ABSTRACT Background : To know the manifestation patient obese related with cardiovascular disease in medical faculty Trisakti University.

Methods : nstruments research usin! with fullfill "uestioner. This research was established by way of cross section. #ocation of this research took place in the campus of medical faculty of Trisakti University. The sample consisted of twenty people or student who divided into two !roups. $irstly% ten students related obese and ten students without obese in medical faculty of Trisakti University. Result : $rom &' student with obese%(') haved hypertension% *') pre hypetension+,-./0 borderline +12C 3/%. $or cholesterol only 4') from &' student with obese. $or ten people with unrelated obese%5') no have hypertension%and 6') in pre hypertension. .nly *') from ten student as a smoker. There are (') student that eatin! more than three times in a day. $or student with unrelated obese%5') from them didn7t smoke. $or diet%only &') from of them that eatin! more than three times in a day. $or this point%we !et 3') from ten people with obese that his0her obese !ot from their family. $rom student with unrelated obese%8') don7t have !enetic from their family. Conclusion : n medical faculty of Trisakty University%there are related between student with obese in cardiovascular disease.

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2TR.9UCT .2 .besity is performed by !enetic% environmental% and comple: interaction between !enetic and environmental factors. $atness levels in obese children are indicative of increased risk for elevated blood pressure% cholesterol% and lipoprotein ratios children and adolescents. Serum cholesterol and blood pressure are related to raise atherosclerotic lesion. Certain cardiovascular disease risk factors in obese children are related to the earliest sta!es of atherosclerosis disease. .bese children have the hi!h risk factors of certain cardiovascular disease. ;enetic factors affectin! metabolic rate can be successfully mana!ed by the introduction of environmental factors such as decrease caloric intake and increase physical activity. The treatment of obesity and of atherosclerotic patients should include dietary restriction +protein sparin! modified fast and hypocaloric balanced diet/% nutrition education% increased physical activity% behavior modification% and familial support. Success fully mana!ement of obesity can improve the "uality of life and reduce the risk of morbidity and mortality associated with obesity.

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This research feature This research form was made with cross sectional methods.

Study Site This research will take place at the medical faculty of Trisakty University. Data Content The result of this research was collected in one week with "uestioner and processin! data of this study%we made in two weeks. Sample Consist of twenty people or student who divided into two !roups. $irstly% ten students related obese and ten students without obese in medical faculty of Trisakti University Research nstruments This research uses questioner A. dentity 2ame A!e ;ander .ccupation

B. >uestions &. how much wei!ht you?......................@! 6. how hi!h your body?........................Cm *. how your B< +body mass inde:/?..................@!0m6 4. 9id you have hypertension? A.Aes B.2o

B. if no.4 yes% how much blood pressure in check while?...............mm-! (. if no.4 yes% how lon! you haved hypertension?...........................month0year 3.have you ever check blood cholesterol? A. Aes B.2o

5. if 2o.3 yes% how many levels of total cholesterol?.................m!)

8. do you smoke? A.Aes B.2o

&'. if no.8 yes% how many bars you smoke in a day? A.&CB stick B.(C&' stick C.&&C&B stick 9. D &B stick

&&. how many times you are eatin! in one day? A. &: day B. 6: day C.*: day 9 more *: day

&6. n your family%anyone have hypertension? A. Aes B. 2o

&*. f no.&6 yes%how lon! did he0she suffered hypertension?..................month0year &4. Anyone in your family who have stroke? A. Aes B. 2o

&B. f no.&4 yes%how lon! did he0she suffered stroke?.......month0year &(. n your family%anyone have Coronary Artery 9isease+CA9/? A. Aes B. 2o

&3. f no.&( yes%how lon! did he0she suffered it?..............month0year &5. n your family%anyone have died because -eart disease? A.Aes B.2o

&8. f no.&5 yes%please choose one of them : a. Stroke b. CA9

c. -eart $ailure d. other%likesEEEE..?

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.besity is a preclinical si!n of lifestyle related disease. t is associated with an increased cardiometabolic risk factors that appear to directly promote the development of

cardiovascular disease +CF9/. The =ndocannabinoid system +=CS/ is an endo!enous and physiolo!ical system which is important in the control of ener!y balance and body wei!ht. ,hen the =CS is overactive% additional fat is stored and the risk of insulin resistance% !lucose intolerance% elevated tri!lyceride levels% and low -9#CC levels is increased. .ver activation of the =CS has now been demonstrated in both human obesity and obesity with a predominance of central abdominal adipose tissue. The activation of the =CS causes hyperpha!ia% e:cessive fat accumulation% and increased cardiovascular risk factors. .besity is now reco!niGed as a maHor risk factor for coronary heart disease% which can lead to heart attack. Some reasons for this hi!her risk are known% but others are not. $or e:ample% obesity can :

raises blood cholesterol and tri!lyceride levels. lowers -9# I!oodI cholesterol. -9# cholesterol is linked with lower heart disease and stroke risk% so reducin! it tends to raise the risk.

raises blood pressure levels. can induce diabetes. n some people% diabetes makes these other risk factors much worse. The dan!er of heart attack is especially hi!h for these people.

The effects of smokin! could actually underestimate the association of B< and C-9. Smokin! has been established as a risk factor for C-9% but also works to prevent wei!ht !ain by suppressin! appetite and increasin! an individualJs basal metabolic rate.

Since these individuals are at risk to develop C-9 and are in the lower B< !roups% they may falsely ne!ate an association between obesity and C-9.

.besity and Associated Comorbidities

.besity is associated with numerous comorbidities such as CF9% type 6 diabetes% hypertension% and certain cancers. n fact% obesity is an independent risk factor for CF9% and CF9 risks have been documented in obese children. between B< in adolescence and allCcause mortality&/. The observed increased risk of death was independent of adult B<
6/

ndeed% a relationship e:ists

. Thus%

obesity is associated with an increased risk of morbidity and mortality and is associated with reduced life e:pectancy. Besides an altered metabolic profile% a variety of adaptations0alterations in cardiac structure and function occur in the individual as adipose tissue accumulates in e:cess amounts% even in the absence of comorbidities. -ence% obesity may affect the heart throu!h its influence on known risk factors such as dyslipidemia% hypertension% !lucose intolerance% inflammatory markers% and as well as throu!h yetCunreco!niGed mechanisms. As a whole% overwei!ht0obesity predisposes or is associated with numerous cardiac complications such as C-9% heart failure% and sudden death throu!h its impact on the cardiovascular system. The pathophysiolo!y of these entities linked to obesity will be discussed in the followin! sections.

.besity and -ypertension

The maHority of patients with hi!h blood pressure are overwei!ht. -ypertension is about ( times more fre"uent in obese subHects than in lean men and women.*/ 2ot only is hypertension more fre"uent in obese subHects than in normalCwei!ht control subHects% but also wei!ht !ain in youn! people is a potent risk factor for subse"uent development of hypertension. A &'Ck! hi!her body wei!ht is associated with a *.'Cmm -! hi!her systolic and a 6.*Cmm -! hi!her diastolic blood pressure. These increases translate into an estimated &6) increased risk for C-9 and 64) increased risk for stroke. t is well reco!niGed that technical difficulties e:ist in the indirect measurement of blood pressure in the obese patient that may result in an overestimation of the level of blood pressure. 2evertheless% obesity is stron!ly associated with hi!herCthanCoptimal blood pressure. This increase in blood pressure is !reatest when the obesity is of abdominal distribution.4/ $actors to be considered in linkin! obesity to an increase in blood pressure are related to chan!es in cardiac output and peripheral vascular resistance% because BKLC.xSFR% where BK is blood pressure% C. is cardiac output% and SFR is systemic vascular resistance. These factors include +&/ direct effects of obesity on hemodynamics and +6/ mechanisms linkin! obesity and an increase in peripheral vascular resistance: endothelial dysfunction% insulin resistance% sympathetic nervous system% .besity per se is associated with alterations in hemodynamics. B/ An increase in o:y!en demand produced by e:cess adipose tissue + &.B m#0k! per minute/ re"uires an increase in cardiac output. Also% a parallel increase occurs in blood volume. Thus% obese individuals have an increase in blood volume% stroke volume% and cardiac output.

Therefore% althou!h an increase in cardiac output may add to the increase in blood pressure% in the obese individual% an abnormal increase in blood pressure is primarily dependent on an increase in peripheral vascular resistance.

.besity and C-$

#eft ventricular hypertrophy is common in patients with obesity and to some e:tent is related to systemic hypertension.(/ -owever% abnormalities in left ventricular mass and function also occur in the absence of hypertension and may be related to the severity of obesity.3/ ncreased left ventricular volume and wall stress in addition to increased stroke volume and cardiac output are commonly seen in systemic hypertension. The hypertrophy of the left ventricle is both concentric and eccentric% and diastolic dysfunction is common. ,hen obesity is present but systemic hypertension is absent% left ventricular volume is often increased% but wall stress usually remains normal. -owever% in obese patients without hypertension% increases in stroke volume and cardiac output as well as diastolic dysfunction are seen. These chan!es in the left ventricle are related to sudden death in obese patients. Chan!es in the ri!ht heart also occur in obesity. The pathophysiolo!y is related to pulmonary hypertension and ri!ht ventricular hypertrophy% dilatation% pro!ressive dysfunction% and finally failure. -owever% ri!ht ventricular dysfunction can also occur as a conse"uence of left ventricular dysfunction% and the heart failure that develops is often biventricular.

R=S=ARC- R=SU#T
n this research can be concluded that the maHority of obese students in medical faculty of Trisakti University have to suffer the risk factors of CF9. nterpretation is obtained based on the followin! factors : &. Comorbidity related CF9 such as hypertension and Cholestrol $rom &' student with obese%(') haved hypertension% *') pre hypetension+,-./0 borderline +12C 3/%. $or cholesterol only 4') from &' student with obese. $or ten people with unrelated obese%5') no have hypertension%and 6') in pre hypertension. 6. -abituation such as smoke and diet.

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.nly *') from ten student as a smoker. $or diet in every day%there are (') student that eatin! more than three times in a day. $or student with unrelated obese%5') from them didn7t smoke. $or diet%only &') from of them that eatin! more than three times in a day. *. -erediter $or this point%we !et 3') from ten people with obese that his0her obese !ot from their family. $rom student with unrelated obese%8') don7t have !enetic from their family.

9 SCUSS .2
As we know% obesity is a role as a maHor risk factor for sufferin! from CF9. .ther factors that also influence CF9 such as lifestyle% !enetics% a!e% !ender and others. The research result it was found that students related obese have hypertensive +(') hypertension% *') pre hypertension/. This could happen due to various factors likes hereditary or from their lifestyle everyday. <aybe they are in the habit of smokin! or eatin! patterns that e:ceed the limit every day+more three times/. Althou!h still youn!% life style is a risk factor is very influential in the future CF9

$or the cholesterol data that only 4')% it happened because (') of them never check blood cholesterol. so that the data was not obtained properly accords. Based on the results "uesioner% students are obese have a fairly hi!h percenta!e +(')/ of !enetics. &&

Some of their parents also suffer the same risk factors. even some of them% their families have died due to manifestations of CF9% like CA9.

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The conclusion for this research was there are related between .besity with Cardiovascular 9isease. .besity is one of important risk factor in Cardiovascular disease. .ther factor likes lifestyle or habituation % !enetics% were also have ruled with manifestation in Cardiovascular disease.

Krevent the risk factors is the best treatment for this cases. #ifestyle modification% likes eatin! don7t more * times in a day%e:ecises and check up blood cholesterol was needed.

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