ARRANGED BY

GROUP 4

SANGRILA LAGARUSU

SERIES OF YANTI KNOWS

SITI NURJANAH SYARIFUDIN

STEVLINTON ROY MOHAMAD

SUMIRA UMANAHU

TARMIZI HAJI LOLO

TIANSIH WAS BORN

YULIANA RASYID

GORONTALO MINISTRY OF HEALTH

POLICE
 FY 2016/2017
FOREWORD

Praise and gratitude for the presence of Allah, who has bestowed the favors of
health, faith, and science to humanity. That delicious base was that we were able to
complete a paper entitled "Hypertension" just in time.
In writing this paper, we received a lot of help from various parties. Therefore,
on this occasion, we would like to thank all those who have assisted in writing this
paper so that we present it. Especially to the lecturer of Respiratory and Cardiovascular
Anatomy Pathology, Mrs. dr. Edwina Monayo, M. Biomed who has provided various
directions and lessons in the sense of self-actualization which is the forerunner of the
formation of this paper.
We are aware that this paper is far from perfect, because of our limited ability
and knowledge. Therefore, we sincerely expect positive and constructive criticism and
suggestions from lecturers, fellow students, and readers alike. Finally, we apologize if in
writing this paper there were many mistakes.

Gorontalo, 09 February 2017

Author
 TABLE OF CONTENTS

Foreword ……………………………………………………. …… ... i

Table of contents ……………………………………………… .. ……………… .... ii

CHAPTER I INTRODUCTION………………………………………………...

A. Background………………………………………………………....
B. Problem Formulation……………………………………………………...
C. Goals .................................................................. ....

CHAPTER II DISCUSSION ………………………………………………..

A. Definition of Hypertension …… .. ………………………………………… ..

B. Symptoms of Hypertension ……………………………… .. …………………….

C. Causes of Hypertension ………………………………………………… ..

D. Treatment of Hypertension ... ..................................................

E. Prevention of Hypertension …… .. …………………………………………

CHAPTER III CLOSING……………………………………………………..

A. Conclusion………………………………………………………......

B.Suggestions…………………………………………………………………

Bibliography ........................................................ iii .... iii

 PIG
PRELIMINARY

A. Background
High blood pressure / hypertension is a medical condition in which there is a
chronic (long-term) increase in blood pressure. This disease is a type of disease that is
very dangerous.
Patients with hypertension in the world today are estimated at more than 800
million people. As many as 10-30% of the adult population in almost every country.
Based on Lancet data (in McMarthy, 2010), the number of people with hypertension
throughout the world continues to increase. In India, hypertension reached 60.4 million
people in 2002 and an estimated 107.3 million people in 2025. In China, 98.5 million
people and would be 151.7 million people in 2025. In other parts of Asia , recorded 38.4
million people with hypertension in 2000 and estimated to be 67.4 million people in
2025. In Indonesia, reaching 17-21% of the population and most are not detected. (wir-
nursing.blogspot.com/2011/04 / between-coffee-cigarettes-and-blood pressure. html) In
Indonesia there are an estimated 15 million people with hypertension but only 4% are
controlled hypertension. Prevalence of 6-15% in adults, 50% of them are not aware of
as sufferers of hypertension so they tend to become severe hypertension because they do
not avoid and do not know the risk factors, and 90% are essential hypertension.
World hypertension day is celebrated every May 17. This date was set by WHO
since 2005.
B. Problem Formulation
1. What is the meaning of hypertension?
2. What are the symptoms of hypertension?
3. What causes hypertension?
4. How to treat hypertension?
5. How to prevent hypertension?

C. Purpose
1. To find out the meaning of hypertension
2. To find out the symptoms of hypertension
3. To find out the cause of hypertension
4. To find out the treatment of hypertension
5. To know the prevention of hypertension
 CHAPTER II
DISCUSSION

A. HYPERTENSION DEFINITIONS
High blood pressure (hypertension) is an increase in blood pressure in the
arteries. Arteries are blood vessels that carry blood from the heart and are distributed to
all tissues and organs of the body. High blood pressure (hypertension) does not mean
excessive emotions, although emotions and stress can increase blood pressure for a
while.
Someone said to have hypertension has a systolic blood pressure of
40140mmHg and a diastoltic blood pressure of ≥90mmHg. A person is said to have
hypertension not only by 1 measurement, but 2 or more times at different times. The
best time to do blood pressure is at rest and sitting or lying down. Classification of
blood pressure according to WHO
Classification Systolic Diastolic (mmHg)
(mmHg)
Normotension <140 <90
Mild hypertension 140-180 90-105
Frontier hypertension 140-160 90-95
Moderate and severe > 180 > 105
hypertension
Isolated systolic > 140 <90
hypertension
Border systolic 140-160 <90
hypertension

whereas based on the Sixth Report of the Joint National Committee on

Preventation, Detection, Evaluation and Treatment of High Bload Pressure, 1997
hypertension classification namely
Category Systolic Diastolic Recommendation
(mmHg) (mmHg)
Normal <130 <85 Double check in 2 years
Border 130-139 85-89 Double check in 1 year
 Level 1 140-159 90-99 Confirmation in 1/2 month.
hypertension Suggest lifestyle modifications
Level 2 160-179 100-109 Evaluation / referral in 1
hypertension month
Level 3 ≥180 ≥110 Evaluate / refer immediately
hypertension within 1 week based on
medical conditions

Hypertension is a risk factor for stroke, heart attack, heart failure, and is a major cause
of chronic heart failure.
As we get older, almost everyone experiences an increase in blood pressure. Systolic
blood pressure continues to increase until the age of 80 years, while diastolic blood
pressure continues to increase until the age of 55-60 years, then decreases slowly / even
decreases dramatically.

B. HYPERTENSION SYMPTOMS
In most people with hypertension do not cause symptoms. However,
inadvertently some symptoms occur together and are believed to be related to
hypertension (when in fact they are not). The intended symptoms are headache,
bleeding from the nose, dizziness, facial redness and fatigue.
If the hypertension is severe or chronic and untreated the following symptoms
can occur:
- Headache
- Fatigue
- Nausea
- Throw up
- Out of breath
- Restless
- Blurred vision occurs due to damage to the brain, eyes, heart and kidneys
Sometimes people with severe hypertension lose consciousness and even coma because
of brain swelling. This condition is called hypertensive encephalopathy which requires
immediate treatment.

C. CAUSES OF HYPERTENSION
Based on the cause of hypertension is divided into 2 namely:
1. Primary / essential hypertension is hypertension that has no or unknown cause, also
called idiopathic hypertension. In 95% of cases. Many factors influence such as genetic,
environmental, sympathetic hyperativitis, renin-angiotensis system, defects in Na
excretion, increase in intracellular Na and Ca, and factors that increase risk, such as
obesity, alcohol, smoking and polycythemia.
2. Secondary hypertension. There are about 5% of cases. Specific causes are known
such as estrogen use, kidney disease, renal vascular hypertension, primary
hyperaldosteronism, and cushing's syndrome, pheochromocytosis, aortic coarctation,
hypertension associated with pregnancy, and others.

D. HYPERTENSION TREATMENT
Exercise is more associated with hypertension treatment, because regular
isotonic exercise (such as cycling, jogging, aerobics) can improve blood circulation so
that it can reduce blood pressure. Exercise can also be used to reduce / prevent obesity
and reduce salt intake into the body (a sweaty body will excrete salt through the skin).
Treatment of hypertension is broadly divided into 2 types, namely:
1. Non-drug treatment (non pharmacological)
2. Treatment with drugs (pharmacological)
a. Non-drug treatment (non pharmacological)
Non-pharmacological treatment can sometimes control blood pressure so that
pharmacological treatment becomes unnecessary or at least postponed. Whereas in
situations where anti-hypertensive drugs are needed, non-pharmacological treatment can
be used as a complement to get a better treatment effect.
Non-pharmacological treatments include:
1. Low salt / cholesterol / saturated fat diet
2. Reducing intake of salt into the body.
Salt reduction advice, should pay attention to patient eating habits. Drastic reduction of
salt intake will be difficult to implement. This method of treatment should not be used
as a single treatment, but rather be used as a complement to pharmacological treatment.
3. Create a relaxed state Various ways of relaxation such as meditation, yoga or
hypnosis can be
control the nervous system which can ultimately reduce blood pressure.
4. Do sports like aerobics or brisk walking for 30-45 minutes as much as 3-4 times a
week.
5. Stop smoking and reduce alcohol consumption
6. Expand the meaning that contains calcium, potassium and magnesium
7. Expand foods that contain fiber
8. Maintain body weight
9. Avoid excessive coffee drinking habits
b. Treatment with drugs (pharmacological)
Antihypertensive drugs. There are many types of antihypertensive drugs currently
available.
For the selection of the right medicine is expected to contact a doctor.

- Diuretic
Diuretic type drugs work by releasing body fluids (through urine) so that the body's
fluid volume decreases resulting in a lighter heart pump.
An example of a medicine is Hydrochlorothiazide.
- Sympathetic Inhibitors
This class of drugs works by inhibiting the activity of sympathetic nerves (nerves that
work when we move).
Examples of drugs are: Methyldopa, Clonidine and Reserpine.
 - Betabloker
The anti-hypertensive mechanism of action of this drug is through a decrease in heart
pumping power. Betabloker type is not recommended for patients who are known to
have respiratory problems such as bronchial asthma.
Examples of drugs are: Metoprolol, Propranolol and Atenolol.
In patients with diabetes mellitus must be careful, because it can mask the symptoms of
hypoglycemia (a condition in which blood sugar levels drop to very low which can
result in danger for sufferers). In the elderly there are symptoms of bronchospasm
(narrowing of the respiratory tract) so that drug administration must be careful.
- Vasodilators
This class of drugs works directly on blood vessels by relaxing smooth muscle (blood
vessel muscles). Included in this group are: Prasosin, Hidralasin. Side effects that are
likely to occur from the administration of this drug are: headaches and dizziness.
- Angiotensin conversion enzyme inhibitors
The way this class of drugs works is that it inhibits the formation of Angiotensin II
substances (substances that can cause an increase in blood pressure).
Examples of drugs that fall into this class are Kaptopril. Side effects that may arise are:
dry cough, dizziness, headache and weakness.

- Calcium antagonist
This class of drugs reduces the heart's pumping power by inhibiting heart contractions
(contractility). Included in this class of drugs are: Nifedipine, Diltiasem and Verapamil.
Side effects that may arise are: constipation, dizziness, headaches and vomiting.
- Angiotensin II Receptor Blockers
The way this drug works is by blocking the attachment of Angiotensin II substances to
the receptors which results in a mild heart pumping power. Drugs that are included in
this group are Valsartan (Diovan). Side effects that may arise are: headache, dizziness,
weakness and nausea. With regular treatment and control, as well as avoiding risk
factors for hypertension, the death rate from this disease can be suppressed.
 Here are 13 natural ways without effective drugs to lower blood pressure
such as:
1. Get used to walking
Hypertensive patients who are accustomed to walking can reduce their blood
pressure quickly by about 6 mmHg to 8 mmHg. Walking will make the heart use more
oxygen more efficiently, so it does not try hard to pump blood.
Do cardio exercises for at least 30 minutes every day of the week. Try increasing the
speed or distance so that the body remains slim.
2. Take a deep breath
Slow breathing and meditation such as qigong, yoga and tai chi will reduce the
stress hormone cortisol which can lift renin, an enzyme from the kidneys that increases
blood pressure.
Do breathing exercises for 5 minutes in the morning and evening. Take a deep
breath and expand the stomach. Exhale and release all tension.
3. Choose potassium-rich products
The potassium content that is abundant in fruits and vegetables is an important
part in the blood pressure reduction program. Try to get a potassium intake of 2,000 to
4,000 mg per day, "said Linda Van Horn, PhD, RD, professor of preventive medicine at
Northwestern University's Feinberg School of Medical.
Potassium-rich food sources include sweet potatoes, tomatoes, orange juice, potatoes,
bananas, kidney beans, peas, melons, watermelons and dried fruits such as raisins.
4. Limit salt consumption
People who have a family history of high blood pressure are more likely to have
high blood pressure, especially those who are sensitive to salt or sodium. But because
there is no way to find out if someone is sensitive to sodium, everyone should reduce
their sodium intake, "said Eva Obarzanek, PhD, research nutritionist at the National
Heart, Lung, and Blood Institute.
Limit the use of salt is 1,500 mg per day. While half a teaspoon of salt contains
about 1,200 mg of sodium. Also pay attention to the levels of salt or sodium in
processed foods, because that's where most of the origin of sodium in food. Season food
with spices, herbs, lemons, and don't add salt.
5. Eat dark chocolate
Dark chocolate contains flavanol which makes blood vessels more elastic. In one
study, 18% of patients who ate dark chocolate every day experienced a decrease in
blood pressure. It's good to eat 1/2 ounce of dark chocolate every day. Make sure the
dark chocolate you eat contains at least 70% cocoa.
6. Take supplements
In a study of 12 studies, the researchers found that coenzyme Q10 reduced blood
pressure by 10 mmHg to 17 mmHg. Antioxidants are needed to produce energy and
dilate blood vessels. Consult with your doctor about using 60 mg to 100 mg
supplements for 3 times a day.
7. Drink a little alcohol
According to studies of 15 studies, the less alcohol you drink, the less blood
pressure can be lowered. A study at Boston's Brigham and Women's Hospital found that
drinking alcohol in a mild level, which is a quarter to half a drink per day for women,
can reduce blood pressure more than those who do not drink every day.
What is meant by one drink is 12 ounces of beer, or 5 ounces of wine or 1.5
ounces of alcohol. Other studies have also found that drinking one drink a day for
women and two drinks a day for men can reduce the risk of heart disease.
"In high amounts, alcohol is clearly detrimental. But moderate alcohol
consumption is a protector of the heart, if taken in adequate portions," Obarzanek said.
8. Drink decaf
Scientists have long debated the effects of caffeine on blood pressure. Some
studies have shown that caffeine does not affect blood pressure, but a study from Duke
University Medical Center found that consumption of caffeine, 500 mg or about three 8
ounces of coffee, can increase blood pressure by 4 mmHg. The effect lasts until
bedtime.
"Caffeine can increase blood pressure by tightening blood vessels and enlarging
the effects of stress. When under stress, the heart pumps more blood and increases blood
pressure. And caffeine will strengthen that effect," said researcher Jim Lane, PhD,
research professor at Duke University .
Lane then recommends replacing regular coffee with decaffeinated coffee to
protect the heart. For comparison, 8 ounces of regular coffee contains 100 to 125 mg. In
the same amount, tea contains 50 mg of caffeine and cola around 40 mg of caffeine.
9. Drink herbal tea
In a study by Tufts University, participants who drank 3 cups of hibiscus tea
every day could reduce systolic blood pressure by 7 points in an average of 6 weeks.
These results are on par with prescription drugs. Participants who drank placebo drinks
only experienced a drop in blood pressure by one point.
Phytochemical ingredients in hibiscus or hibiscus seem to be able to reduce high
blood pressure a lot. In herbal tea, many contained hibiscus. Look at the mixture of
ingredients contained in tea products, and choose products that contain lots of hibiscus
in each portion.
10. Reduce overtime
Working more than 41 hours a week in the office will increase the risk of
hypertension by 15%, according to a study by the University of California, Irvine of
24,205 Californians.
The reason, working overtime makes the body rarely exercise and eat healthy.
Try to finish work at the right time so you can visit the fitness center or cook healthy
food more often.
11. Relax with music
To reduce blood pressure, besides being helped by drugs, it can also be helped
by changing lifestyles. According to researchers at the University of Florence in Italy,
the right songs can help lower blood pressure.
Researchers asked 28 adults who had used hypertension pills to listen to
classical music, Celts, or Indian music for 30 minutes every day while breathing slowly.
After a week, the participants experienced an average reduction in systolic blood
pressure of 3.2 points. A month later, the figure dropped by 4.4 points.
12. Overcoming snoring during sleep
 Loud snoring is one of the main symptomsobstructive sleep apnea(OSA).
Researchers from the University of Alabama found that many sleep apnea sufferers
have high levels of aldosterone, a hormone that can increase blood pressure. In fact, it is
estimated that half of all people who experience sleep apnea have high blood pressure.
People with sleep apnea usually experience many sleep disorders that have the
potential to interfere with breathing and are life-threatening during sleep. Besides
snoring loudly, excessive fatigue during the day and headaches in the morning are also a
sign of sleep apnea.
If you have high blood pressure, ask your doctor whether your sleep apnea can
be cured. Treating sleep apnea can reduce aldosterone levels and improve high blood
pressure.
12. Eat lots of soy
research publishedThe Journal of the American Heart Association found for the
first time that replacing refined carbohydrates with foods rich in soy protein or milk,
such as low-fat milk, can reduce systolic blood pressure in people with hypertension or
prehypertension

E. HOW TO PREVENT HIPERTENSION

Before hypertension attacks us it will be better if we prevent it first. The right way to
prevent hypertension is:
1. Don't smoke because the nicotine in cigarettes can cause a heart beat
faster and narrow the small blood vessels that cause the heart
forced to pump stronger to meet the needs of our bodies
2. Reduce salt consumption because excess salt in the blood can cause
more water is stored and this results in high blood pressure
3. Reduce fat, excess fat will accumulate around blood vessels
and make it thick and stiff
4. Maintain ideal body weight
5. Exercise regularly
6. Avoid alcohol consumption
7. Eat healthy foods, low in fat, rich in vitamins and natural minerals
 CHAPTER III
CLOSING

A. CONCLUSION
Someone said to have hypertension has a systolic blood pressure of 40140mmHg
and a diastoltic blood pressure of ≥90mmHg. This disease is a dangerous disease
because it is one of the risk factors for stroke. Hypertension based on the cause is
divided into 2, namely primary hypertension or hypertension with a cause that is not
known with certainty. Secondary hypertension is hypertension caused by certain
specific causes, for example kidney disease, endocrine disease or due to aortic
coartation disease.

B. SUGGESTION
After reading this paper, we advise the readers:
- Always maintain health. Health is a priceless gift. Because in a healthy body there is a
strong soul.
- Always pay attention to food intake that enters our bodies. Eat foods that are highly
nutritious that can meet all our body's needs
- Diligent in exercising
Advanced

BIBLIOGRAPHY

http://health.detik.com/read/2012/02/12/080305/1840292/766/how-how-salam-to-lose-
press-darah
http://wir-nursing.blogspot.com/2011/04/antara-kopi-rokok-dan-tekan-darah.html
http://cai-sl.blogspot.com/2012/06/latar-belakang-hipertensi-penyakit.html
http://kesmas-ode.blogspot.com/2012/11/makalah-hipertensi.html
http://nuurasiyah.blogspot.com/
Mansjoer Arif, Triyanti Kuspuji, Savitri Rakmi, Wardani Wahyu Ika, Setiowulan,
Editor, Capita Selekta Medical Volume 1 Edissi III, Media Aesculapius Faculty of
Medicine, University of Indonesia, 2001
Hypertension and Risk Factors in Epidemiological Studies. Makassar: FKM
Unhas.Bustan, MN 2007.
Epidemiology of Infectious Diseases Jakarta: Rineka CiptaDedy. 2010.
High Blood Pressure (Hypertension). Sidenreng.comSitorus, Sampe. 2009
High Blood Pressure (Hypertension). Wordpress.comSurya, Andari. Without years.
Hypertension Papers www.scribd.comTohaga, Edwin. Without years. Hypertension,
Symptoms and Complications. Wordpress.comhttp: //id.wikipedia.org