WHAT IS HYPERTENSION???

Prevalence of hypertension is high in Indonesia, although it is not as high as in developed country. It become a public health problem that needs handling well.

Accroding to DR.Dr.Idrus Alwi, SpSD-KKV, FACC, the leader of PAPDS JAYA, the level of public care in Indonesia toward the danger of hypertension is still low. It is caused hypertension often appears without symptom and the patients do not fell sickness (Kabar Sehat,2008:11).

Hypertension is the medical term for high blood pressure. It is known as the “silent killer” since it has no symptoms but can lead to long term diseases and complications. It is because many people have high blood pressure and don’t know it. Blood pressure is measured by a blood pressure cuff and recorded as two numbers, for example 120/80 mmHg (milimeters of mercury). Blood pressure measurements are usually taken at the upper arm over the bracial artery.

The sign and symptom of hypertension according to Corwin (2009:487). They are follows:

• Headache when wake up, sometimes with nauseous and vomit because there are increasing of intracranium blood pressure.
• The vision is not clear because there are hypertensif damage in the retina
• Stagger because of  damage of central nerve
• Nocturia because of increasing of blood circulation in the kidney and glomelurus filtration
• Edema dependen and swollen because of increasing of capiler pressure

Hypertension is a cronic disease because of increasing of artery blood pressure that diastolic pressure is more than 90 mmHg and sistolic pressure is more than 140 mmHg  (Abdulrochim, 1992:11).

There are two types of hypertension. They are as follows:

·  Essential hypertension

Essential hypertension have no symptoms, but people can experience headaches, tiredness, dizziness, or nose bleeds. Although the cause is unknown, research do know that obesity, smoking, alcohol, diet, and heredity all play a role in essential hypertension. So, it  has no signal identification cause.

·  Secondary hypertension

The most common cause of secondary hypertension is an abnormality in the arteries supplying blood to the kidneys. Other causes include airway obstruction during sleep, disease and tumor of the adrenal glands, hormon abnormalities, tiroid diseases, and too much salt or alcohol in the diet. It also can be caused by another medical condition or treatment.

There are several complications of hypertension according to Corwin (2009:487). They are as follows:

·      Stroke

Stroke happens because of hemoragic high pressure in the brain or the release of embolus from artery  or vein except high pressure of brain. Stroke also happens in the cronic hypertension if artery in the brain that supplying blood experience hypertrofi or thicked, so blood circulation in the brain decrease. Brain artery that experience atherosclerosis can be weak, as a consequence the forming of aneurisma can increase.

·      Miokard infark

Miokard infark occurs if coronary artery with atherosclerosis can not supply oxygen to miokard or if the forming of trombus has blocked. Cronic hypertension and ventricel hypertension can not fill the necessity of oxyigen, it can happen iscemic. It is the mumber one of death associated with hypertension.

·      Kidney disease

Hypertension is a major cause of kidney disease and kidney failure. Kidney disease happens because there are high pressure in the glomerulus, and it become broke. As a consequence, the circulation of blood (nefron) can be disturbed and proteinuria. It can cause edema.

·      Preeclampsia

High blood pressure can be a sign of preeclampsia, a pregnancy related problem that can become life threatening. The plasenta of BBL is inadequate so BBL has a low weight.  And then, it can be hypoksia and acidosis if women pregnancy has convulsions experience before birth.

 ·      Diabetes

Hypertension ia a risk factors for the development and worsening of many diabetes complications and having diabetes increase the risk of developing high blood pressure.

Diagnostic measurement  of high pressure use sphygmomanometer. It will show the increase of sistolic and diastolic pressure. It uses a stethoscope and a cuff and gauge or by an automatic machine. This is one of vital signs which have to be examined in a routine manner. The sistolic and diastolic is for example 120/80 mmHg. The top number (120) is sistolic pressure. happed when left ventricular contracts or aorta valve opens. The bottom number (80) is diastolic pressure. This reflects the pressure in the arteries while the heart is filling and resting between heartbeats. According to Abdulrochim (2009) shows that the sign of hypertension is more than 140 mmHg and more than 90 mmHg.

The diagnostic laboratories of hypertension is needed (http://www.emedicinehealth.com/highbloodpressure/page5em.htm#Exams%20and%20Tests Accessed on Sunday, oct 16, 2011).

They are as follows:

·      Renal system

The tests are microscopic urinalysis, proteinuria (in the preeclamsia women), serum BUN (Blood Urea Nitrogen) and creatine.

·      Endocrine system

The tests are serum sodium, pottasium, calcium, TSH (Tjyriod Stimulating Hormone).

·      Metabolic system

The tests are fasting blood glucose, total cholesterol, HDL, and cholesterol, triglycerides

·      Others

Electrocardiogram (ECG) may help evaluate heart rate and rhythm. It is a screening test to help assess heart muscle thikness. If hypertension is long standing, the heart muscle has to hypertropy, or get largest, to push blood against the increased pressure within the arteries of body.

Echocardiogram is an ultrasound examination of the heart. It is use to evaluate the anatomy and the function of the heart. A cardiologist is requierd to interpret this test and can evaluate the heart muscle and determine how thick it is, and how efficiently it can push blood out to the rest of body. It also assess heart valves.

Doppler ultrasound is used to check blood flow through arteries at pulse point in your arms, legs, hands, feet. This is an accurate way to detect peripheral vascular disease which can be assiciated with high blood pressure. It also can measure blood flow in the arteries to both kidneys and sometimes depict narrowings that can lead to high blood pressure in a monitiry of patients.

So, Hypertension is a cronic diseases which is known as the “silent killer” because it has no symptoms, but can be looked with complication diseases such as stroke, miokard infark, kidney diseases, preeclampsia, and diabetes.

Futhermore, the sign and symptoms of hypertension usually are not known, before the person may suffer complication diseases. Besides that, hypertension also occurs because there are factors interaction which influence the increase of blood pressure. They are age, gender, genetic factors, obesity, smoke, and emotional depression. So, hypertension is one of diseases which is very dangerous.

Sumber: Asih, Laksmi. 2011. “HYPERTENSION”. English Paper. Tidak Diterbitkan.