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Physiology: Regulation of Systemic

Blood Preassure

Neuronal regulation

Hormonal regulation

Autoregulation
Tortora G.J. and Bryan D., 2009, Principle of Anatomy and Physiology, 12th Ed., John Wiley and Sons Inc., United States of America.

Physiology: Regulation of Systemic Blood
Preassure

Lilly L.S., 2011, Pathophysiology of Heart Disease, 5th Ed.,
Wolters Kluwer, Philadelphia.

Definition and Classification
 Hypertension is defined
as an elevation of
diastolic blood pressure
≥90 mm Hg and/or
systolic blood pressure
≥140 mm Hg in a
repeated measurement.

Perhimpunan Dokter Spesialis Kardiologi Indonesia, 2015, PedomanTatalaksana Hipertensi pada Penyakit Kardiovaskular, Ed.
ke-1, Jakarta.
ESH/ESC, 2013, Hypertension Gudelines for the Management of Arterial Hypertension, Eur Heart J, 34:2159-219.
NIH/NHLBI, 2003, The 7th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of
High Blood Preassure.

.. Philadelphia. Wolters Kluwer.Etiology Lilly L.. Pathophysiology of Heart Disease.S. 5th Ed. 2011.

Overweight/ Obese Sedentary life Family history style Race Tobacco Unhealthy Age diet Excessive Diabetes alcohol usage Sleep apnea Stress .

. Philadelphia.. 5th Ed. Wolters Kluwer. Pathophysiology of Heart Disease. .S. 2011.Patophysiology Lilly L.

Headache. Wolters Kluwer. Philadelphia. 2011. Pathophysiology of Heart Disease. Symptom and Sign Asymptomatic and are diagnosed simply by blood Symptoms Sign pressure measurement during routine physical Epistaxis LVH examinations. sweating Arterial bruits Lilly L. dizziness ↑BP Blurred vision Retinopathy Flushing. ...S. 5th Ed.

organ damage. Hypertension Gudelines for the Management of Arterial Hypertension. . 2013. Eur Heart J. and concomitant clinical conditions ESH/ESC. 34:2159-219. Diagnosis Evaluation  Confirm the diagnosis of hypertension  Detect causes of secondary hypertension  Assess CV risk.

. Diagnostic Evaluation ESH/ESC. 34:2159-219. 2013. Hypertension Gudelines for the Management of Arterial Hypertension. Eur Heart J.

Risk factors: age. Hypertension Gudelines for the Management of Arterial Hypertension. dyslipidaemia. smoking. obesity and family history of premature CVD. Asymptomatic organ damage: left ventricular hypertrophy. . ESH/ESC. 2013. evidence of vascular damage and microalbuminuria. 34:2159-219. Eur Heart J. glucose intolerance. male sex.

Hypertension Gudelines for the Management of Arterial Hypertension. Eur Heart J.ESH/ESC. 2013. 34:2159-219. .

ahajournals. available at http://hyper. An Effective Approach to High Blood Pressure Control.org .Non Pharmacology Treatment AHA/ACC/CDC. 2013.

11th Ed.... Anthony T.M. Mechanism of Action Antihypertensive Agent Katzung B. Basic and ClinicalPharmacology. Susan B.J. 2009. The McGraw-Hill Companies .G.

Pharmacology Treatment .

2013. JAMA. . 2014Evidence-BasedGuideline for theManagement of HighBlood Pressure inAdults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC8).American Medical Association.

2013.ahajournals.org . An Effective Approach to High Blood Pressure Control. available at http://hyper.AHA/ACC/CDC.

ESH/ESC. 2013. 2013 ESH/ESC Guidelines for themanagement of arterial hypertension. 31 (7): 1281-1357. Jhypertension. .

PedomanTatalaksana Hipertensi pada Penyakit Kardiovaskular. ke-1. Jakarta. 2015.Perhimpunan Dokter Spesialis Kardiologi Indonesia. Ed. .

2013. 31 (7): 1281-1357. . Possible Combination of Antihypertension Drug ESH/ESC. 2013 ESH/ESC Guidelines for themanagement of arterial hypertension. Jhypertension.

.

Drug of Choice ESH/ESC. 31 (7): 1281-1357. . Jhypertension. 2013 ESH/ESC Guidelines for themanagement of arterial hypertension. 2013.

2013 ESH/ESC Guidelines for themanagement of arterial hypertension. Contraindication of Antihypertension Agent ESH/ESC. Jhypertension. 2013. . 31 (7): 1281-1357.

Summary of Antihypertension Agent .

2013. 2014Evidence-BasedGuideline for theManagement of HighBlood Pressure inAdults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC8). . JAMA.American Medical Association.

American Medical Association. 2014Evidence-BasedGuideline for theManagement of HighBlood Pressure inAdults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC8). 2013. JAMA. .

S. Philadelphia. Wolters Kluwer.. Pathophysiology of Heart Disease. .. Complication of Hypertension Lilly L. 2011. 5th Ed.

CONTOH KASUS .

Identitas  Nama : Tn. Mungguk Badang Gg. Mandiri  Pekerjaan : PNS  Status Perkawinan : Menikah . SS  Jenis Kelamin : Laki-laki  Usia : 50 tahun  Agama : Islam  Alamat : Jln.

pingsan (-). muntah (-). . durasi dalam hitungan jam hingga sepanjang hari. mual (-). Pekerjaan yang berat diduga memicu nyeri dan dapat mereda jika tidur/minum obat antinyeri/dipijat. nyeri ulu hati (- ). trauma (-). Nyeri kepala dirasakan di seluruh bagian kepala hingga ke leher.Anamnesis  Keluhan Utama Nyeri kepala  Riwayat Penyakit Sekarang Pasien datang dengan keluhan nyeri kepala hilang timbul sejak 1 minggu. silau saat melihat cahaya (-). Nyeri lebih sering timbul pada siang hari. Riwayat pusing berputar (-). terasa tegang seperti diikat erat. hampir setiap hari.

DM (+). ginjal (-). dislipidemi tidak diketahui. tiroid (-) . tiroid (-)  Riwayat Penyakit Keluarga HT (+). dislipidemi tidak diketahui. stroke (-). DM (-). Pengobatan: Amlodipin 1x10 mg. PJK (+). asma (-). hiperurisemi tidak diketahui.Anamnesis  Riwayat Penyakit Dahulu HT (+) sejak 3 tahun. stroke (-). hiperurisemi tidak diketahui. ginjal (-). PJK (-). tidak rutin mengkonsumsi obat. asma (-).

olahraga sangat jarang.Anamnesis  Riwayat Sosial Ekonomi Merokok (+). senang makan makanan berlemak jenuh (+). pekerjaan di depan komputer/konsentrasi penuh >2 jam per hari (-). minum alkohol (-). .

reguler Suhu : 37oC .Pemeriksaan Fisik  Vital Sign Nadi : 90 kali per menit. reguler. equal TD : 170/100 mmHg RR : 20 kali per menit. kuat angkat. isi cukup.

simetris . secret (-).Pemeriksaan Fisik Status Generalis  Kulit: sianosis (-). pupil isokor. lidah kotor (-)  Tenggorokan: faring hiperemis (-). perdarahan (-)  Hidung: deviasi septum (-). pucat (-). kering (-). sklera ikterik (-/-). reflex cahaya (+/+)  Telinga: nyeri tekan tragus (-). spider nevi (-). pembesaran tiroid (-)  Toraks: bentuk normal. d= 3 mm. ruam (-)  Kepala dan leher: Status lokalis  Mata: konjungtiva anemis (-/-). tonsil T 0/ T0  Leher: pembesaran limfonodi (-). sekret (-/-). lembab (-). perdarahan (-/-)  Mulut: bibir sianosis (-).

rhonki (-/-). edema (-) .Pemeriksaan Fisik  Paru Inspeksi : simetris. CRT<2 derik. nyeri tekan (-). hepar lien tidak teraba Perkusi : timpani  Ekstremitas : Akral hangat. spider nevi (-) Auskultasi : bising usus (+) 8 kali/menit Palpasi : supel. pergerakan simetris Palpasi : fremitus taktil normal dan simetris Perkusi : sonor di kedua lapang paru Auskultasi : vesikuler (+/+). venektasi (-). wheezing (-/-)  Abdomen Inspeksi : distensi (-).

gallop (-) . JVP 5+2 cmH2O  Jantung: Inspeksi : ictus cordis tidak terlihat Palpasi : ictus cordis teraba di SIC V linea midclavicularis sinistra Perkusi : Batas kanan jantung: SIC III linea parasternal dextra Pinggang jantung: SIC II linea parasternal sinistra Apeks : SIC V linea midclavicularis sinistra Auskultasi : S1S2 reguler tunggal. ROM leher bebas. nyeri tekan (-). deformitas (-). simetris. murmur (-).Status Lokalis  Kepala dan leher: bentuk normocephal.

Pemeriksaan Penunjang  Kolesterol total : 250 mg/dl  GDS : 120 mg/dl  Asam urat : 4.2 mg/dl .

Diagnosis  Tension type headache  Hipertensi grade II  Dislipidemia .

Tatalaksana Nonmedikamentosa Medikamentosa  Penurunan BB  Lisinopril 1x10 mg  Berolahraga rutin  Amlodipin 1x10 mg  Restriksi garam  Simvastatin 1x10 mg  Diit rendah lemak  Asam mefenamat 3x500  Manajemen stres mg prn .