MAKALAH BAHASA INGGRIS

HYPERTENSI

DISUSUN OLEH :KELOMPOK III

1. RINCE MARIPADANGNIM. 9113129062111.035

2. HERLINANIM. 9113129062111.036

3. JAMALUDDINNIM. 9113129062111.045

4. SARMIANIM. 9113129062111.046

5. FRESTIANANIM. 9113129062111.057

STIK AVICENNA MULTIKAMPUS RAHA

TAHUN 2013

CHAPTER I

INTRODUCTION

1.1. Background

High blood disease known as hypertension is a disease that gets

attention from all circles of society, considering its impact both short and

long term and thus require long-term response that fully. Hypertension cause

morbidity (illness) and mortality (death) is high.

Hypertension is a disease resulting from the interaction of various risk

factors a person has. Various studies have linked between the various risk

factors on the incidence of hypertension.

Based on the research that has been conducted poorer prevalence

(incidence) of hypertension increases with age.From various epidemiological

studies conducted in Indonesia showed 1.8 to 28.6% of the population aged

over 20 years are hypertensive.

Hypertension, currently there is a trend that more urban than rural

communities suffer from hypertension. This is partly attributed to the urban

lifestyle associated with the risk of hypertension such as stress, obesity

(overweight), lack of exercise, smoking, alcohol, and eating foods high in fat

content.

Along with age, almost everyone has experienced an increase in blood

pressure, systolic blood pressure continues to increase until the age of 80

years and diastolic pressures continue to increase until the age of 55-60

years, then decrease slowly or even decreased dramatically.

1.2. Problem Formulation

a. How does the definition of hypertension?

b. How to measure blood pressure?

c. Explaining the causes of hypertension?

d. Explain the symptoms of hypertension?

e. Describe the effect of hypertension?

f. How hypertension prevention?

g. Explain the treatment of hypertension?

1.3. The purpose

a. To find definitions of hypertension.

b. To learn how to measure blood pressure.

c. To determine the cause of hypertension.

d. To know the symptoms that caused.

e. To know the result of hypertension.

f. To know the prevention of hypertension.

g. To determine the treatment of hypertension.

CHAPTER II

DISCUSSION

2.1    Definitions

Hypertension or high blood pressure, is increased blood pressure or

force of blood pressing on the walls of the cavity where the blood was. High

Blood Pressure (hypertension) is an increase in blood pressure in the

arteries. (Hiper means Overrated, tension means pressure /

t egangan; j adi, hipertensi is p system disorders that cause blood

eredaran rise in blood pressure above the normal value.

Blood pressure in a person's life varies naturally. Infants and children

normally have a blood pressure that is much lower than adults. Blood

pressure is also affected by physical activity, which will be higher at the time

of the activity and lower when resting. Blood pressure is also different in one

day, the highest in the morning and most re ndah during nighttime sleep.

2.2    Measuring Blood Pressure

On examination the blood pressure will get two points. A higher figure

obtained when the heart contracts (systolic), a lower number obtained when

the heart relaxes (diastolic).Blood pressure is written as systolic pressure

diastolic pressure slash, eg 120/80 mmHg, read a hundred and twenty

eighty. Along with age, almost everyone has experienced an increase in

blood pressure , systolic blood pressure continues to increase until the age of

80 years and diastolic pressures continue to increase until the age of 55-60

years, then decrease slowly or even decreased dramatically.

Blood pressure is written with two numbers, the number units mmHg

(millimeters of mercury) in blood pressure tool / tension meter, the systolic

and diastolic. Is the highest systolic blood pressure is when the heart is doing

contract or contraction. Diastolic is the lowest figure at the heart expands in

the final relaxation.

For example, blood pressure 120/80 mmHg mean systolic pressure of

120 and diastolic pressure of 80 mmHg.

Blood pressure is the pressure generated by:

a. Strength buds urgent cardiac left ventricle to insert the contents of the

blood into the arterial trunk.

b. Resistance in the arterial blood flow.

c. Autonomic nerves are made up of the sympathetic and the sympathetic

system.

Classification of blood pressure

No Classification Systolic Diastolic

1 Optimal <120 mmHg <80 mmHg

2 Normal <130 mmHg <85 mmHg

3 Normal high 130-139 mmHg 85-89 mmHg

4 Mild hypertension 140-159 mmHg 90-99 mmHg

5 Hypertension was 160-179 mmHg 100-109 mmHg

6 Severe hypertension > 180 mmHg > 110 mmHg

Normal blood pressure

Blood pressure varies per person per day, depending on the

circumstances, and are affected by the activities of a person, so normalpun

blood pressure varies.

Adults when the blood pressure showed the number 140/90 mmHg is

considered normal upward. There is a perception of low blood pressure is not

good, it is less precise.Because statistics show that people with low blood

pressure have the same age with so-called normal. The best thing is to

maintain normal blood pressure and the assumption that increasing age is

higher blood pressure is not a problem, is the assumption that needs to be

clarified, because based on statistics of parents whose blood pressure in the

normal range, the trend gets low stroke disorders. Check your blood pressure

regularly at least once every 6 months or whenever the doctor / health

facility.

2 classification known hypertension (by cause), namely:

a. primary hypertension (hypertension idiophatik), in which the cause is not

known with certainty. It also said that hypertension is the impact of

lifestyle and environmental factors.

b. secundary hypertension, is hypertension that occurs due to the disease

from other diseases such as abnormalities in the kidneys or keruskanan of

the hormone system.

WHO classifies hypertension based on the presence or absence of

abnormalities in other organs, namely:

a. hypertension without abnormalities in other organs.

b. hypertension with cardiac enlargement.

c. hypertension with abnormalities in other organs in addition to the heart.

Classification of hypertension by high blood pressure are:

a. borderline hypertension: blood pressure between 140/90 mmHg and

160/95 mmHg.

b. mild hypertension: blood pressure between 160/95 mmHg and 200/110

mmHg.

c. Moderate Hypertension: Blood pressure between 200/110 mmHg and

230/120 mmHg.

d. severe hypertension: blood pressure between 230/120 mmHg and

280/140 mmHg.

2.3    Causes of hypertension

There are 2 kinds of hypertension, essential and secondary.

a. hypertension Essential hypertension is the most not known cause. There

are 10 - 16% of adults suffer from high blood pressure.

b. hypertension Secondary hypertension is a known cause and why.

Hypertension kind is only a small part, which is only about 10%.

Some of the causes of hypertension, among others:

· Because hormonal, for example, from the adrenal glands.

· The use of drugs.

· smoking because the nicotine contained in tobacco.

· Alcoholic beverages.

· Abnormalities in the kidneys.

· Intracranial Abnormalities resulting in increased intracranial pressure or

because of its location near the center of persyarafan that affect blood

pressure.

· Abnormalities of the large blood vessels (aorta) that koartasio aorta

where the aortic arch aorta is continuous with decendens.

2.4. Anatomy

a. Heart

Measuring about one fist and is located within the chest, the limit on

the right is right and apeksnya sternum in the fifth intercostalis space

midclavicular left linea.

Relation of heart is:

Above: large blood vessels

Bottom: diaphragm

Each side: lung - lung

Rear: the descending aorta, esophagus, vertebral Columna

b. Arteries

Is the tube through which the blood flow in tissues and

organs.Consists of layers of the arteries: a slippery layer, the middle layer

of elastin tissue / muscle: the aorta and major branches have laposan

center consisting of a network of elastin (to deliver blood to the organs),

smaller arteries have a muscular middle layer (regulating the amount of

Blood delivered to an organ).

c. Arterioles

Are the blood vessels with smooth muscle wall is relatively

thick. Arteriolar wall muscles to contract. Contractions caused kontriksi

diameter blood vessels. When kontriksi localized, blood supply to the

tissues/organs is reduced. If there kontriksi general, blood pressure will

increase.

d. Major blood vessels and capillaries

The main blood vessels are thin-walled vessels that run directly from

arterioles to venul. Capillaries are the network of small blood vessels open

major blood vessels.

e. Sinusoids

There are spleen, liver, bone marrow, and endocrine

glands.Sinusoids three to four times greater than in capillaries and partially

coated with reticulo-endothelial system cells. In places the sinusoid, having

direct contact with the blood cells and the exchange does not take place

through the network space.

f. Vena and venul

Venul is a combination of small veins formed capillaries. Veins

formed by the combined venul. Veins have three walls that are not

adjacent to each other perfectly. (Gibson, John. Issue 2 2002, p 110)

2.5. Physiology

The heart has the function as a pump oxygenated blood in the arterial

system, which was brought into the cell and the entire body to collect blood

deoxygenation (blood oxygen levels less) of the vein system are delivered to

the lungs for reoksigenasi (Black, 1997)

2.6. Pathophysiology of hypertension

The mechanisms that control the constriction and relaxation of blood

vessels located in the vasomotor center, the medulla of the brain.This stems

from the central vasomotor sympathetic nerve pathway, which continues

down to the spinal cord and the spinal cord out of the column to the

sympathetic ganglia in the thorax and abdomen.stimulation of the vasomotor

center is delivered in the form of impulse moves down through the

sympathetic nerves to the sympathetic ganglia. At this point, neurons release

acetylcholine preganglion, which will stimulate post-ganglion nerve fibers to

the blood vessels, which resulted in the release of norepinephrine

constriction of blood vessels. Various factors such as anxiety and fear can

affect vascular response to stimuli vasokontriktor. Individuals with

hypertension are very sensitive to norepinephrine, although it is not clear

why it could happen.

At the same time stimulate the sympathetic nervous system in which

the blood vessels in response to emotional stimuli, the adrenal glands are

also stimulated vasoconstriction resulting in additional activities. Secreting

adrenal medullary epinephrine causes vasoconstriction. Adrenal cortex

secrete cortisol and other steroids, which DAPT strengthen blood vessels

vasokontriktor response.vasoconstriction resulting in decreased blood flow to

the kidneys, causing the release of renin. Renin stimulates the formation of

angiotensin I, which is then converted to angiotensin II, a potent

vasoconstrictor, which in turn stimulates aldosterone secretion by the

adrenal cortex. hormone causes retention of sodium and water by the kidney

tubules, causing an increase in intravascular volume. All of these factors tend

to provoke a state of hypertension.

Structural and functional changes in the peripheral vascular system

responsible for the changes in blood pressure that occurs in the

elderly. These changes include atherosclerosis, loss of elasticity of the

connective tissue, and a decrease in vascular smooth muscle relaxation,

which in turn lowers the ability of tensile strength distension and blood

vessels. Consequently, the aorta and large arteries less able to accommodate

the volume of blood pumped by the heart (volume sekuncup), resulting in

decreased cardiac output and increased peripheral resistance (Smeltzer,

Bare, 2002).

2.7. The symptoms of hypertension

The symptoms of hypertension, among others:

a. Much of no symptoms.

b. Pain in the back of the head.

c. stiff neck.

d. Fatigue.

e. Nausea.

f. Shortness of breath.

g. Restless.

h. Vomiting.

i. easily offended.

j.   hard to sleep.     

Complaints are not always going to be experienced by a patient with

hypertension. Often a person with symptoms of pain behind his head,

irritability and difficulty sleeping, when the blood pressure measured showed

a normal blood pressure numbers. The only way to determine the presence

or absence of hypertension only by measuring blood pressure.

2.5    The effects of hypertension

Hypertension if not controlled can lead to serious complications, such as:

a. kidney damage.

b. damages blood vessels.

c. brain hemorrhage / stroke.

d. Paralysis.

e. enlarged heart / heart trouble.

f. Narrowing of the coronary arteries / heart attack.

2.6    Prevention of hypertension

Person's risk for hypertension (except essential), can be reduced by:

a. Checking blood pressure regularly .

b. Maintain ideal weight .

c. Reducing salt intake .

d. Do not smoke .

e. Exercising regularly .

f. regular life .

g. Reducing stress .

h. Do not rush .

i. Avoid fatty foods.

Primary Prevention:

·  Adequate sleep, between 6-8 hours per day.

·  Reduce high cholesterol foods and multiply physical activity to lose weight.

·  Reduce alcohol consumption.

·  Consumption of fish oil.

·  The supply of calcium, although only slightly lower blood pressure but

calcium is also quite helpful.

Secondary Prevention

· Pattern whice food healthy.

· Reduce salt and sodium in your diet.

· Physical active.

· Reduce intake Alcohol.

· Stop smoking.

Tertiary Prevention

· Control of blood on a regular basis.

· Sports regularly and adjusted to body condition.

2.7    Treatment of hypertension

Treatment of hypertension is best:

a.  Always control your blood pressure checked regularly by a doctor .

b.  Always take medication regularly even without a complaint .

c.  Reducing salt intake .

d.  Increase consumption of vegetables and fruit .

e.  Obeying doctor's advice.

The content of salt (Sodium or Sodium)

Someone who is suffering from hypertension should control themselves

in salt consumption. The meaning here is the sodium salt of salt present in

almost all foods derived from animals and plants.One major source of sodium

is table salt. Therefore, the recommended salt intake of no more than ¼ - ½

teaspoon / day or to use other than the sodium salt.

Low salt diet goal is to help eliminate the salt or water retention in the body

tissues and lowers blood pressure in hypertensive patients.The terms of a low

salt diet is:

· Enough energy, protein, minerals, and vitamins.

· Forms of foods according to the disease state.

· The amount of sodium adjusted to the severity of salt or water retention

and / or hypertension.

This diet contains enough nutrients. In accordance with the state of the

disease can be given different levels of Low Salt Diet.

· Low Salt Diet I (200-400 mg Na)

This diet was given to patients with edema, ascites, and / or severe

hypertension. In the food processing no salt added. Avoided the foods high in

sodium.

· Low Salt Diet II (600-800 mg Na)

This diet was given to patients with edema, ascites, and / or hypertension

are not too heavy. Daily feeding with Low Salt Diet I. In the food processing

may not use salt ½ tsp (2 g). Avoided the foods high in sodium.

· Low Salt Diet III (1000-1200 mg Na)

This diet is given to patients with edema and/or mild hypertension. Daily

feeding with Low Salt Diet I. In the food processing may use 1 teaspoon salt (4

g).

2.8. Content of Potassium or Potassium

Potassium suplements 2-4 grams per day can help lower blood

pressure. Potassium is generally fat found in some fruits and

vegetables. Fruits and vegetables that contain potassium and good for

people with hypertension consumed include watermelon, avocado, melon,

bitter melon fruit, squash, bligo, machete pumpkin / gourd, cucumber, aloe

vera, celery, onion and garlic. In addition, foods containing omega 3 sagat

elements known to be effective in helping to decrease blood pressure

(hypertension).

In patients with hypertension where blood pressure> 160 / g mmHg, in

addition to the provision of anti-hypertensive drugs need dietetic therapy and

lifestyle changes. The objective of dietary management is to help lower blood

pressure and maintain blood pressure to normal. In addition, the diet is also

intended to reduce risk factors such as overweight, high cholesterol and fat

levels of uric acid in the blood. It should be noted also that accompanies

other degenerative diseases such as high blood pressure, heart, kidney and

diabetes mellitus.

a. SETTING MENU FOODS

Adjusting diet is recommended for patients with hypertension to avoid

and limit foods that can increase blood cholesterol levels and increase blood

pressure, so people do not have a stroke or cardiac infarction.

Foods to be avoided or restricted are:

1. The food is high in saturated fat (brain, kidney, lung, coconut oil, lard).

2. Food was prepared by using sodium salt (cookies, crakers, chips and dried

foods are salty).

3. Food and drinks in cans (sardines, sausage, korned, vegetables and fruits

in cans, soft drink ).

4. Preserved foods (jerky, pickled vegetables or fruit, shredded, salted,

boiled, dried shrimp, salted eggs, peanut butter).

5. Milk full cream , butter, margarine, cheese, mayonnaise, and other

sources of animal protein are high in cholesterol such as red meat (beef /

mutton), egg yolk, chicken skin).

6. Condiments such as soy sauce, maggi, shrimp paste, tomato sauce, chili

sauce, tauco and other flavorings generally contain sodium salt.

7. Alcohol and alcohol-containing foods such as durian, tape.

How to set up a diet for people with hypertension is to improve the

taste by adding sugar fresh red / white onion (red / white), ginger, and other

spices kencur are not salted or salt contains less sodium.Food can be sauteed

to improve the taste. Put salt at the table above can be taken to avoid

excessive use of salt. It is recommended to always use iodized salt and salt

use no more than 1 teaspoon per day.

Increasing potassium intake (4.5 grams or 120-175 mEq / day) can give

the effect of a mild decrease in blood pressure. In addition, administration of

potassium also helps to replace lost sodium and low potassium result. Can

generally used medium size (50 grams) of apples (159 mg potassium),

orange (250 mg potassium), tomato (366 mg potassium), banana (451 mg

potassium) baked potato (503 mg potassium) and 1 cup skim milk (406 mg

potassium). Adequacy of calcium is important to prevent and treat

hypertension: 2-3 glasses of skim milk or 40 mg / day, 115 grams of low-

sodium cheese to meet the needs of calcium 250 mg / day. While the needs

of the average daily calcium 808 mg.

In pregnant women food enough protein, calories, calcium and sodium

are associated with a lower incidence of hypertension of

pregnancy. However, pregnant women are especially hypertension

accompanied by swelling and urinary protein (pre-eclampsia), other than

medicines recommended to reduce salt intake and increase food sources of

Mg (vegetables and fruits).

b. SUPPLEMENTATION anti oxidant

Despite antioxidant supplementation still require further research, but

today many supplements are sold and consumed by the public. As medical

personnel should be careful giving advice supplement drink to avoid

overdose.

1. Vitamins and Decrease Homocysteine

Folic acid, vitamin B6, vitamin B12 and riboflavin are enzyme co-factor

essential for the metabolism of homocysteine. Various studies have shown

that elevated levels of homocysteine in the blood increases the risk of

coronary artery disease. Low levels of folic acid are associated with an

increased risk of coronary disease and low vitamin levels are also associated

with an increased risk of atherosclerosis, although the risk of atherosclerosis

associated with low levels of vitamin B6 was not associated with a high

concentration of homositein. while vitamin B12 is not associated with

vascular disease.

2. Soybeans and Isoflavones

Soy contains many isoflavones are estrogen-Phy, which have weak

estrogen activity. Research meta-analysis in 1995 concluded that isoflavones

from soy protein more significantly reduce total cholesterol, LDL cholesterol and

triglycerides, without affecting HDL cholesterol levels. So it is recommended to

consume soy protein (20-50 grams / day) and dietary modifications in patients

with cholesterol (total and LDL) is high. Tempe is the result of processing

soybeans fermented with better nutritional content than soy. So that tempeh is

recommended for consumption by people with hypertension as a source of

vegetable protein.

3. Tempe

Tempe is one of the traditional food of Indonesia, fermented

fungus Rhizopus ohgosporis or rhizopusoryzal on soybean seed that has been

boiled. There are various kinds of tempeh, tempeh discussion is made of soy,

which is a compact product, wrapped flat by the mycelium fungus that

appears white in color, and when sliced pieces seem pale yellow soya beans,

among the mycelium. Fermentation mold produces a change in the texture of

soy, are soft and nutritional value of tempeh better than soybeans.

Nutritional value Tempe:

· Protein

Enzymes produced molds, producing free amino acids, so the level is

increased to 85 times the levels of soy protein.

· Carbohydrates

Soybeans contain carbohydrates in the form of sakrosa and stakhiosa and

rifinosa (the latter two led to the formation of gas in the

stomach). Fermented soybeans into soybean producing carbohydrates.

· Fat

Enzymes in the mold can reduce the total fat content from 22.2% to 14.4%

and increased free fatty acid levels from 0.5% to 21%.

· Mineral

In the soybean contained phytic acid which is a compound forfose, which

can not be utilized by the body. With fermentation, molds produce the

enzyme phytase which outlines the phytic acid, so it can be utilized

forfosenya body.

· Vitamin

The fermentation process can increase levels of vitamin B2 (Riboferum),

Vitamin B6 (pyridoxine), folic acid, panthotenat, and nicotinic acid. While

vitamin B1 levels decreased due to the growth of mold and also vitamin

B12 formed by bacteria that do not exist in other vegetable products.

Benefits Tempe:

Tempe is a good source of nutrients, especially for patients with hyper

kolesterolemia. From various studies it turns out tempeh can lower

cholesterol levels in the blood and prevent blood vessel constriction, because

tempeh contains polyunsaturated fatty acids. So that hypertensive patients

are encouraged to eat tempeh every day, in addition to a diet low in

saturated fat.

Tempe also contains antibacterial substances that can inhibit the

growth of some gram-positive bacteria as well as cause diarrhea

(Salmonella sp and Shigella sp.) Therefore, tempeh is also recommended to

be consumed under five with diarrhea.

4. Omega 3 Fatty Acids

Eating one serving of high-fat fish (or fish oil) per day can be the intake

of omega 3 fatty acids (EPA and DHA) of approximately 900 mg / dl, and has

been reported to lower cholesterol and prevent coronary heart disease.

5. Fiber

Although sharing of studies show an association between some types

of fibers with decreased cholesterol or LDL and total cholesterol, but there is

no direct evidence showing the relationship between fiber supplements with

decreased cardiovascular disease.

·         Name the dish, main ingredient, processing methods, and tools food diet

hypertension and dyslipidemia

Menu Ingredients 

Food Processing Equipment Method Supplementary Material misstatement 

soft rice 

Sauteed Chicken + Rice - Boiling + steaming porcelain dish 

skinless chicken stir-fry dishes porcelain salt 

Carrots Carrots 

boiled Nutmeg Bowl 

Coffee Milk Glass Milk Sugar Water + 

Sugar Pudding Fruit Jelly boiled Saucer 

Mango Mango 

Milk cups low fat Milk 

Rice Boiled Rice + Plato steamed 

fish Pepes Fish Plato saffron steamed 

soy chicken sauteed chicken red sugar Plato 

Glass Milk Skimmed milk powder 

Sugar 

Watercress Oseng + carrots + green beans stir-fried salt Plato Carrots 

Watercress 

Beans

Diet 

Breakfast Menu 

• Nasi software 

• Sauté chicken + carrots 

soy milk • Coffee 

(E: 225 Cal, KH: 30 g, L: 6.5 g, P: 30 g 

Interlude 1 and 2 

• Mango Pudding 

• low fat milk 

(E: 330 Cal, KH: 59 g, L: 7 g, P: 7 g) 

Lunch 

• White rice 

• Pepes know 

• Soup beans + carrots 

• Papaya fruit 

(E: 325 Cal, KH: 44 g, L: 7.5 g, P: 18.5 g) 

Dinner 

• White Rice 

• Sauteed Spinach 

• Pepes Fish 

• Fruit Papaya 

(E: 360Kal, KH: 57 g, L: 3 g, P: 12g)

CHAPTER III

CLOSING

3.1    Conclusion

Hypertension or high blood pressure, is increased blood pressure or

force of blood pressing on the walls of the cavity where the blood was.

Blood pressure in a person's life varies naturally. Infants and children

normally have a blood pressure that is much lower than adults. Blood

pressure is also affected by physical activity, which will be higher at the time

of the activity and lower when resting. Blood pressure is also different in one

day, the highest in the morning and lowest at night during sleep.

3.2. Suggestion

How to set up a diet for people with hypertension is to improve the

taste by adding sugar fresh red / white onion (red / white), ginger, and other

spices kencur are not salted or salt contains less sodium. Food can be

sauteed to improve the taste. Put salt at the table above can be taken to

avoid excessive use of salt. It is recommended to always use iodized salt and

salt use no more than 1 teaspoon per day.