Effect of giving tomato therapy ... Journal of Tropical Biology. Vol.13 No.

January 1,
2013. 102 ISSN: 1411-9587 EFFECT OF GIVING TOMATIC THERAPY
(Lycopersicum grandifolium) ON DECREASING BLOOD PRESSURE IN ELDERLY
WITH HYPERTENSION IN PSTW "PUSPAKARMA" MATARAM

Hastuti Handayani (1), Kusmiyati (2) and Ni Made Sumatywati (3) (1) and (3) Mataram
School of Health Nursing (STIKES) Study Program (2) Unram Faculty of Teacher
Training and Education Biology Study Program

ABSTRACT
The aging process in the course of human life occurs continuously and is naturally
sustainable. Elderly people experience various changes, both physically and mentally. One of
the changes that occur in the elderly is the cardiovascular system, which is a decrease in the
elasticity of blood vessels, which increases peripheral vascular resistance resulting in high
blood pressure (hypertension). Tomatoes contain betacarotine and vitamin E as anti-oxidants
that can prevent blood agglutination, which can reduce blood pressure. The purpose of this
study was to determine the effect of tomato therapy on reducing blood pressure in elderly
hypertension in Mataram's "Puspakarma" PSTW. This study uses the Quasy design of the pre
post design experiment. Based on the total sampling technique, there were 22 respondents.
The sample was divided into a control group and the experimental group consisted of 11
people respectively. The experimental group was treated with tomato therapy and the control
group was not treated. This study was conducted for 21 days in elderly with mild, moderate,
and severe hypertension. Data were analyzed by t test statistics with a 5% error rate. In the
treatment group before being given tomato therapy treatment the majority of respondents
were in moderate hypertension as many as 8 respondents (72, 73%), in the control group
most were in moderate hypertension 5 respondents (45.46%). The treatment group after being
given tomato therapy, most of the respondents were in mild hypertension 6 respondents
(54.54%), in the control group most were moderate hypertension as many as 7 respondents
(63.64%). The t-test results obtained t-count = 4.46> t table (0.05) = 2.086, so it can be
concluded that the provision of tomato therapy has a significant effect on the reduction of
blood pressure in elderly with hypertension in Mataram's "Puspakarma" PSTW.
Key words: Elderly, Blood pressure reduction, Tomato therapy.

ABSTRACT
Aging process on the continuous ongoing in nature way of life. Elderly underwent several
changes, both physical and mental health systems that decrease in the elasticity of blood
vessels so that increasing peripheral vascular resistance results in high blood pressure
(hypertension). Betakarotin and tomatoes contain vitamin E and antioxidants that can prevent
blood pressure. The therapeutic effect of tomato to decrease the blood pressure in the elderly
with PSTW "Puspakarma" hypertension in Mataram. This study uses experimental design
quasi pre post design. Sampling technically based on a total of 22 respondents was obtained.
The first group is 11 people who were subjected to treatment of tomatoes and other groups
are not given treatment. Research was done for the 21 days subject to classification of blood
pressure havemild hypertension, moderate, severe, used analysis was the test with
significance level of 5%. In the treatment group, the majority of respondents (72.73%) were
treated as a treatment group before therapy, the control group was mostly located in
hypertension is five respondents (45.46%). Treatment groups after the treatment given in the
form of tomatoes were mild mild hypertension in 6 respondents (54.54%), the control group
was hypertensive as much as 7 respondents (63.64%). The test results of the test statistic t
found the value t count = 4.46> t table (0.05) = 2.086. The conclusion of this study was the
effect of blood pressure reduction in the “Puspakarma” in the elderly hypertensive in PSTW
Mataram.
Key words: Elderly, Decrease in blood pressure, Tomato Therapy.

PRELIMINARY

 Hypertension (high blood pressure) is the third leading cause of death in the world after
stroke and tuberculosis, which reached around 6.7%. The number of hypertensive sufferers
worldwide continues to increase, in Indonesia, the number of hypertensive sufferers is
estimated at 15 million, but only 4% is controlled hypertension. The prevalence of 6-15% in
adults, 50% of whom are not aware of being hypertensive, so they tend to become severe
hypertension, because they do not avoid and do not know the risk factors. At present
degenerative and cardiovascular diseases are already one of the public health problems in
Indonesia. The prevalence of hypertension in Indonesia according to the Household Health
Survey / SKRT (2004), in people aged 25 years and over shows that 27% of men and 29% of
women suffer from hypertension (Akhmad, 2010).
The Tresna Werdha Social Institution (PSTW) is a place or institution that provides
physical, spiritual and social care and care and protection to meet the needs of the elderly in
order to enjoy a reasonable standard of living (Ministry of Social Affairs, 2002). The number
of elderly people in 2008-2010 was 86 people, with the elderly aged between 60-86 years, in
2008 the number of elderly people suffering from hypertension was 20 people, in 2009 the
number of elderly people suffering from hypertension was 22 people, while in 2010 the
elderly suffered hypertension did not increase as many as 22 people.
According to Basha (2009), hypertension is a condition where a person experiences
an increase in blood pressure above normal, which results in morbidity and mortality or
mortality. Sustrani et al (2005) state that hypertension or high blood pressure is a disorder of
the blood vessels which results in the supply of oxygen and nutrients carried by the blood
hampered to the tissues of the body that needs it. Hypertension is often called a dark killer
(silent killer), because it includes a lethal one without symptoms first as a warning to the
victim.
The causes of hypertension include atherosclerosis (thickening of the arterial wall
which causes loss of blood vessel elasticity), heredity, increased amount of blood pumped to
the heart, kidney disease, adrenal gland, and sympathetic nervous system, obesity,
psychological stress, stress, and tension (Marzuky 2009).
Hypertension can be prevented from causing further complications by requiring proper and
efficient handling. According to Marlia (2009) in general the handling of hypertension can be
done pharmacologically and non-pharmacologically.
Pharmacological treatment consists of the administration of drugs that are diuretic,
sympathetic, betabloker, and vasodilators. H Effect of Tomato Therapy in the journal
Tropical Biology. Vol.13 No. 1 January 2013. 104 ISSN: 1411-9587 with regard to place,
work mechanism and level of compliance. Non-pharmacological treatments include weight
loss, regular exercise, low fat and salt diets, and complementary therapies. Non-
pharmacological treatment is very popular with the community because it is very easy to
practice and does not cost too much. In addition, non-pharmacological treatments also do not
have dangerous side effects, so people prefer handling non-pharmacologically from
pharmacologically. One of the non-pharmacological treatments to cure hypertension is
complementary therapy. Complementary therapies that are therapeutic in natural medicine
include herbal therapy, nutritional therapy, progressive relaxation, meditation, laughter
therapy, acupuncture, acupressure, aromatherapy, bach flower remedy therapy, and
reflexology. Herbal therapy is widely used by people in dealing with hypertension, because it
has few side effects. Types used in herbal therapy are tomatoes (Lyocopercison
lycopersicum), celery or celery (Apium graveolens), garlic or garlic (Allium sativum), onion
or onion (Allium cepa), watermelon (Citrullus vulgaris) (Sustrani, et al 2005) .
Tomato is a type of herbal therapy to treat hypertension. According to Azwar Agoes
(2007), tomato extract has a content such as lykopen which is effective for lowering
cholesterol, betakarotin and vitamin E as anti-oxidants which can prevent blood
agglutination, so that it can lower blood pressure. The lykopen content contained in tomatoes
is one reason tomatoes are used as an alternative to reduce symptoms of hypertension. the
high incidence of hypertension in the elderly is the basis for implementing the provision of
tomato therapy on a regular basis, where in PSTW "Puspakarma" Mataram has never been
given tomato therapy for patients with hypertension, therefore researchers are interested in
conducting research on the benefits of tomatoes in particular in decreasing blood pressure.

MATERIALS AND METHODS

The tools and materials used in this study are tomatoes, blenders, scales, cages,
sphygmomanometers (tensimeters) and stethoscopes. The subjects in this study were all
elderly who had hypertension, while the population was all elderly who had hypertension at
the PSTW "Puspakarma" Mataram. The sample in this study were elderly who had mild,
moderate and severe hypertension in the "Puspakarma" PSTW Mataram, as many as 22
people with total sampling techniques.
 This study uses Quasy experiment.pre-postest design 'This design seeks to reveal
cause and effect with the control group besides the experimental group. In this study, 22
respondents were then divided into two groups namely the control group and the
experimental group, in which the blood pressure was measured. as data pretest) and both
were given pharmacological therapy captopril 25 mg. In the control group only
pharmacological therapy was given without tomatoes, while the experimental group was
given pharmacological therapy followed by tomato therapy. After being given tomato
therapy, the two groups measured their blood pressure (as posttest data).
Before giving tomato therapy treatment, tomatoes that are large round and not
damaged are chosen first (Figure 1), after that the tomatoes are weighed, then washed
thoroughly, then the tomatoes are steamed for 3 minutes, after steaming the tomatoes are
smoothed using The blender is then poured into a serving glass with a size of 120 cc, given
twice a day at 08.00 and 12.00 WITA for 21 days. Blood pressure data is collected using a
sphygmomanometer (tensimeter) and stethoscope, in a sitting position. Blood pressure
measurement is carried out before and after treatment. Data were analyzed using the t-test
with an error rate of 5%. Figure 1. Tomatoes

RESULTS AND DISCUSSION

The results of elderly blood pressure measurements in the experimental group before
being given tomato therapy and the control group, are summarized in Table 1. The data were
used as pretest data.

Table 1: Blood Pressure Status of Experimental Groups and Control Groups

Experiment Group Control Group
No. Blood pressure Total % Blood pressure Total %
status status
1. Lightweight 2 18,18 Lightweight 4 36,36
2. Medium 8 72,73 Medium 5 45,46
3. Weight 1 9,09 Weight 2 18,18
Total 11 100 11 100
 Table 1 shows that most respondents in both groups experienced moderate
hypertension. Based on observations, moderate hypertension with systole between 150-170
mmHg and diastole between 90-100 mmHg. Sorting the status of hypertension is in
accordance with the blood pressure category according to Sutomo (2009), as follows:

Category Systolic (mmHg) Diastolic (mmHg)

Normal 120-129 80-84
Mild hypertension 140-159 85-89
Moderate hypertension 160-179 90-99
Severe hypertension 180-209 90-99
Very severe hypertension 210 110

The elderly who were respondents in this study were 65-85 years old. The age range is at risk
for hypertension. According to Hadi (2004) the pathogenesis of hypertension in the elderly is
slightly different from what happens in adults, the factors that play a role in old age are:
1. Decreased renin levels due to decreased number of nephrons due to aging (Aging
Process).
2. Increased sensitivity to sodium intake. The older you are, the more sensitive you are
to increasing or decreasing sodium levels.
3. a decrease in the elasticity of peripheral blood vessels due to the aging process will
increase peripheral vascular resistance which in turn will result in systolic
hypertension only.

Potter & Perry (2005) added that blood pressure tends to increase with age, whereas
according to Smeltzer & Bare (2001), as the age and structure of the heart and blood vessels
increase, changes contribute to the increase in blood pressure. These changes include
atherosclerosis, loss of connective tissue, and decreased relaxation of vascular smooth muscle
resulting in reduced ability of the aorta and arteries to accommodate blood pumped by the
heart, resulting in decreased cardiac output and increased peripheral resistance. This is also
found in 14% of patients over the age of 60 years, especially in men. After menopause
women experience an increase in blood pressure higher than men. The findings of Ekowati &
Sulistyowati (2009), that the risk factors for hypertension in the age group ≥70 years are
11.53 times higher than the 25-34 year age group which is 1.56 times.
This shows the risk of hypertension increases significantly as we age. At the time of the
study it was found that elderly people aged 70 years and over had fewer activities than those
aged 65 years. They sleep more rest, and sit back, while those who are in their 60s are
admitted to still doing strong jobs such as making crackers from rice, cooking, etc. According
to Martuti (2009), lack of exercise or activity tends to increase blood pressure. Tjokronegoro
(2001) added that lower blood pressure is found in individuals who are healthier physically,
regular physical exercise is highly recommended to prevent hypertension and heart disease,
because fat will not be buried in the body so that the blood flow will be smooth. The results
of measurements of elderly blood pressure in the experimental group after being given
tomato therapy and the control group are summarized in Table 2.
The data is used as the posttest data. Table 2 shows that after being given tomato therapy
as many as 11 respondents had mild hypertension and 5 respondents (45.46%) had normal
blood pressure. In the control group that was not given tomato therapy, most respondents
were 7 respondents (63.64%) still experiencing moderate hypertension and 1 respondent
(9.09%) was at normal blood pressure. Thus a decrease in blood pressure after being given
tomato therapy, from the level of mild hypertension to normal and hypertension being mild.
The results of statistical tests with the t test obtained t count = 4, 46> t table (0.05) = 2.086,
which means that the provision of tomato therapy has a significant effect on the reduction of
blood pressure in elderly with hypertension in Mataram's "Puspakarma" PSTW. This can be
understood because in tomatoes there are antioxidants that can lower blood pressure.

Table 2: Experimental and Control Group Blood Pressure Status

Experimental group Control group
No Blood pressure status Total % Blood pressure status Total %
.
1 Normal 5 45,46 Normal 1 9,09
2 Lighweight 6 54,54 Lightweight 3 27,27
3 Medium 0 0 Medium 7 63,64
4 Weight 0 0 Weight 0 0
Total 11 100 11 100

According to Azwar Agoes (2007), the content of tomatoes that can reduce blood
pressure include:
1. Beta-nicotine and vitamin E as anti-oxidants that can prevent blood agglutination, so
that it can lower blood pressure.
2. Lykopen in tomatoes is a substance that is effective for lowering cholesterol.
3. Vitamin B6 and folate, the body needs to convert homocysteine into more harmless
compounds, high levels of homocysteine can harm blood vessel walls and are
associated with increasing the risk of heart attack and stroke.
4. Potassium can lower blood pressure and reduce the risk of heart disease.

      The observation shows that the majority of male respondents are smokers, this
condition facilitates the occurrence of hypertension, as stated by Bangun (2003) which states
that smoking can facilitate the occurrence of vascular disease, and can increase heart rate and
transient blood pressure. This is caused by the influence of nicotine in blood circulation, so it
can be concluded that cigarettes have a large relationship with the incidence of hypertension.
Other studies suggest smoking can also increase platelet aggregation and cause coronary
artery spasm, nicotine plays a role in increasing pressure and blood supply to the heart
(Leuckenotte in Suastana, 2010).
 Decreasing blood pressure after administration of tomato therapy shows that in tomatoes
there are substances that can fight the harmful content of cigarettes. As argued by Azwar
Agoes (2007), that in tomatoes contain kumarat acid and chlorogenic acid that fight
nitrosamines, which are the main carcinogens contained in cigarettes CONCLUSION The
provision of tomato therapy has a significant effect on the reduction of blood pressure in
elderly with hypertension in PSTW "Puspakarma" Mataram , which is indicated by the results
of the t test obtained by the value of t arithmetic = 4.46> t table (0.05) = 2.086.
 BIBLIOGRAPHY

Akhmad 2010. Degenerative diseases. Jakarta: PT Gramedia Main Library.

Azwar Agoes, 2007. Tomato content. Accessed on October 5, 2011
http://www.google.co.id/kandungan + tomato + for + lower + pressure + blood.
Get up. 2003. Traditional Juice & Herb Therapy for Hypertension. Jakarta: Agromedia
Library
Basha, 2009. Nursing: Concepts, Processes, and Practices. Volume 2. Interpreting: Renata
Komalasari, et al. Jakarta: EGC.
RI Ministry of Social Affairs. 2002. Standardization of Tresna Werdha Social Institution
Social Welfare Services (PSTW). Jakarta.
Ekowati, R. & Sulistyowati, T. 2009. Prevalence of Hypertension and Determinants in
Indonesia. (accessed http: //www.repositoryusu.abst ract.ac.id) obtained in November 2011.
Hadi, M. 2004. Geriatric Textbook: Management of Hypertension in the Elderly. Jakarta:
Balai Publishit FK UNDIP.
Marlia, 2009. Prevent Hypertension. Accessed on 21 / april / 2009 from
http://www.unpad.ac.id/archive/16 429.
Martuti. 2009. Caring for and Curing Hypertension (High Blood Pressure Disease).
Bandung: Discourse Creation
Marzuky 2009. causes of hypertension. accessed on 3 January 2010. http://www.e-
psikologi.com
Perry & Potter. 2005. Textbook of Fundamental Nursing: Concepts, Processes, and
Practices. Volume 2. Interpreting: Renata Komalasari, et al. Jakarta: EGC.
Smeltzer, S and Bare, B. 2001. Medical Nursing Textbooks Surgery Brunner & Suddart.
Jakarta: EGC.
 Sustrany, L., et al. 2005. Hypertension. Jakarta: Main Gramedia Library.
Suastana. 2010. Effectiveness of Back Massage on Decreasing Blood Pressure in
Hypertension in the Social Institution of Tresna Werdha Puspakarma Mataram.
 Sutomo Budi. 2009. Menu of Healthy Conqueror of Hypertension. Jakarta: Demedia
Tjokronegoro, A. 2001. Books Teach Internal Medicine. Volume 1. Edition 3. Jakarta:
FKUI Publisher Hall.
 THE EFFECT OF GIVING TOMATIC THERAPY (Lycopersicum
grandifolium) ON DECREASING BLOOD PRESSURE IN ELDERLY
WITH HYPERTENSION IN PSTW "PUSPAKARMA" MATARAM

Arranged by:
SOLEH GUNAWAN

SEKOLAH TINGGI ILMU KESEHTAN RAJAWALI

BANDUNG
2018