Algorithm content developed by John Anderson, PhD, and Sanford C. Garner, PhD, 2000.
Lifestyle Modifications for
Prevention of Hypertension
• Lose weight if overweight
• Limit alcohol
• Increase physical activity
• Decrease sodium intake
• Keep potassium intake at adequate levels
• Take in adequate amounts of calcium and magnesium
• Decrease intake of saturated fat and cholesterol
• Stop smoking
Nutritional Management
• DASH DIET (1997)
• Dietary Approaches to Stop Hypertension
• Penambahan 1 porsi sayuran dan 1-2 porsi buah
• Banyak sayuran dan buah (tinggi kalium)🡪 10 porsi
sehari
• 4 – 5 porsi kacang2an, biji2an 🡪 bahan makanan
sumber magnesium, kalium dan serat
• DASH DIET 🡪 TINGGI Kalsium, Kalium dan
Magnesium
DASH-Sodium Trial
multi-center, feeding trial
randomized to control or DASH diet
3 levels of sodium intake (150, 100, 50
mmol/d) in cross-over design
2-week run in; 30 days at each sodium level
randomly assigned
outcome: change in BP (blinded)
* Chemical analysis
of menus Appel LJ et al. N Engl J Med 1997; 336:117-24
DASH-Sodium Trial
6.7
3.5
3.0
1.6
َ اَﻟ ﱠﻠ ُﮭ ﱠم أَرِ ﻧَﺎ اﻟْﺣَ قﱠ ﺣَ ّﻘًﺎ َوارْ ُز ْﻗﻧَﺎ اﺗﱢـﺑَﺎﻋَ ﮫ ُ َوأَرِ ﻧَﺎ ا ْﻟﺑَﺎطِ ل
ﺑَﺎطِ ﻼً َوارْ ُز ْﻗﻧَﺎ اﺟْ ِﺗﻧَﺎ َﺑ ُﮫ
Non Pengelolaan
Farmakologis
Farmakologis bedah
Obat yang
Pengaturan
mengurusi
makanan
nafsu makan
Obat yang
Latihan menghalangi
jasmani penyerapan zat
gizi dari usus
Tipe
Cenderung Pria.
Lemak tertumpuk di perut
Resiko tinggi
Cenderung wanita
Lemak di pinggul dan bokong.
Resiko terhadap penyakit umumnya kecil, kecuali resiko terhadap
penyakit arthritis dan varises vena (varicose veins).
Sumber protein hewani Ikan, putih telur, unggas tanpa kulit, Daging kambing, jeroan, otak,
susu skim, yoghurt dan keju rendah sosis, sardin, kuning telur, susu
lemak whole, susu kental manis, es krim
Sumber protein nabati Tempe, tahu, dan kacang-kacangan Dimasak dengan santan dan
digoreng dengan minyak jenuh
Sayuran Semua sayur dalam bentuk segar, Dimasak dengan mentega, minyak
direbus, dikukus, disetup, ditumis kelapa sawit dan santan kental
dengan minyak jagung, kedelai
Buah Semua dalam keadaan segar atau Buah yang diawetkan
dijus
Sumber lemak Minyak jagung, kedelai, kacang Minyak kelapa, kelapa sawit,
tanah, bunga matahari dan wijen mentega margarin, santan, lard,
mayones
Aspek Biomolekuler Olahraga
EXERCISE
Variable N %
1. Prevalence of MetS in Sex
Yogyakarta Special Region : Male 35 24,82%
26,24 % Female 106 75,18%
Waist Circumference
2. The most common of MetS Central Obesity 89 63,12%
component was Normal 52 36,88%
hypertension ( 35,46 %), Triglycerides Level
hypertriglycerides ( 57,45 Hyper triglyceride 81 57,45%
Normal 60 42,55%
%), and central obesity
Blood Pressure
(63,12 %). Hypertension 50 35,46%
3. There was a higher Normal 91 64,54%
prevalence of MetS in Metabolic Syndrome
females compared to Status
Metabolic Syndrome 37 26,24 %
males ( 24,1 % vs 2,1 %)
Normal 104 73,76 %
Waist Circumference and Triglyceride
Level (A.D.A. Dewi & Mahfida, 2019)
Correlative Test between Waist • The greater of waist circumference, the higher
Circumference and Triglyceride
Level
the level of blood triglycerides
• Relationship between abdominal
Variable R P value circumference and triglyceride levels can be
Triglyceride Level 0,4212 0,000
through several mechanisms.
1. Accumulation of visceral fat deposits can be
assessed by measurement of abdominal
Waist Circumference and Triglyceride Level circumference.
Waist Total P value 2. Triglyceride levels can be an indicator of low
Circumf Hyper Normal density cholesterol (VLDL) lipoprotein levels.
erence triglyceride 3. The increase in both indicators of abdominal
Normal 40 49 89 0,000 circumference and triglycerides is a
Central 41 11 52
manifestation of the body's failure to
Obesity
Total 81 60 141
metabolize energy and store fat, a process
known as protective metabolic deposition
Sex, Waist Circumference , Triglyceride Level , and Blood Pressure
Sex Blood Pressure Total P value
Hypertension Normal
• significant relationship of Male 6 29 35 0,009
waist circumference Female 44 62 106
Total 50 91 141
among gender Sex Waist Circumference Total P value
• Females in obese stage Central Obesity Normal
had the higher Male 6 29 35 0,005
triglycerides level Female 46 60 106
Total 89 52 141
compared to males Sex Triglycerides Level Triglycerides P value
• Estrogens have been a Hyper Normal Level
factor for lowering glucose triglyceride
and lipid abnormalities Male 18 17 35 0,406
Female 63 43 106
Total 81 60 141
Intervensi
Non Pengelolaan
Farmakologis
Farmakologis bedah
Pengaturan
Obat yang
makanan
mengurusi nafsu
(Weight
makan
Management)
Obat yang
menghalangi
Aktivitas Fisik
penyerapan zat
gizi dari usus
Komplikasi
Intervention to Reduce Risk of CVD
and DM Type 2
(Hoyas & Leon-Sanz, 2019)
Rekomendas tinggi serat, cereal, ubi, kentang pastries, biskuit, krakers berlemak,
kue-kue berlemak
i Bahan Sumber protein hewani Ikan, putih telur, unggas tanpa kulit, Daging kambing, jeroan, otak,
Makanan susu skim, yoghurt dan keju rendah sosis, sardin, kuning telur, susu
untuk MetS lemak whole, susu kental manis, es krim
Sumber protein nabati Tempe, tahu, dan kacang-kacangan Dimasak dengan santan dan
digoreng dengan minyak jenuh
Sayuran Semua sayur dalam bentuk segar, Dimasak dengan mentega, minyak
direbus, dikukus, disetup, ditumis kelapa sawit dan santan kental
dengan minyak jagung, kedelai
Buah Semua dalam keadaan segar atau Buah yang diawetkan
dijus
Sumber lemak Minyak jagung, kedelai, kacang Minyak kelapa, kelapa sawit,
tanah, bunga matahari dan wijen mentega margarin, santan, lard,
mayones
Aspek Biomolekuler Olahraga
EXERCISE
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J. C.,
James, W. P. T., Loria, C. M., & Smith, S. C. (2009). Harmonizing the metabolic syndrome: A joint interim
statement of the international diabetes federation task force on epidemiology and prevention; National
heart, lung, and blood institute; American heart association; World heart federation; International
atherosclerosis society; And international association for the study of obesity. Circulation, 120(16),
1640–1645. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
Castro-Barquero, S., Ruiz-León, A. M., Sierra-Pérez, M., Estruch, R., & Casas, R. (2020). Dietary strategies for
metabolic syndrome: A comprehensive review. Nutrients, 12(10), 1–21.
https://doi.org/10.3390/nu12102983
Dewi, A.D.A., & Mahfida, S. L. (2019). Nutrition Information , Sex , Family Disease History And Syndrome
Metabolic In Yogyakarta . Jurnal Gizi Pangan Soedirman, 3(1), 38–48.
Dewi, Agil Dhiemitra Aulia. (2019). Asupan gizi, status biokimia, dan status sindrom metabolik pegawai
Universitas X: studi deskriptif. Journal of Health Studies, 3(2), 1–9. https://doi.org/10.31101/jhes.651
Hoyas, I., & Leon-Sanz, M. (2019). Nutritional Challenges in Metabolic Syndrome. Journal of Clinical Medicine,
8(9), 1301. https://doi.org/10.3390/jcm8091301
TERIMA KASIH