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Definisi Hipertensi
Hipertensi adalah kondisi di mana tekanan darah lebih tinggi
dari 140/90 milimeter merkuri (mmHG). Angka 140 mmHG
merujuk pada bacaan sistolik, ketika jantung memompa darah
ke seluruh tubuh. Sementara itu, angka 90 mmHG
mengacu pada bacaan diastolik, ketika jantung dalam keadaan
rileks sembari mengisi ulang bilik-biliknya dengan darah.
Faktor Peningkatan TD
• Garam
• Merokok
• Pil antihamil
• Stres (ketegangan emosional)
• Drop
• Hormon pria dan Kortikosteroid
TIPE HIPERTENSI BERDASAR PENYEBAB
Lipolisis
Hiperinsulinemia
Hipertensi
Klasifikasi Tekanan Darah Orang Dewasa
(JNC7)
Klasifikasi Sistolik (mm Hg) (Diastolik (mm Hg)
Normal < 120 < 80
Pre hipertensi 120-139 80-89
Tahap 1 hipertensi 140-159 90-99
Tahap 2 hipertensi > 160 > 100
Penatalaksanaan Terapi
Tujuan terapi:
• Penurunanan mortalitas dan morbiditas yg berhubungan dengan
kerusakan organ target (mis: kejadian kardiovaskular atau
serebrovaskular, gagal jantung, dan penyakit ginjal)
Target TD:
• Normal : < 140/90 mmHg
• Pasien diabetes: < 130/80 mmHg
• Pasien ginjal kronis: < 130/80 mmHg
MODIFIKASI LIFESTYLE
• Diuretik
1. Diuretika lengkung henle: furosemida, bumetanida, etakrinat
2. Diuretik thiazida: HCT, klopamida, klortalidon
3. Diuretik hemat kalium: spironolakton
4. Diuretik osmosis: manitol dan sorbitol
Na+ berkurang, Volume darah
turun, TD turun
Stimulasi
Angiotensin I
Volume darah
ACE Naik
Vasokontriksi
Angiotensin II Retensi Na+
Aldosteron
ACEI
Mekanisme kerja
• Merintangi enzim ACE yg mengubah AT I menjadi AT II
• ACEI juga mencegah degradasi bradikinin dan prostaglandin
yg seharusnya di rombak oleh ACE -> terjadi akumulasi di
saluran napas dan paru-paru -> batuk
Con’t
Mekanisme kerja
• Menduduki reseptor AT II yg terdapat di myokard, dinding
pembuluh, susunan syaraf pusat, ginjal, anak ginjal dan hati.
Dimana reseptor AT II mempunyai efek vasokontriksi,
pelepasan aldosteron, pelepasan hormon antidiuretik.
• Tidak seperti ACEI, ARB tidak mencegah pemecahan
bradikin -> tdk memberikan efek samping batuk
Con’t
Reseptor β terdapat 2:
• Reseptor β1 terdapat di jantung. Blokade reseptor ini akan
mengakibatkan pelemahan daya kontraksi (efek ionotropik
negatif, penurunan frekuensi jantung (efek kronotropik
negatif, bradikardi)
• Reseptor β2 terdapat di paru-paru, pembuluh darah perifer
dan usus. Blokade reseptor ini menimbulkan penciutan
bronchia dan vasokontriksi perifer.
Con’t
Mekanisme kerja
• Menyebabkan relaksasi jantung dan otot polos dengan
menghambat saluran kalsium yg sensitif terhadap tegangan
(voltage sensitive), sehingga mengurangi masuknya kalsium
ekstraseluler ke dalam sel.
• Relaksasi otot polos vaskuler menyebabkan vasodilatasi dan
berhubungan dengan reduksi tekanan darah
Con’t
Penggolongan CCB;
• Derivat dihidropiridin: efek vasodilatasinya amat kuat. Yg termasuk
dalam derivat dihidropiridin yaitu nifedifin, amlodipin, nicardifin,
nimodipin.
• Non dihidropiridin: verapamil, diltiazem. Verapamil bekerja terhadap
jantung (menurunkan frekuensi dan daya kontraksi) dan terhadap
sistem pembuluh (vasodilatasi). Diltiazem kerjanya sama dengan
verapamil, tetapi efek ionotrop negatifnya lebih ringan.
Penghambat α1
Contents
02 Get a modern PowerPoint Presentation that is beautifully
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Contents
03 Get a modern PowerPoint Presentation that is beautifully
designed. I hope and I believe that this Template will your Time.
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04 Get a modern PowerPoint Presentation that is beautifully
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