Hypertension, or high blood pressure, is defined as a systolic blood pressure of 140 mmHg or higher and/or a diastolic blood pressure of 90 mmHg or higher. Around 90% of hypertension cases are considered "essential" or "primary" hypertension, which likely has a genetic component. Risk factors for hypertension include obesity, physical inactivity, stress, excessive salt intake, alcohol consumption, and smoking. Left uncontrolled, hypertension can increase the risk of heart disease, stroke, kidney disease, and other health issues. Treatment involves lifestyle changes like losing weight, exercising, and reducing salt intake, as well as medication if needed.

1. HIPERTENSI Oleh: Divisi Humas MER-C

2. Apa itu hipertensi? Tekanan darah tinggi (hipertensi) adalah peningkatan tekanan darah di dalam arteri (pembuluh darah nadi) di atas angka normal. Seringkali hipertensi terjadi tanpa gejala, sehingga penderita tidak merasa sakit. Pada pemeriksaan tekanan darah (tensi) akan didapat 2 angka yakni angka yang atas diperoleh saat jantung berkontraksi (sistolik) sedangkan angka bawah diperleh saat jantung relaksasi (diastolik). Sehingga hasil pemeriksaan tensi menunjukkan sekian per sekian,

6. Usia Yang Paling Rentan Franklin, S.S., J Hypertens 1999; 17 (suppl 5): S29-S36 0 10 20 30 40 50 60 70 18-29 30-39 40-49 50-59 60-69 70-79 80+ SBP > 140 mm Hg DBP > 90 mm Hg Usia) Persentase 4 11 21 44 54 64 65

7. 25% 12.5% 12.5% 50% Berobat tapi tidak kontrol rutin Berobat dan terkontrol Yang tidak tahu Pasien yang tidak berobat dan tidak kontrol Source : Joffres et al. (1997) Am. J. Hypertension 10: 1097-1102 RULE OF HALF

10. ASK-DNC ATP-III 2001 - Criteria IDF 2005 - Criteria GULOH CISAR PEDIATRIC OBESE WORLD OBESITY TRENDS GLOBESITY – DIABESITY (Summarized : Tjokroprawiro 2005-2007) Stage― 3 or the MetS will be &quot;TIME-BOMB DISEASE ” in Indonesia ? Pre c lini c al : the MetS IFG, IGT, Pedr.-Obese Healthy Lifestyle “ Westernized” Unhealthy Lifestyle Obesit y (Abdominal Obesit y ) STAGE – 0 STAGE – 1 STAGE – 2 STAGE – 3 STAGE – 4 Clinical : CAD T2DM, Pedr.-T2DM, Stroke 3 Blood Pressure > 130/85 mmHg 4 GDS > 100 mg/dl 1 Triglyceride > 150 mg/dl 2 HDL-Chol < 40 mg/dl < 50 mg/dl o + o Lingkar Pinggang > 90 cm > 80 cm + o o PEDIATRIC T2DM 44

11. ASK-DNC TEN PRACTICAL GUIDELINES FOR HEALTHY LIFE GULOH-CISAR = SYNDROME-10 (Tjokroprawiro 1995-2007) 34 G U L O H 1 2 3 4 5 C I S A R 6 7 8 9 10 Stop Smoking Daily Regular Exercise : TAKE MINIMALLY 6-HOUR SLEEP/DAY Stop Alcohol Regular Check-Up Esp. > 40 Years Old : 3, 6 or 12 Months Limit Sugar Consumption Restrict Purine Intake : JAS-BUKET Consume Low Fat Diet : TEK-KUK-CS 2 Prevent Obesity (Target : BMI < 25) Measure BP Regularly (Less than g Sodium/day) 3 +300 kcal/day or 3 km walk +Sit up 50-100 x/day JAS-BUKET : Jerohan, Alkohol, Sarden - Burung Dara, Unggas, Kaldu, Emping, Tape (Bowels, Alcohol, Sardines - Pigeon, Fowls, Meat-Broth, Beaten Nut, Fermented Cassava) TEK-KUK-CS2 : Telor, Keju - Kepiting, Udang, Kerang - Cumi, Susu, Santen (Egg, Cheese - Crab, Shrimp, Mussel - Squid, Milk, Coconut - Juice) &quot;MABUK&quot; (Rich in Chromium) : M rica, A pel, B rokoli, U dang, K acang-kacangan; good for DM Recommended Food Supplements : Green Bean, Onions, Green Tea, Pepper, ARGININE, TKW-PJKA-BK G = Glucose U = Uric Acid L = Lipids O = Obesity H = Hypertension C = Cigarette I = Inactivity S = Stress A = Alcohol R = Regular Check Up

12. Initiation of Antihypertensive treatment : ESC 2OO7 Other risk factors, OD, or disease Normal SBP 120-129 or DBP 80-84 High normal SBP 130-139 or DBP 85-89 Grade 1 HT SBP 140-159 or DBP 90-99 Grade 2 HT SBP 160-179 or DBP 100-109 Grade 3 HT SBP  180 or DBP  110 No other risk factors No BP intervention No BP intervention Lifestyle changes for several months then drug treatment if BP uncontrolled Lifestyle changes for several weeks then drug treatment if BP uncontrolled Lifestyle changes + immediate drug treatment 1-2 risk factors Lifestyle changes Lifestyle changes Lifestyle changes for several weeks then drug treatment if BP uncontrolled Lifestyle changes for several weeks then drug treatment if BP uncontrolled Lifestyle changes + immediate drug treatment  3 risk factors, MS or OD Lifestyle changes Lifestyle changes and consider drug treatment Lifestyle changes + drug treatment Lifestyle changes + drug treatment Lifestyle changes + immediate drug treatment Diabetes Lifestyle changes Lifestyle changes + drug treatment Lifestyle changes + drug treatment Lifestyle changes + drug treatment Lifestyle changes + immediate drug treatment Established CV or renal disease Lifestyle changes + immediate drug treatment Lifestyle changes + immediate drug treatment Lifestyle changes + immediate drug treatment Lifestyle changes + immediate drug treatment Lifestyle changes + immediate drug treatment