Name Grup :

• Ni Made Puspa Darmayanti (19)

• Putu Desta Paramita Ermawan (27)
• Kadek Canda Pratiwi (07)
• Ni Putu Yuni Anti (23)
• Ketut Budi Arta Ningsih (11)
• I Gede Eva Suardana (03)
• Nabila (15)

XI MIPA – 1 Date: 14 November 2022

RESEARCH PAPER

SMA NEGERI BALI MANDARA

info@smanbalimandara.sch.id
Jl. Raya Air Sanih, Desa Kubutambahan, Kecamatan Kubutambahan, Kabupaten
Buleleng, Provinsi Bali (0362) 3435051
2022
 CHAPTER I
PRELIMINARY

1.1 Background
Hypertension is a circulatory system disorder that causes an increase in blood pressure above
normal, which exceeds 140/90 mmHg (Triyanto, 2014). In general, the risk of blood pressure
increases slowly with age, systolic pressure continues to increase until the age of 80 years and diastolic
pressure will continue to increase until the age of 55-60 years and sometimes decreases slowly.
Hypertension is a disease that is often experienced by the elderly and is a major factor causing heart
failure and coronary heart disease. The initial step that can be taken in reducing hypertension in
addition to taking anti-hypertensive drugs is by lifestyle modification including managing stress and
anxiety which triggers an increase in Heart Rate (HR), blood pressure, and muscle tension, thus
requiring medical intervention and nursing intervention. One of the interventions that can be given
to the elderly with hypertension to control blood pressure is in the form of physical exercise such as
Tai Chi exercises.
Hypertension has become a major health problem in the world. According to the World Health
Organization (WHO), in 2012 there were at least 893 million cases of hypertension, and it is estimated
that by 2025 it will increase to 1.15 billion, about 80% of hypertension cases occur mainly in
developing countries. In Indonesia, based on the 2016 National Health Indicators Survey (Sirkenas),
the prevalence of hypertension reached 32.4%. In East Java the prevalence of hypertension reaches
10.7% (Riskesdes, 2013). In the city of Surabaya, based on the health profile of Surabaya in 2014-2016
the prevalence of hypertension has increased from 3.34% to 10.43% and based on data obtained from
the Sidotopo Wetan Public Health Center Surabaya the prevalence of hypertension in 2014-2016 has
increased from 261 patients to 657 patients. Meanwhile, based on the initial survey of research
conducted in November 2017 at the Elderly Posyandu RW.05 Sidomulyo, Sidotopo Wetan Village,
Kenjeran District, Surabaya, the prevalence of hypertension was 50 out of 80 elderly.
The increasing number of people with hypertension in the world has made this disease a global
health problem. The incidence of hypertension is caused by several factors including gender, heredity,
poor diet, obesity, never exercising, smoking, drinking alcohol, and frequent stress, so proper
treatment is needed. But in fact this disease has a nature that tends to be unstable and difficult to
control, both with treatment and other medical measures. Non-adherence in medication and
prolonged stress can make this disease worse, administration of drugs in the long term can be
detrimental and have a negative impact on the body, therefore drug therapy needs to be given in
conjunction with non-pharmacological therapy, in this case non-pharmacological therapy that can be
given is physical exercise such as Tai Chi gymnastics. Tai Chi movements that include body-
mindsoul-breath on a regular basis have been shown to increase the release of nonadrenaline through
the urine, lower cortisol levels, and reduce sympathetic nerve activity which has a positive impact on
the heart (in the form of a stable heart rate and blood pressure dropping to normal). This happens
because the activity of the sympathetic and parasympathetic nerves becomes balanced and
harmonious. The exercise can also increase antioxidants to eliminate free radicals in the body and
stabilize blood pressure (Sutanto, 2013).
Treatment of hypertension is broadly divided into two, namely pharmacological treatment and
non-pharmacological treatment. Pharmacological treatment is treatment using drugs or compounds
whose work can affect blood pressure, grouping of pharmacological therapies used to control blood
pressure in patients with hypertension such as diuretics, adrenergic blockers, ACE-inhibitors,
Angiotensin-II-blockers, calcium angiotensin, vasodilators and emergency hypertension, such as
malignant hypertension (Triyanto, 2014). Non-pharmacological treatment is treatment without using
antihypertensive drugs, in this case the therapy that can be done is healthy lifestyle therapy, some
lifestyle modification efforts that can be done are by means of a low-salt diet, changing diet by
increasing consumption of fruits and vegetables. Fruits and vegetables are rich in potassium, calcium,
and magnesium which work to lower blood pressure. In addition to regulating the pattern and the
right type of food, people with hypertension must also do physical activity and exercise regularly.
Types of physical activity and sports that can be done for example by morning walks, cycling, or
gymnastics, because by exercising regularly for 30-45 minutes with a frequency of 3-5 times a week
can help reduce body weight and reduce the risk of various cardiovascular diseases (Garnadi, 2012).
). While the type of exercise that is effective for the elderly is aerobic exercise with moderate intensity
such as walking and gymnastics for the elderly, the type of exercise that is usually done by the elderly
is low impact aerobic exercise or slow movement exercise such as Tai Chi. Tai Chi exercise is a form
of way to lower blood pressure in the elderly who suffer from hypertension, because with Tai Chi
exercise regularly it can relax muscles and reduce stress, thereby reducing the production of
catecholamines and cortisol hormones and can reduce the production of renin and angiotensin which
are the main factors. trigger for hypertension. Based on previous research conducted by Anik Supriani
in 2014 stated that Tai Chi exercise can reduce blood pressure if it is done regularly, namely with a
frequency of 3 times a week for 1 month with 15-30 minutes of Tai Chi exercise. Regular physical
exercise can increase the efficiency of the heart's work, the heart muscle becomes stronger so that it
can contract less in pumping the same amount of blood, this decrease in heart rate can reduce cardiac
output which can ultimately lower blood pressure. Based on the problems above, researchers are
interested in conducting research on the effect of Tai Chi exercise on reducing blood pressure in the
elderly with hypertension.
1.2 Problem formulation
Is there any effect of Tai Chi exercise on reducing blood pressure in the elderly with hypertension?

1.3 Purpose of the paper

1.3.1 General purpose

Studying the effect of Tai Chi exercise on reducing blood pressure in the elderly with hypertension.

1.3.2 Special purpose

1. Identifying blood pressure before doing Tai Chi exercise in the treatment and control groups of
the elderly with hypertension.
2. Identifying blood pressure after Tai Chi exercise in the treatment and control groups of the
elderly with hypertension.
3. Analyzing the effect of Tai Chi exercise on reducing blood pressure in the treatment and control
group for the elderly with hypertension.
4. Analyze the difference in blood pressure before and after Tai Chi exercise in the treatment and
control groups of elderly patients with hypertension.

1.4 Benefits of Papers

1.4.1. Theoretical Benefits

This research can provide construction for the development of science and technology in the health
sector as well as provide insight for further research related to gerontic nursing.

1.4.2. Practical Benefits

1. Benefits for the nursing profession This research can be used as a guideline in implementing
and developing effective and efficient nursing care, especially in controlling blood pressure in
the elderly with hypertension.
2. Benefits for Respondents This study can increase the participation of the elderly in participating
in physical exercises such as Tai Chi which is useful for lowering blood pressure in the elderly
with hypertension.