ii
CONTENTS
Welcome Message ....................................................................................................................... iv
Greetings ..................................................................................................................................... v
Organizing committee .................................................................................................................. xi
Workshop schedule ..................................................................................................................... xiv
Symposium schedule.................................................................................................................... xviii
Symposium floor plan .................................................................................................................. xxi
ABSTRACT.................................................................................................................................... 1
Implementation of Guideline Directed CV Management with BPJS Coverage:
How Far is the Gap?............................................................................................................. . 2
I Wayan Wita
Decongestion Strategies in the Management of Hypervolemic Hyponatremia in
Heart Failure ............................................................................................... ........................ 4
I Ketut Rina
New Management of Heart Failure with Hyponatremia ........................................................ 5
I Ketut Suwitra
Comorbidities in Heart Failure: How to Manage? .................................................................. 6
I Nyoman Wiryawan
Update of Diagnosis and Management of STE-ACS: What Does the Guideline Tell Us? ........... 7
I Wayan Aryadana
Dual Antiplatelet for ACS Patients: Consideration to Choose P2Y12 Inhibitor to Achieve
Optimum Outcomes: Role of Clopidpgrel ............................................................................. 8
I G. N. Putra Gunadhi
Advanced the Anticoagulant Co-therapy in STE-ACS Patients: Role of Enoxaparine ................ 9
I Made Junior Rina Artha
Practical Approach of Hypertension Management: Which Guideline for Which Patients? ....... 10
Kadek Susila Surya Darma
Hypertensive Crisis and Cardiovascular Damage ................................................................... 11
M. Saifur Rohman
Newest Guideline of Acute Rheumatic Fever ......................................................................... 12
Luh Oliva Saraswati Suastika
vii
Acute Presentations of Heart Valve Stenosis ........................................................................ 13
Wayan Sutarmawan
Pulmonary Hypertension in General and Associated Valvular Heart Disease .......................... 14
Lucia Kris Dinarti
Emerging Risk Factors of CAD: What is New? ......................................................................... 15
I Wayan Aryadana
Management of Dyslipidemia: Focus on Statin ...................................................................... 16
I Wayan Wita
Non-statin Role in Management of Dyslipidemia .................................................................. 17
I. B. Rangga Wibhuti
Diagnosis and Management of Critical Ill Baby with Congential Heart Disease ....................... 18
Eka Gunawijaya
Breaktrough in Congenital Heart Disease Intervention .......................................................... 19
Radityo Prakoso
Burden Risk Stratification and Management in Atrial Fibrillation Patients .............................. 20
Bagus Ari Pradnyana
Differentiation Between NOACs ........................................................................................... . 21
I Putu Gede Budiana
Personalized NOAC Therapy: When to Choose the Right NOAC for the Right Patients ............ 22
I Made Putra Swi Antara
How to Improve Outcomes in Cardiac Arrest Patients: Review of ACLS .................................. 23
Made Satria Yudha Dewangga
Managing Acute Lung Edema in Emergency Setting .............................................................. 25
I Ketut Susila
POSTER PRESENTATION ............................................................................................................... 27
Total Occlusion of RCA as Late Manifestation of Kawasaki Disease in A Young Man ............... 28
Pramana Adiputra, Lena Agustini
Rheumatic Heart Disease with Complication of Atrial Fibrillation: A Case Report ................... 29
Samudra Andi Yusuf, Irma Vitriani, I Gusti Ayu Suryawati
viii
Early Anticoagulation Should Postponed on Acute Cardioembolic Strokes – A Case Report..... 31
I Wayan Gustafa, Raditya Surya
Resolution of Inferior STEMI in A Woman Who Not Undergoing Reperfusion Therapy
(A Problematic Cardiovascular Management in A Remote Area): A Case Report ..................... 32
Kristianto Yusi Adiputra, Achmadi Eko Sugiri
Diabetic Ketoacidosis Complicated by Supraventricular Tachycardia in
A Young Adult: A Case Report .............................................................................................. 33
Vien Stefani, Gilrandy Budiarto Baktiar
Atrial Fibrillation with Rapid Ventricular Respond Treated With
Intravenous Digoxin: A Case Report ..................................................................................... 34
I Putu Gde Fredy Gunawan, Lie Juliawan, Komang Katrini, Putu Kiki Wulandari
Atrial Functional Mitral Regurgitation in Patient with Atrial Fibrillation Associated
Gastroesophageal Reflux Disease Who Successfully Convert to Sinus Rhythm
With Proton Pump Inhibitor: A Case Report .......................................................................... 35
Indana Surya Putra IGA, Badjra Nadha I K, Suryadarma IGA
Case Report: Spironolactone Induced Gynecomastia in
Chronic Heart Failure Patient with High Dose and Long Term Use .......................................... 37
Putu Giani Anabella Bestari Putri, Nurfitriani, I Gusti Ayu Suryawati
Prevalence and Comorbidity of Atrial Fibrillation in Kuningan,
West Java: A Descriptive Study ............................................................................................. 39
Gilrandy Budiarto Baktiar, Vien Stefani
Autolysis in CAD STEMI Anteroextensive Wall
Appropriate Initial Management Related to Clinical Improvement: A Case Report ................. 40
Agung Adhyaksa Bhaskara, Arinta Setyasari, Sherly Yosephina, Nizamuddin Ubaidillah
Remote Ischemic Preconditioning Reduces the Incidence of Contrast-Induced Nephropathy in
Patients Undergoing Coronary Angiography/Intervention– Systematic Review And Meta-
Analysis Of Randomized Controlled Trials ............................................................................ . 41
Raymond Pranata, Rachel Vania, Bambang Budi Siswanto
ix
Transjugular Approach for Permanent Pacemaker (PPM) Implantation in
Octogenarian with Inaccessible Upper Limb Venous System .................................................. 42
Rido Mulawarman, Muhammad Hatta, Alexander Edo Tondas
Case Report: A Month Preterm Infant Girl with Patent Ductus Arteriosus
Treat or No Treat ................................................................................................................. 44
A A Gede Agung Angga Kesuma, Samudra Andi Yusuf, I Gusti Ayu Suryawati
Enteric Myocarditis in a 9 Year Old Girl: A Case Report .......................................................... 46
Fenila E. J. U. Sitompul, Mahendria Sukmana
Acute Cardiorenal Syndrome and Cardiac Hepatopathy in Heart Failure: A Case Report ........ 47
Alexsandro R, Pratama MG, Tsai YR, Sinurat BC, Kirana IR, Nadhira F, Shakita TGD
Obesity and Hypertension Among Adolescents:
A Systematic Review and Meta-Analysis ff Cross Sectional Studies ........................................ 48
Abdi Baskara Mayun, Dwipa Krisna Devi, Raditya Rizki M
Prevalence of Essential Hypertension Based on AHA/ACC Guideline 2017 Compared
with JNC 7 Among Pre-Elderly and Elderly in Kintamani, Bali ................................................. 49
Yuliantini N.N., Utomo M.F.P., Sudewa I.B.A., Khrisna N.E.A., Erawan I.G.N.A.T
Association Between Hyperuricemia with Hypertension Among Female-adult
Population in Suter Village, Kintamani, Bali .......................................................................... 50
Muhammad Faisal Putro Utomo, Ni Nyoman Yuliantini, Maya Paramita Wijaya, Ni Putu Eka
Umarista Apriliani, I Gusti Ngurah Agung Tresna Erawan
Tricuspid Atresia with Transpotition of the Great Arteries Patient: What Can Be Done? ......... 51
Suprayoga IM, Dewi A, Paramita D, Sukandar A
Assessing Anxiety as an Indicator of Risk of Peripartum Cardiomyopathy: A Case Report ....... 52
Hans Nuari, Niyata Hananta Karunawan, Dhani Tri Wahyu Nugroho
ORAL PRESENTATION ................................................................................................................... 53
High Level of Individual Lipid Profile and Lipid Ratio as A Predictive Marker of Poor Glycemic
Control in Type-2 Diabetes Mellitus ..................................................................................... 54
Agha Bhargah
Diabetes and Premature Ventricular Contractions, Do They Linked? ...................................... 55
Ida Bagus Ananta Wijaya, Yusuf Dwiyanto, Ronally Rasmin, Muhammad Bachtiar Rachmat Jati,
Rizky Aulia Fanani
x
Evaluation of The Use of Antitrombothic Based on CHA2DS2-VASC Score and
Has Bled Score on the Pattern of Treatment in Stroke Ischemic Patient
with Atrial Fibrilation ........................................................................................................... 56
Gusti Ayu Putu Ika Bella Saptaning Astyari, Rizaldy Taslim Pinzon, Lidwina Tarigan
Characteristics of Therapy of Hypertensive Crisis Patients in Emergency Room
RSUD Kabupaten Penajam Paser Utara from January to May 2019 ........................................ 57
Putra B, Manuputty F
The Monocyte-HDL Ratio in Patients with Acute Coronary Syndrome in
ICCU Surya Husadha Hospital During September 2017-2018 .................................................. 58
I Wayan Gustafa, Raditya Surya
A Time-To-Event Analysis on Air Pollutants with The Risk of Cardiovascular Disease
and Mortality – A Systematic Review and Meta-Analysis of 84 Cohort Studies ....................... 60
Raymond Pranata, Rachel Vania, Budhi Setianto Purwowiyoto
Primary Pulmonary Hypertension During Pregnancy. What Should We Do? ........................... 61
Suprayoga IM, Dewi A, Paramita D
Prediction of MACE by Integrated ST-Segment Elevation Scores in STEMI
Patiens Undergoing Primary PCI ........................................................................................... 62
D. Gde A. Diprabawa, H. Wirawan, R. Paramitha I. Maliawan, AAA. Dwi A. Yasmin, IGN Putra
Gunadhi
Relationship of General Practitioner Distribution with Prevalence of ACS:
Towards a Better Indonesian Health System ......................................................................... 64
Maya Paramita Wijaya, Muhammad Faisal Utomo, Luh Oliva Saraswati Suastika, I Made Putra Swi
Antara
Defisiensi Selenium (Se) Sebagai Faktor Risiko Dilated Cardiomyopathy (DCM) di Rumah Sakit
Umum Pusat Sanglah, Bali : Studi Kasus – Kontrol ................................................................. 65
Luh Nyoman Ananda Mahayati
49
PREVALENCE OF ESSENTIAL HYPERTENSION BASED ON AHA/ACC GUIDELINE 2017 COMPARED WITH
JNC 7 AMONG PRE-ELDERLY AND ELDERLY IN KINTAMANI, BALI
Yuliantini N.N.1, Utomo M.F.P.1, Sudewa I.B.A. 1, Khrisna N.E.A. 1, Erawan I.G.N.A.T.2
1Medical Student, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia 2Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah General Hospital,
Bali, Indonesia
ABSTRACT
Introduction: Hypertension is a non-communicable disease that prevalence is increased by the years in
Indonesia. Based on Riskesdas 2018, approximately 34.1% adult had hypertension in Indonesia, where
previously in 2013 only 25.8% with the highest prevalence in elderly. The diagnosis of hypertension that
commonly used in Indonesia was systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure
(DBP) ≥90 mmHg based on JNC 7, but the AHA/ACC released new guideline in 2017 where threshold of
hypertension changed to SBP ≥130 mmHg or DBP ≥80 mmHg.
Methods: A cross-sectional study who involved pre-elderly and elderly population (above 45 y.o.) in 8
village in Kintamani, Bangli, Bali. Primary data were taken from “Posyandu Lansia” and “Puskesmas
Keliling” program on July-August 2018. Demographic data and blood pressure (BP) measurement were
collected and analyzed by SPSS with univariate analysis.
Results: This study involved 380 samples between 45-98 y.o and the most were female (58.7%).
Prevalence of hypertension from total samples was 51.3% (JNC 7) and increased to 77.1% patients
(AHA/ACC 2017). According to each stage, there were no different prevalence between the two guidelines
for normal BP (12.4%) and stage 1 hypertension (25.8%). In AHA/ACC 2017, the term of prehypertensive
stage (JNC 7) was replaced with elevated BP and the prevalence of pre-hypertension stage (36.3%) was
higher than elevated BP (10.5%). The markedly increased can be found in stage 2 hypertension, where the
prevalence in JNC 7 was 25.5 %, but in AHA/ACC 2017 was 51.3%.
Conclusions: Compared with JNC 7, AHA/ACC 2017 guidelines result markedly increased of hypertension
prevalence in Kintamani-Bali. The difference of hypertension definition can affect various factor,
especially threshold for initial therapy, cost for therapy, and target BP for minimizing complication. The
physician must be wise to choose by considering the benefit of each guideline to reduce morbidity and
mortality due to hypertension.
Keyword: Blood pressure, hypertension, AHA/ACC Guideline 2017, JNC 7, elderly
Tabel 1. The classification of blood pressure based on AHA/ACC Figure 1. Prevalence o Guideline 2017 line 201
The increase of prev
2017 also found in US
Health and Nutrition Ex
ment Longitudinal Study
Chinese adult populatio
pertensive would increa
respectively. The increa
increase in the recomm
China, respectively, 7.5
recommended for treat Tabel 2. The classification of blood pressure based on JNC 7
A cross-sectional study conducted and involved pre-elderly and el- Compared with JNC 7,
derly population (above 45 years old) in 8 village in Kintamani, Bangli, creased of hypertension
Bali. Primary data were taken from “Posyandu Lansia” and “Puskesmas hypertension definition c
Keliling” programs on July-August 2018. Demographic data from inter- initial therapy, cost for th
view and blood pressure (BP) measurement using sphygmomanometer in which can be studied in
the sitting position were collected and analyzed by SPSS with univariate choose by considering t
analysis. and mortality due to hyp
PREVALENCE OF ESSENTIAL HYPERTENSION BASED ON AHA/ACC GUIDELINE 2017 COMPARED WITH JNC 7
AMONG PRE-ELDERLY AND ELDERLY IN KINTAMANI, BALI
Ni Nyoman Yuliantini1, Muhammad Faisal Putro Utomo1, Ida Bagus Ari Sudewa1, I Nyoman Endi Ananda Khrisna1, I Gusti Ngurah
Agung Tresna Erawan2
1Medical Student, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia 2Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah General Hospital, Bali, Indonesia
Keywords : blood pressure, hypertension, AHA/ACC Guideline 2017, JNC 7, elderly
BACKGROUNDS
RESULTS
Hypertension is a non-communicable disease that prevalence is in-
creased by the years in Indonesia. Based on Riskesdas 2018, approxi-
mately 34.1% adult had hypertension in Indonesia, where previously in
2013 only 25.8% with the highest prevalence in elderly. The increases of
hypertension prevalence make the physician more concerned and many
guidelines for hypertension management released to reduce the compli-
cation. The diagnosis of hypertension that commonly used in Indonesia
was systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pres-
sure (DBP) ≥90 mmHg based on JNC 7, but the AHA/ACC released new
guideline in 2017 where threshold of hypertension changed to SBP ≥130
mmHg or DBP ≥80 mmHg. The different of hypertension definition get
various responses from clinicians, because in addition to the different hy-
pertension threshold, AHA/ACC guideline 2017 also have a lower blood
pressure target than JNC 8 (modified from JNC 7 for hypertension
management guideline), which is less than 130/80 mmHg.
BP Category Systolic BP Diastolic BP
Normal Elevated
Hypertension stage I
Hypertension stage II
<120 mmHg
120-129 mmHg
130-139 mmHg
≥140 mmHg
and
and
or
or
<80 mmHg
<80 mmHg
80-89 mmHg
≥90 mmHg
BP Category Systolic BP Diastolic BP
Normal <120 mmHg and <80 mmHg
Prehypertension 120-139 mmHg or 80-89 mmHg
Hypertension stage I 140-159 mmHg or 90-99 mmHg
Hypertension stage II ≥160 mmHg or ≥100 mmHg
This study involved 380 samples between 45-98 years old and the
most were female (58.7%). Prevalence of hypertension from total sam-
ples was 51.3% (JNC 7) and increased to 77.1% patients (AHA/ACC
2017). According to each stage, there were no different prevalence be-
tween the two guidelines for normal BP (12.4%) and stage 1 hyperten-
sion (25.8%). In AHA/ACC 2017, the term of prehypertensive stage (JNC
7) was replaced with elevated BP and the prevalence of pre-hypertension
stage (36.3%) was higher than elevated BP (10.5%). The markedly in-
creased can be found in stage 2 hypertension, where the prevalence in
JNC 7 was 25.5 %, but in AHA/ACC 2017 was 51.3%.
f blood pressure based on AHA/ACC Guide-
7 with JNC 7 in Kintamani, Bali
alence of hypertension with AHA/ACC Guideline
and Chinese population based on US National
amination Survey and China Health and Retire-
, where they found the proportion of the US and
n aged between 45 and 75 years classified as hy-
se from 49.7% to 63.0% and 38.0% to 55.0%,
se of prevalence would be accompanied by the
endation to start treatment, where in the US and
million and 55.3 million people would be newly
ment based on AHA/ACC Guideline 2017.
METHODS CONCLUSION
AHA/ACC 2017 guidelines result markedly in-
prevalence in Kintamani-Bali. The difference of
an affect various factor, especially threshold for
erapy, and target BP for minimizing complication
future research. The physician must be wise to
he benefit of each guideline to reduce morbidity
ertension.
REFFERENCES
1. Kementrian Kesehatan Republik Indonesia. Hasil Utama Riskesdas 2018.
2.American College of Cardiology Foundation and American Heart Association. Clinical Practical Guideline: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/
NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Journal of American College of Cardiology. 2018
May;71(19):127-248.
3. U.S. Department of health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. The Seventh Report of the Joint National Com-
mittee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No 03-5233. 2003 December.
4. Muntner P, Carey RM, Gidding S, et al. Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline. Circulation. 2018 January; 137:109-118.
5. Khera R, Lu Y, Lu J, et al. Impact of 2017 ACC/AHA guidelines on prevalence of hypertension and eligibility for antihypertensive treatment in United States and China:
nationally representative cross sectional study. BMJ Publishing Group. 2018 July;362:k2357.
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