e8 Journal of Hypertension Vol 39, e-Supplement 2, May 2021
Result: Out of the 138 respondents, a total of 21 elderly men and women experi-
enced depression with hypertension. The number of respondents who experienced
depression without hypertension was 30 (22%), while the number of respondents
who experienced hypertension without depression was also 30 (22%). A chi-
squared test was performed to observe the association between the two variables,
and the p value obtained was 0.468 (p≥0.05).
Conclusion: There was no association between hypertension and the occurrence
of depression in the elderly residents of the Tresna Budi Mulia nursing home in
Jakarta.
Keywords: Elderly, hypertension, depression
30. SHOULD WE LOWER THE INTIMA MEDIA THICKNESS CUT
OFF TO 0.9 TO START SECONDARY STROKE PREVENTION
IN HYPERTENSIVE PATIENTS?
Ahdinar Rosdiana Dewi, Taufik Mesiano, Mohammad Kurniawan, Rakhmad Hi-
dayat, Al Rasyid, Salim Harris. Department of Neurology, Faculty of Medicine
Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Background: Hypertension is a common risk factor of stroke. Carotid intima
media thickening (IMT) is an early sign of atherosclerosis in stroke patient.
Objective: This study aimed to found IMT cut off difference in hypertension and
non-hypertension stroke patient.
Methods: This was a retrospective cross-sectional study using stroke registry
in Neurology Outpatient Clinic, RSUPN dr. Cipto Mangunkusumo, Jakarta, in
January-December 2020. Hypertension was measured clinically, whereas IMT
was measured using carotid duplex. Subjects were categorized into hypertension
and non-hypertension. Patients with diabetes mellitus were excluded. Univariate
analysis and Mann-Whitney test were performed to evaluate the differences.
Result: Of 108 subjects with the mean age of 56.13+10,98 years, 73 (67,6%)
subjects were male. The proportion of hypertension was 53.7%. The median of
left CIMT in hypertension and non-hypertension group were 0.955 (0.5-1.55)
and 0.8 (0.4-1.1) (p <0.001). The median of right IMT in hypertension and non-
hypertension group were 0.9 (0.4-1.6) and 0.8 (0.4-1) (p 0.038).
Discussion: Hypertension may cause sheer stress and inflammation at bilateral
endothelium common carotid artery (CCA), which predisposed to atherosclero-
sis and manifested into IMT. The current guideline recommended IMT threshold
value of 1 mm to be associated with greater risk to develop a new vascular event.
In this study, we found that median of IMT was 0.9 mm in stroke with hyperten-
sion patients, which was lower than currently recommended cut off.
Conclusion: IMT 0.9 mm should be considered as a new value to start secondary
stroke prevention in hypertension patients.
Keywords: carotid duplex, hypertension, intima media thickness, stroke
31. HYPERTENSION AND RISK OF MORTALITY IN STROKE
JAVANESE PATIENTS IN NEURO HCU DR. MOEWARDI
HOSPITAL SURAKARTA
Baarid Luqman Hamidi1, Dewi Hayu Kirana2, Diah Kurnia Mirawati1, Rivan
Danuaji1, Subandi1, Pepi Budianto1, Yetty Hambarsari1, Hanindya Prabaningtyas1.
1Neurology Staff, Dr Moewardi Hospital and Faculty of Medicine, Universitas Se-
belas Maret Surakarta, Indonesia, 2Resident of Neurology, Faculty of Medicine,
Universitas Sebelas Maret, Surakarta, Indonesia
Background: Worldwide, stroke are the second leading cause of death and the
third leading cause of disability.According to WHO in 2016, 70% of stroke cases
were found in low and middle income countries, 87% of deaths from stroke were
also found in these countries.
Objective: This study aims to determine the factors that influence the mortality
of stroke patients.
Method: This study was conducted on all stroke patients in the Neuro HCU Dr.
Moewardi Hospital in the period January to June 2020. The independent variables
were assessed for their effect on patient mortality using a quantitative observa-
tional analytic approach with logistic regression analysis.
Results: There were 124 patients in this study. From eleven variables, only hyper-
tension and stroke type passed the verification test. Further tests were carried out
and it was found that patients with hypertension and subarachnoid hemorrhage
(SAH) had the highest probability of mortality (0.888).
Conclusion: The probability of mortality for hypertension and SAH in this study
is in accordance with previous studies that hypertension increases the risk of mor-
tality in stroke patients and SAH patients have high mortality and morbidity rates.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Therefore, optimizing the management of blood pressure and SAH is needed to
reduce the mortality of stroke patients.
Keywords: hypertension, stroke, mortality, javanese
32. HYPERTENSION AND DILATED CARDIOMYOPATHY IN
PEDIATRIC PATIENT: THE ROLE OF L-CARNITINE
Gusti Ngurah Prana Jagannatha1, Wayan Agus Surya Pradnyana1, Stanly Ka-
mardi1, AA Ayu Dwi Adelia Yasmin2, Ni Putu Veny Kartika Yantie3. 1Student of
Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia,
2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Uday-
ana University, Denpasar, Bali, Indonesia, 3Department of Pediatric, Faculty of
Medicine, Udayana University, Denpasar, Bali, Indonesia
Background: Carnitine is an essential compound for cellular metabolism, and
plays an important role in blood pressure (BP) regulation and cardiac development.
Carnitine deficiency is a disorder that relate to pediatric hypertension and dilated
cardiomyopathy, with possibilities of rapid reversal after carnitine replacement.
Objective: This report describe a child suffering from hypertension and dilated
cardiomyopathy with suspected carnitine deficiency.
Case description: A 4-year-old boy came to emergency department on August
2018 with shortness of breath. BP was 140/80 mmHg, electrocardiogram revealed
sinus tachycardia 150 bpm, echocardiography demonstrated stretch PFO, moder-
ate TR, mild AR, and dilated cardiomyopathy with EF 31.14%. He was diagnosed
with grade II hypertension and congestive heart failure. Antihypertensive and
heart failure treatment were administered. There was no vascular disorder found,
kidney function test and urinalysis were within normal limit. He was also found to
have malnutrition, stunting, and suspected to suffered from carnitine deficiency,
hence L-carnitine and vitamin B6 were commenced since day 16. Patient’s condi-
tion was gradually improved and discharged on the 26th day. Unfortunately, he
stopped L-carnitine 1 year afterwards, but still continue to take vitamin B6. The
last follow-up evaluation on January 2021 showed improvement of BP control
(112/70 mmHg) and reversal of cardiac dysfunction with EF 68.9%.
Discussion: Carnitine deficiency is a rare but treatable cause of pediatric hy-
pertension and cardiomyopathy. Although previous case reports showed complete
improvement within a few months, however that was not happened in this case,
that may be caused by L-carnitine withdrawal.
Keywords: Hypertension, Dilated Cardiomyopathy, Carnitine Deficiency,
33. CHARACTERISTICS AND COMORBIDITIES OF
HYPERTENSIVE PATIENTS IN SANGLAH GENERAL
HOSPITAL DURING COVID-19 PANDEMIC
I Wayan Agus Surya Pradnyana1, Gusti Ngurah Prana Jagannatha1, Stanly Ka-
mardi1, AA Ayu Dwi Adelia Yasmin2. 1Student of Medicine, Faculty of Medicine,
Udayana University, Denpasar, Bali, Indonesia, 2Department of Cardiology and
Vascular Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali,
Indonesia
Background: Recent evidences suggest that hypertension is the most common
underlying comorbid among COVID-19 patients, which often occurs in adults
who are at higher risk of being infected with the SARS-CoV-2 virus and experi-
encing severe symptoms. Hypertension is also commonly accompanied by many
comorbidities that will further compromised the clinical presentation of COV-
ID-19 patients. Determination and appropriate management of hypertension and
its comorbidities would be an important aspect during the pandemic
Objective: The aims of this study is to define the characteristics and comorbidi-
ties among hypertensive patients in outpatient settings during pandemic era.
Methods: This descriptive cross-sectional study included 108 medical records of
patients with hypertension diagnosis in outpatient cardiology clinic, at Sanglah
General Hospital in January 2021.
Result: Among 108 subjects, there was male predominance (57.4%) with mean
of age 54.07 years old. About 23.1% subjects were active smokers and 61.1% were
overweight/obese. The most common comorbidities that was found on subjects
was Coronary Artery Disease (50%), which was followed by heart failure (27.8%)
and Diabetes Melitus (14.8%). Blood pressure was controlled only in 39.8%
patients. The patients most commonly took combination therapy (74.1%), with
calcium channel blocker (CCB) was the most used pharmacotheraphy (81.5%).
Conclusion: Hypertension and its comorbidities were important predictors of
poor outcome among COVID-19 patients. Therefore, optimal therapy and control
for all risk factors during this pandemic are mandatory, regarding the benefit for
morbidity and mortality.