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Hypertension or High Blood is a situation where a person experiences an increase in blood

pressure above normal or chronic (long time). Hypertension is a disorder that is difficult to know

by our own bodies. The only way to know hypertension is to measure our blood pressureregularly.

Unknown out of !" people who suffered from hypertension could not be identified the cause ofthe disease. That is why hypertension was nicknamed the silent killer. #omeone had felt the

impact of severity of hypertension when there have been complications. #o only reali$ed when it

has led to organ disorders such as cardiac dysfunction% coronary% renal function% impairedcognitive function or stroke. Hypertension essentially reduces the life expectancy of sufferers.

Hypertension in addition to resulting in high mortality rates (high case fatality rate) also have an

impact on the expensive treatment and care that must be borne by the patient. &t should also beremembered for the reduction of hypertension also affect the 'uality of life.

Hypertension in fact can be derived from parents to their children. &f one parent affected by

hypertension% the tendency of children to suffer from hypertension are higher than those who donot have parents Hypertension sufferers.

iagnosis

in general% someone said to suffer from hypertension if the systolic blood pressure diastoliknya

exceeds !*"" mmHg (normal !+"," mmHg). #ystolic blood pressure is when the heart pumpsblood into the arteries (when the heart contract.) &s diastolic blood pressure when the heart

expands and suck the blood back (empty deflating arteries).

-ctually% the line between normal blood pressure and high blood pressure are unclear% so theclassification of hypertension are based on high levels of blood pressure that lead to increased

risk of heart disease and blood vessels.

-ccording to H/% in the last guidelines in !% the limit of blood pressure that is still

considered normal is less than !0",1 mmHg% whereas if more than !*"" mmHg is stated as

hypertension% and between the value they will be referred to as normal2high. (These limits are foradult individuals above !, years).

#ymptoms

3echanism of /ccurrence of Hypertension #ymptoms of hypertension include headache%

flushing% headache% bleeding from the nose of a sudden% sore neck% and others. The impact that

can be caused by hypertension is kidney damage% bleeding in the cornea (the eye4s retina)%

rupture of blood vessels in the brain% and paralysis.

5ause

Based on the cause% Hypertension can be classified into two namely6

!. 7ssential or primary hypertension

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The exact cause of essential hypertension is still not yet known. However% various factors

suspected to play a role as a primary cause of hypertension% such as increasing age%

psychological stress% and heredity (descent). -pproximately "8 of hypertensive patients

classified as primary hypertension while !"8 is classified as secondary hypertension.

+. Hypertension secondary li9

#econdary hypertension is hypertension that cause can be known% among other abnormalities

of kidney blood vessels% disorders of the thyroid gland (hyperthyroidism)% adrenal gland disease

(hiperaldosteronisme)% and others. Because the largest group of patients with hypertension is

essential hipertensia% the investigation and treatment of more directed to people with essential

hypertension.

Based on the factor due to hypertension is an increase in blood pressure in the arteries can occur

in several ways6

2 - stronger heart pumps that drain more fluid in every second

2 There was thickening and stiffness in the artery wall due to old age. :arge arteries lose

elasticity and become rigid% so that they can not inflate when the heart pumps blood through the

arteries. Therefore the blood in each heart beat are forced to pass through narrow vessels than

usual and cause a rise in pressure.

2 &ncreased fluid in the circulation can cause increased blood pressure. This happens if there areabnormalities of renal function and is unable to dispose of salt and water from the body. The

volume of blood in the body increases% so the blood pressure also increases.

Therefore% if the heart pumping activity is reduced% widening the arteries experience% and plenty

of fluids out of circulation. Then the blood pressure will decrease or become smaller.

Based on the trigger factors% hypertension is differentiated into uncontrollable such as age%

gender% and heredity. &n ;"2,"8 of cases of primary hypertension% history of hypertension found

in the family. &f a history of hypertension was found in both parents% the alleged primaryhypertension is greater. Hypertension is also often found in patients with mono$ygotic twins (one

egg)% when one of them suffered from hypertension. These allegations suggesting that geneticfactors have a role in the occurrence of hypertension.

hile that can be controlled% such as overweight obesity% stress% lack of exercise% smoking% and

alcohol and salt consumption. 7nvironmental factors also influence the incidence of essentialhypertension. The relationship between stress with hypertension% allegedly through the activation

of sympathetic nerves. #ympathetic nerves are the nerves that work at the time we move% the

parasympathetic nerves are the nerves that work when we4re inactive.

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&ncreased sympathetic nerve activity can increase blood pressure in intermittent (unpredictable).

&f prolonged stress% can cause high blood pressure settled. -lthough this has not been proven% butthe incidence is higher in urban communities than in rural areas. This can be attributed to the

influence of stress experienced by groups of people who lived in the city.

Based on the investigation% obesity is a characteristic of the population of Hypertension and

proved that this factor has a close connection with the occurrence of hypertension in the future.

-lthough not yet explained the relationship between obesity and essential hypertension% but theinvestigation proved that the heart pumps blood volume and circulation of obese patients with

hypertension is higher compared with patients who have normal weight.

on2drug treatment (non2pharmacological) +. Treatment with drugs (pharmacological)

>on2drug treatment (non2pharmacological)

>on2pharmacological treatment can sometimes control the blood pressure so that

pharmacological treatment becomes unnecessary% or at least postponed. hile in a state where

anti2hypertensive medications re'uired% non2pharmacological treatment can be used as acomplement to obtain better treatment effect.

>on2pharmacological treatment include the following6

!. iets low in salt cholesterol saturated fat +. ?educing salt intake in the body.

-dvice salt reduction% patients should pay attention to eating habits. ?educing salt intake will

dramatically difficult. How this medication should not be used as a single treatment% but better

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used as an ad=unct to pharmacological treatment.

0. 5reate a relaxed state

ifferent modes of relaxation such as meditation% yoga or hypnosis to control the nervous

system that ultimately can lower blood pressure.

*. 7xercise such as aerobics or brisk walking for 0"2*1 minutes 02* times as much as a week.

1. @uitting smoking and reducing alcohol consumption

Treatment with drugs (pharmacological)

-ntihypertensive drugs. There are many types of antihypertensive drugs currently available. Aor

the selection of the right drugs are expected to contact a doctor.

iuretics

The drugs work by type diuretics remove fluid body (through urine) so that the volume of fluid

in your body that result in reduced pump power into a lighter heart.

7xample obatannya is hydrochlorothia$ide.

&nhibiting the sympathetic

This class of drugs works by inhibiting the activity of sympathetic nerves (nerves that workwhen we move).

7xample medicine are6 3etildopa% Clonidin and ?eserpin

Betabloker

3echanism of action of anti2hypertensive drugs is through a reduction in cardiac pump power.

Type betabloker not recommended in patients who have been known to suffer from respiratory

disorders such as bronchial asthma.

7xample medicine are6 3etoprolol% propranolol and atenolol. &n patients with diabetes mellitus

have to be careful% because it can mask the symptoms of hypoglycemia (a condition in which

blood sugar levels fall to very low which could result in danger to the sufferer). &n older people

there are symptoms of bronchospasm (narrowing of the airways) so that drug administration

should be careful.

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Dasodilator

These drugs work directly on blood vessels by relaxing smooth muscle (muscle of blood

vessels). &ncluded in this group are6

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disadari ketika telah menyebabkan gangguan organ seperti gangguan fungsi =antung% koroner%

fungsi gin=al% gangguan fungsi kognitif atau stroke .Hipertensi pada dasarnya mengurangi

harapan hidup para penderitanya.

Hipertensi selain mengakibatkan angka kematian yang tinggi (high case fatality rate) =uga

berdampak kepada mahalnya pengobatan dan perawatan yang harus ditanggung para penderita.

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penderita hipertensi tergolong Hipertensi primer sedangkan !"8 nya tergolong hipertensi

sekunder.

2. Hipertensi sekunder/li>

Hipertensi sekunder adalah hipertensi yang penyebabnya dapat diketahui% antara lainkelainan pembuluh darah gin=al% gangguan kelen=ar tiroid (hipertiroid)% penyakit kelen=ar

adrenal (hiperaldosteronisme)% dan lain lain. Carena golongan terbesar dari penderita

hipertensi adalah hipertensia esensial% maka penyelidikan dan pengobatan lebih banyakditu=ukan ke penderita hipertensi esensial.

Berdasarkan faktor akibat ipertensi terjadi peningkatan tekanan darahdi dalam arteri

bisa ter=adi melalui beberapa cara6

2 Eantung memompa lebih kuat sehingga mengalirkan lebih banyak cairan pada setiap detiknya

2 Ter=adi penebalan dan kekakuan pada dinding arteri akibat usia lan=ut. -rteri besar kehilangan

kelenturannya dan men=adi kaku% sehingga mereka tidak dapat mengembang pada saat =antung

memompa darah melalui arteri tersebut. Carena itu darah pada setiap denyut =antung dipaksauntuk melalui pembuluh yang sempit daripada biasanya dan menyebabkan naiknya tekanan.

2 Bertambahnya cairan dalam sirkulasi bisa menyebabkan meningkatnya tekanan darah. Hal ini

ter=adi =ika terdapat kelainan fungsi gin=al sehingga tidak mampu membuang se=umlah garam dan

air dari dalam tubuh. Dolume darah dalam tubuh meningkat% sehingga tekanan darah =ugameningkat.

/leh sebab itu% =ika aktivitas memompa =antung berkurang% arteri mengalami pelebaran% danbanyak cairan keluar dari sirkulasi. 3aka tekanan darah akan menurun atau men=adi lebih kecil.

Berdasarkan faktor pemicu% Hipertensi dibedakan atas yang tidak dapat dikontrol seperti umur%

=enis kelamin% dan keturunan.

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dibandingkan dengan di pedesaan. Hal ini dapat dihubungkan dengan pengaruh stress yang

dialami kelompok masyarakat yang tinggal di kota.

Berdasarkan penyelidikan% kegemukan merupakan ciri khas dari populasi Hipertensi dandibuktikan bahwa faktor ini mempunyai kaitan yang erat dengan ter=adinya Hipertensi

dikemudian hari. alaupun belum dapat di=elaskan hubungan antara obesitas dan hipertensiesensial% tetapi penyelidikan membuktikan bahwa daya pompa =antung dan sirkulasi volume

darah penderita obesitas dengan hipertensi lebih tinggi dibandingan dengan penderita yangmempunyai berat badan normal.

Pencegahan

Hipertensi dapat dicegah dengan pengaturan pola makan yang baik dan aktivitas fisik yangcukup. Hindari kebiasaan lainnya seperti merokok dan mengkonsumsi alkohol diduga

berpengaruh dalam meningkatkan resiko Hipertensi walaupun mekanisme timbulnya belum

diketahui pasti.

Pengobatan

/lah raga lebih banyak dihubungkan dengan pengobatan hipertensi% karena olah raga isotonik

(spt bersepeda% =ogging% aerobic) yang teratur dapat memperlancar peredaran darah sehingga

dapat menurunkan tekanan darah. /lah raga =uga dapat digunakan untuk mengurangi mencegahobesitas dan mengurangi asupan garam ke dalam tubuh (tubuh yang berkeringat akan

mengeluarkan garam lewat kulit).

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>asehat pengurangan garam% harus memperhatikan kebiasaan makan penderita.

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tua terdapat ge=ala bronkospasme (penyempitan saluran pernapasan) sehingga pemberian obat

harus hati2hati.

Dasodilator

/bat golongan ini beker=a langsung pada pembuluh darah dengan relaksasi otot polos (ototpembuluh darah). ang termasuk dalam golongan ini adalah 6 ifedipin% iltiasem dan Derapamil.7fek samping yang mungkin timbul adalah 6 sembelit% pusing% sakit kepala dan muntah.