan makanan, dan pengukitran indeks aktivitas dan angka stress. Penentuan determinan tekanan darah sistolik pada kelompok lanjut usia pria, dilakukan dengan menggunakan 2 tehnik analisa statistik multivariat; regesi linear ganda langsung pada independen variabe! awal, dan regesi linear ganda yang dilakukan pada komponen-komponen yang dihasilkan dari analisa faktor. Kedua tehnik analisa statistik ini menghasilkan gatnbaran detenninan tekanan darah sistolik yang lidak bertentangan. Analisa regesi linear ganda langsung pada independen variabel awal menghasilkan massa lemak tubuh, dan LDL kolesterol sebagai determinan tekanan darah sistolik pada lanjut usia pria. Analisa regesi linear ganda menggunakan komponen-komponen yang dihasilkan dari analisa faktor menghasilkan massa lemak tubuh, indeks massa mbuh, junilah massa lemak bawah kulit dan lingkar perut sebagai detenninan tekanan darah sistolik pada lanjut usia pria. (Med J Indones 2006; 15:115-20)

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The objective of this study was to assess the determinants of systolic blood pressure in elderly men. A cross sectional study was undertaken in 4 big cities in Indonesia using multistage random sampling. The respondents were 320 elderly men who were the sub-sample of 981 sample of a larger population study. Data were collected through anthropometric measurements, biochemical blood analysis, nutrient intake assessment, activity index and stress score. Two type of statistical analysis techniques were used to determine the determinants of systolic blood pressure in elderly men; multiple regression analysis and factor analysis. This study shows thai determinants of systolic blood pressure, analyzed with these two types of analysis, multiple regression and factor analysis, resulting in no contradictory result. Direct multiple regression analysis to all independent variables showed that there was correlation between systolic blood pressure with fat mass, and LDL cholesterol. Multiple regression analysis to components resulting from factor analysis showed that there was positive correlation between systolic blood pressure with fat mass, body mass index (BMI), sum of skin-folds and waist circumference. (Med J Indones 2006; 15:115-20)"

"Ketersediaan data tentang faktor?faktor yang berhubungan dengan metabolik sindrom pada kelompok lanjut usia di Indonesia sangat terbatas. Data tersebut sangat diperlukan dalam upaya pencegahan penyakit kardiovaskular. Tujuan penelitian ini untuk mengetahui prevalensi metabolik sindrom dan hubungan pengukuran antropometrik, profil lipid, tekanan darah, asupan makanan dan aktifitas fisik dengan metabolik sindrom pada kelompok lanjut usia. Suatu studi dengan rancangan ?cross sectional? dilakukan di Jakarta dengan menggunakan metoda ?multistage random sampling?. Jumlah responden 352 orang lanjut usia wanita dan 137 orang lanjut usia pria. Pengumpulan data dilakukan dengan pengukuran antropometri, analisa biokimia darah, analisa asupan makanan dan pengukuran indeks aktivitas. Prevalensi metabolik adalah 18.2% pada lanjut usia wanita dan 6.6% pada lanjut usia pria. Studi ini menunjukkan bahwa pada lanjut usia yang mempunyai berat badan berlebih, risiko untuk mempunyai metabolik sindrom hampir empat kali lebih tinggi dibanding lanjut usia dengan indeks masa tubuh normal (rasio odds suaian = 3.98; 95% confidence interval 2.23 - 7.10). Lanjut usia dengan plasma total kolesterol ≥ 240 mg/dl, risiko untuk mendapatkan metabolik sindrom 2.7 kali lebih tinggi dibandingkan yang mempunyai plasma total kolesterol < 240 mg/dl. Sementara lanjut usia yang mempunyai rasio total kolesterol terhadap HDL kolesterol ≥ 5, risiko untuk menderita metabolik sindrom dua kali lebih tinggi dibandingkan yang rasionya < 5. Studi ini menunjukkan bahwa pemeriksaan profil lipid, pengukuran tekanan darah dan pengukuran antropometrik sederhana yang teratur pada kelompok lanjut usia penting dilakukan untuk mendeteksi risiko terjadinya sindroma metabolik. (Med J Indones 2007; 16:195-200)

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Available data on metabolic syndrome amongst the aged Indonesian population are limited, despite the importance of these data for cardio vascular disease (CVD) preventive measures. The objective of this study was to assess prevalence of metabolic syndrome and the associations between anthropometric measurements, lipid profiles, blood pressure, nutrient intakes and physical activity and metabolic syndrome in the elderly. A cross-sectional study was undertaken from January to April 2000 at selected Public Health Centers in Jakarta using multistage random sampling. Data were collected through anthropometric measurements, biochemical blood analysis, nutrient intake assessment and activity index. The subjects consisted of 352 females and 137 males. Prevalence of metabolic syndrome among females was 18.2% and 6.6% in males. This study shows metabolic syndrome was associated with gender, body mass index, total cholesterol and the ratio of total to HDL-cholesterol. Elderly who were overweight based on body mass index (BMI) had almost a four-fold increased risk for metabolic syndrome (adjusted odds ratio = 3.98; 95% confidence interval 2.23 - 7.10). Those who had plasma total cholesterol ≥ 240 mg/dl had a 2.7 times greater risk of having metabolic syndrome than those with plasma total cholesterol < 240 mg/dl. Furthermore, in terms of the ratio of total to HDL cholesterol, those who had a ratio ≥ 5 compared to a ratio < 5 had two-fold increased risk for metabolic syndrome. In conclusion, this study shows the importance of routine checks of lipid profile, blood pressure and simple anthropometric assessment to detect the risk of metabolic syndrome in the elderly. (Med J Indones 2007; 16:195-200)"

"Penyakit kardiovaskular telah menjadi penyebab kematian utama di Indonesia dan prevalensi yang tinggi didapatkan pada kelompok lanjut usia. Studi mengenai hubungan antara dislipidemia dan penyakit kardiovaskular pada kelompok lanjut usia masih jarang dilakukan di Indonesia. Informasi mengenai hubungan dislipidemia dengan penyakit kardisvaskuler sangat diperlukan agar para pengelola program dapat menyusun program penanggulangan penyakit kardiovaskuler yang lebih tepat. Tujuan utama dari studi ini adalah mengetahui prevaliensi dislipidemia pad akelompok lanut usia di kota Padang, daerah terhadap 205 responden lanjut usia di kota Padang. Pengambilan sampel menggunakan metode multistage random sampling. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner terstruktur pengukuran antropometri, pengukuran kadar lemah darah dan pengukuran tekanan darah. Analisa data menggunakan SPSS program versi 7.5. Hasil penelitian menunjukkan prevalensi dislipidemia yang tinggi, yaitu lebih dari 50% (total kolesterol > 240 mg/dl dan LDL koleksterol > 160 mg/dl). Rasio total kolesterol terhadap HDL koleksterol yang tinggi (> 5), didapatkan pada 47.6% populasi penelitian. Penyuluhan kesehatan terhadap kelompok lanjut usia agar menekankan pada pemilihan makan sehar dan pentingnya menjaga aktivitas fisik yang memadai yang mempunyai efek proteksi terhadap dislipidemia. Pemerikaan kadar lemak darah secara teratur perlu dilakukan sebagai deteksi dini faktor penyakit kardiovaskuler.

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Cardiovascular disease has become the first cause of death. Highest morbidity is found in the elderly. Many studies on the relationship between dyslipidemia and cardiovascular disease has been done, however studies on prevalences of dyslipidemia among the elderly in Indonesia are lacking. Therefore, there is an urgent neeg to obtain information on dyslipidemia in the Indonesia elderly, which will allow the policy makers top provide appropriate intervention programs againts cardiovascular diseases. The primary purpose of this study was to the observe prevalence of dyslipidemia among the aged in Padang, an area with high prevalence of cardiovascular diseases. A cross sectional study was undertaken in Padang with a total sample of 205 elderly using multisatage random sampling. Subjects were recruited from free living elderly population. Data were collected through interviews using structured questionaires, anthropometric measurements, biochemical blood analysis, and blood pressure measurements. Data were analyzed by using SPSS programs for Windows version 7.5.Prevalence of dyslipidemia (hypercholesterolemia and LDL-cholesterolemia) found in the study was quite high, more than 50 of the study population. The ration of total cholesterol to HDL cholesterol (> 5) was also quite high in the study population ( 47.6%). Nutrition education to elderly group should emphasize healthy nutrients with protecting effect against dyslipidemia. Suggestion for proper physical activity as a protecting factor against hypertension is very important for the elderly. Regular checkinh of plasma lipid should be conducted for early detection of cardiovascular desease risk factors. Future studies should be directed on public health and nutrition intervention to the elderly community."

"Data tentang faktor-faktor yang berhubungan dengan sindrom metabolik pada kelompok eksekutif di Indonesia yang diperlukan untuk upaya pencegahan penyakit kardiovaskular sangat terbatas. Penelitian ini bertujuan untuk mengetahui prevalensi dan determinan sindrom metabolik pada kelompok eksekutif. Penelitian dilakukan di Jakarta dan sekitarnya dengan menggunakan rancangan cross sectional. Jumlah responden yaitu 220 orang eksekutif laki-laki dan 68 orang eksekutif wanita. Pengumpulan data dilakukan dengan pengukuran antropometri, analisis biokimia darah, analisis asupan makanan, pengukuran angka stres, dan pengukuran indeks aktivitas. Analisis regresi logistik ganda dilakukan untuk mengetahui hubungan beberapa independen variabel dengan dependen variabel. Analisis ini menghasilkan indeks massa tubuh (overweight, odds ratio (OR) = 5,54; obesitas, OR = 7,44) dan rasio total kolesterol/high density lipoprotein (HDL)-kolesterol (OR = 8,83) sebagai determinan sindrom metabolik pada kelompok eksekutif. Penelitian ini menunjukkan bahwa pemeriksaan profil lipid dan pengukuran antropometri sederhana yang teratur pada kelompok eksekutif penting dilakukan untuk mendeteksi risiko sindrom metabolik.

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Available datas on metabolic syndrome among Indonesian executives are limited, despite the fact of the importance of these data for cardiovaskular prevention. The objective of this study was to assess prevalence of metabolic syndrome and its associations between anthropometric measures, lipid profiles, blood pressure, nutrient intakes, and life style in executive group. A cross sectional study was undertaken in some factories in Jakarta, using multistage random sampling. The respondents were 287 executives, 219 male and 68 female. Data were collected through anthropometric measurements, biochemical blood analysis, nutrient intake, stress score, and activity index assessment. Multiple logistic regression analysis used to assess associations between independent variables and metabolic syndrome. This study showed that body mass index (overweight, odds ratio (OR) = 5,54; obesity, OR = 7,44) and ratio serum total cholesterol to high density lipoprotein (HDL)-cholesterol (OR = 8,83) were potential determinants of metabolic syndrome. This study shows the importance of routine check of lipid profile, blood pressure, and simple anthropometric assessment to detect the risk of metabolic syndrome in the elderly."