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Tuesday, 16 July 2013

MAKALAH BAHASA INGGRIS HYPERTENSI

MAKALAH BAHASA INGGRIS

HYPERTENSI

DISUSUN OLEH :

KELOMPOK III

1. RINCE MARIPADANG
 NIM. 9113129062111.035

2. HERLINA

NIM. 9113129062111.036

3. JAMALUDDIN

NIM. 9113129062111.045

4. SARMIA

NIM. 9113129062111.046

5. FRESTIANA

NIM. 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

Optimal

<120 mmHg

<80 mmHg

Normal

<130 mmHg

<85 mmHg

Normal high

130-139 mmHg

85-89 mmHg

Mild hypertension

140-159 mmHg

90-99 mmHg

5
Hypertension was

160-179 mmHg

100-109 mmHg

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.