ABSTRAK
Latar Belakang : Hipertensi merupakan faktor resiko utama penyakit kardiovaskular, terutama sindrom koroner akut dan stroke. Peningkatan konsumsi garam berhubungandengan kenaikan tekanan darah. Beberapa studi randomized-controlled trial (RCT)menyatakan bahwa konsumsi rendah garam dapat menurunkan tekanan darah padapopulasi dewasa dengan atau tanpa hipertensi. Variabilitas tekanan darah selama 24 jambersifat dinamis. Peningkatan darah nokturnal memiliki makna klinis yang cukup besar,merupakan salah satu prediktor dari penyebab kerusakan target organ, terutama kejadiankardiovaskular dan stroke. Asupan garam dapat mempengaruhi variasi tekanan darah 24jam, yang dalam hal ini dapat juga berpengaruh pada hipertensi nokturnal. Obat penyekatEKA merupakan obat hipertensi lini pertama yang sering digunakan, terutama pada usiamuda dan hipertensi yang disertai sindrom metabolik, mengingat peranan Sistem ReninAngiotensin memiliki peranan yang sangat penting dalam patofisiologi hipertensi. Asupangaram juga memiliki peranan pada patofisiologi terjadinya hipertensi dalam sistem ReninAngiotensin. Sedikit studi yang meneliti perpaduan obat penyekat EKA dengan asupanrendah garam dalam menrunkan kejadian hipertensi. Oleh karena itu, Menarik untuk ditelitipengaruh asupan garam dengan tekanan darah nokturnal pada pasien yang mengkonsumsiobat penyekat EKA.Tujuan : Menilai pengaruh asupan garam dengan tekanan darah nokturnal pada pasienhipertensi yang mendapatkan terapi penyekat EKA. Metode : Pasien poliklinik berusia 30 ? 50 tahun yang terdiagnosis hipertensi dan belumpernah mendapatkan anti-hipertensi sebelumnya, dibagi menjadi 2 kelompok (asupanrendah garam (Na <15 g/hari) dan asupan tinggi garam ≥15 g/hari). Kedua kelompok akandiberikan lisinopril dan dilakukan pemeriksaan natrium urin 24 jam dan home bloodpressure monitoring..Hasil Penelitian : Sebanyak 80 pasien hipertensi pasien hipertensi yang belummendapatkan terapi diikutsetakan dalam penelitian ini, yang terdiri dari 37 pasienkelompok rendah garam dan 43 pasien kelompok tinggi garam. Kelompok pasien denganasupan 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 padakelompok asupan tinggi garam. Rerata asupan garam pada penelitian ini sebesar 16,77gram/hari. Pada analisa multivariat didapatkan delta penurunan tekanan darah tidakdipengaruhi 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 correlatesto high blood pressure. Some Randomized-Controlled-Trials stated that low saltintake may decrease blood pressure in adult population with or withouthypertension. Blood pressure variation in 24 hours is not static but dynamicallychanges. Increasing nocturnal blood pressure has significantly impacts, and becomeone of predictor of target organ damage, especially cardiovascular events andstroke. 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 associatedwith metabolic syndrome, due to important role of Renin Angiotensin AldosteroneSystem in pathophysiology of hypertension, whereas salt intake also has role in thatsystem. Only few of studies that had proved combination of ACE Inhibitors andlow 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 pressurein hypertension patient treated with ACE Inhibitors.Objectives : To know impact of low salt intake to nocturnal blood pressure inhypertension patient treated with ACE Inhibitors.Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreatedhypertension, divided into two groups (low salt intake (Na <15 grams/day) and highsalt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg andunderwent 24-hours sodium urine collection and home blood pressure monitoringperiodically.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 intakegroup. 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 saltintake group. Mean salt intake in this study was 16.77 grams/day. Multivariateanalyzes showed that the difference of decreasing nocturnal blood pressure was notinterfered 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 correlatesto high blood pressure. Some Randomized-Controlled-Trials stated that low saltintake may decrease blood pressure in adult population with or withouthypertension. Blood pressure variation in 24 hours is not static but dynamicallychanges. Increasing nocturnal blood pressure has significantly impacts, and becomeone of predictor of target organ damage, especially cardiovascular events andstroke. 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 associatedwith metabolic syndrome, due to important role of Renin Angiotensin AldosteroneSystem in pathophysiology of hypertension, whereas salt intake also has role in thatsystem. Only few of studies that had proved combination of ACE Inhibitors andlow 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 pressurein hypertension patient treated with ACE Inhibitors.Objectives : To know impact of low salt intake to nocturnal blood pressure inhypertension patient treated with ACE Inhibitors.Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreatedhypertension, divided into two groups (low salt intake (Na <15 grams/day) and highsalt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg andunderwent 24-hours sodium urine collection and home blood pressure monitoringperiodically.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 intakegroup. 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 saltintake group. Mean salt intake in this study was 16.77 grams/day. Multivariateanalyzes showed that the difference of decreasing nocturnal blood pressure was notinterfered 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 correlatesto high blood pressure. Some Randomized-Controlled-Trials stated that low saltintake may decrease blood pressure in adult population with or withouthypertension. Blood pressure variation in 24 hours is not static but dynamicallychanges. Increasing nocturnal blood pressure has significantly impacts, and becomeone of predictor of target organ damage, especially cardiovascular events andstroke. 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 associatedwith metabolic syndrome, due to important role of Renin Angiotensin AldosteroneSystem in pathophysiology of hypertension, whereas salt intake also has role in thatsystem. Only few of studies that had proved combination of ACE Inhibitors andlow 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 pressurein hypertension patient treated with ACE Inhibitors.Objectives : To know impact of low salt intake to nocturnal blood pressure inhypertension patient treated with ACE Inhibitors.Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreatedhypertension, divided into two groups (low salt intake (Na <15 grams/day) and highsalt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg andunderwent 24-hours sodium urine collection and home blood pressure monitoringperiodically.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 intakegroup. 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 saltintake group. Mean salt intake in this study was 16.77 grams/day. Multivariateanalyzes showed that the difference of decreasing nocturnal blood pressure was notinterfered 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. |
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