Blood Pressure Profile of Young Adults at the Faculty of Medicine Universitas Indonesia.

BACKGROUND: hypertension remains a global burden. Complications of unrecognized hypertension might increase mortality as shown by a WHO 2013 report that hypertension caused 9.4 million deaths worldwide. There is no prior data in Indonesia on blood pressure status in young adults with similar education levels. Medical students are at high risk of developing early hypertension due to modern lifestyle habits. This study aimed to determine the blood pressure profile of medical students as representative of the young adult population. METHODS: we measured the prevalence of hypertension in medical students. All medical students who agreed to participate completed a questionnaire. Afterwards, we conducted a physical examination and obtained blood and urine samples to screen for blood pressure, estimated glomerular filtration rate, and the lipid profile. RESULTS: the prevalence of students with prehypertension or hypertension was 29.6%. The mean eGFR was 105.45 ml/min/m2. The mean total cholesterol was within normal limits. CONCLUSION: the prevalence of hypertension in medical students was high. This study shows that early detection of hypertension is key to treating it early and therefore to reducing morbidity and mortality.

The relationship between body mass index and blood pressure in patients undergoing chronic hemodialysis: A reverse epidemiology in Jakarta, Indonesia.

In the general population, obesity is positively correlated with hypertension. On the other hand, there was hypothesis of "reverse epidemiology" in the relationship between body mass index (BMI) and blood pressure (BP) of hemodialysis (HD) patients. This study aimed to investigate the "reverse epidemiology" of the relationship between the two variables in Jakarta, Indonesia. Cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Koja District Hospital, and Cengkareng District Hospital in July 2018. Total sampling was performed with a total of 525 HD patients aged >18 years. All data were analyzed from the medical records. Of 525 patients, 27.4% were obese. The post hoc analyses showed that obese patients had significantly lower post-HD systolic BP (P = 0.006) and diastolic BP (P = 0.004) than the normal-weight patients. The Chi-square analyses showed that the overweight group [odds ratio (OR) = 0.53; 95% confidence interval (CI) 0.31-0.87; P = 0.011] and the obese group (OR = 0. 63; 95% CI 0.400.97; P= 0.038) had significant protective effect (OR <1) on the post-HD hypertension. Being obese was a strong predictor for reduced BP (coefficient ß = -0.02; P = 0.031). BMI is inversely associated with BP in patients undergoing chronic HD.

Treating patients with hypertension in Indonesia's primary health care centre: A challenging condition.

BACKGROUND: In Indonesia, hypertension treatment relies on primary health care services, and there are no current data on blood pressure control and hypertension treatment in Indonesia's primary health care system. METHODS: We conducted a cross-sectional study including all patients with hypertension (n = 273) who visited the Tegal Alur II Community Health Center in 2017. For all patients with hypertension, medical records containing the most recent blood pressure results and antihypertensive treatments were examined by the authors. The primary outcome in this study was optimal blood pressure control according to the Joint National Committee (JNC) VII guidelines. RESULTS: The mean systolic and diastolic blood pressures were 143.7 mmHg (SD 18.5) and 87 mmHg (SD 11.4), respectively. Calcium channel blockers were the most frequently used antihypertensive agents (58.6%). Of all patients with hypertension, 27.1% achieved controlled blood pressure. Bivariate analysis revealed a significant association between antihypertensive agents and blood pressure control (p = 0.009). Multivariate analysis showed that calcium channel blockers were the strongest predictor of blood pressure control, with an adjusted odds ratio of 1.9 (95% confidence interval CI [1.1-3.5], p = 0.022). CONCLUSION: Controlled blood pressure was achieved by less than half of all patients with hypertension visiting the Tegal Alur II Community Health Center in 2017. The majority of patients with hypertension received single-drug therapy with calcium channel blockers, the most frequently used antihypertensive agents. There was a significant association between antihypertensive agents and blood pressure control. FUNDING: This study received no financial support from any specific funding agencies.

The impact of reusable dialyzer membrane on end-stage renal disease patients' Quality of life: A multicenter study in Jakarta, Indonesia.

Data from 8th Report of the Indonesian Renal Registry in 2015 reported that there was an increase in the prevalence of hemodialysis (HD) patients in Indonesia. Measures had been taken to reduce the cost of HD such as utilizing reusable dialyzer membrane. However, little is known on the impact of reusable dialyzer membrane on patients' quality of life (QOL), and hence, this study was conducted. We conducted a multicenter study at Cipto Mangunkusumo Hospital, Koja District Hospital, and Cengkareng District Hospital with a total of 389 patients. Cipto Mangunkusumo Hospital represented single-use dialyzer group while, Koja and Cengkareng District Hospital represented reusable dialyzer group. Face-to-face interviews were conducted using Kidney Disease QOL-Short Form 36 questionnaires. Single-use dialyzer group's scores were significantly higher than reusable dialyzer group's scores in the following dimensions: kidney disease component summary (KDCS; 74.2 vs. 66.3; P <0.001), physical component summary (PCS; 70.6 vs. 55.2; P<0.001), mental component summary (MCS; 76.1 vs. 70.7; P= 0.023), and overall health rating (73.4 vs. 64.9; P <0.001). In the linear regression model, reusable dialyzer was still a strong predictor in KDCS (coefficient ß = -9.3; P<0.001) and PCS (coefficient ß = -17.2; P <0.001). Reusable dialyzer was associated significantly with patients' QOL impairment. Unemployment, age, and illiteracy also showed significant association with patients' QOL.