UNDERGRADUATE THESIS

OVERVIEW OF DRUGS USED FOR TREATMENT IN

HYPERTENSION FOR ELDERLY PATIENTS IN
SANGLAH HOSPITAL, DENPASAR, BALI

ARCHANA LAXMI PATHMANATHAN

NIM 1402005192

MEDICAL EDUCATION STUDY PROGRAM

MEDICAL FACULTY
UDAYANA UNIVERSITY
DENPASAR
2018

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OVERVIEW OF DRUGS USED FOR TREATMENT IN
HYPERTENSION FOR ELDERLY PATIENTS IN
SANGLAH HOSPITAL, DENPASAR, BALI

Sheet of Approval

RESEARCH OF THIS UNDERGRADUATE THESIS HAS BEEN APPROVED

ON THE DATE OF 25 JANUARY 2018

Adviser 1 Adviser 2

dr. I Nyoman GedeWardana, M.Biomed dr. I Gusti Ayu Widianti, M.Biomed

NIP. 197807092005011012 NIP. 196802091999032001

Approved by,
Coordinator of Medical Program
Medical Faculty of Udayana University

Dr.dr. Komang Januartha Putra Pinatih, M.Kes

NIP. 196701221996011001

ii
 Page of Committee of Examiners of Thesis

This Research has been Tested and Assessed by the Examining Committee of the

Program Study of Medical Doctors in Medical Faculty of Udayana University

On the Date of 25 January 2018

Committee of Examiners:

Leader : dr. I Nyoman Gede Wardana, M.Biomed

Member :
1. dr. I Gusti Ayu Widianti, M.Biomed
2. dr.Yuliana, M.Biomed

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 PREFACE

I might want to extend my earnest appreciation to the Almighty God for showering

me with great wellbeing and the wellspring of astuteness and information furthermore

to put my needs right to finish this paper in the dispensed time. Next, my affirmation

toward the Medical Faculty of Udayana, Denpasar for giving me the chance to grow

my concentrating on degree and expand my enthusiasm into my picked point of

elective study, hypertension and the medication that is used to treat hypertension in

elderly patients. My outmost appreciation will be for dr. I Nyoman Gede Wardana,

M.Biomed and dr. I Gusti Ayu Widianti, M.Biomed for controlling me all through the

procedure from day one, from accumulating the rundown of diaries and trusting the

best out of my execution.

I trust this undergraduate thesis is completed in years to come and I am looking

forward for the up and coming semesters to proceed with my study in this theme.

To wrap things up, to loved ones for their genuine collaboration and commitment to

finish this paper with achievement.

Denpasar, January 2018

Medical Student Semester 7

________________________

(ARCHANA LAXMI PATHMANATHAN)

1402005192

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 STATEMENT OF ORIGINALITY

I hereby declare that in this thesis there is no paper ever submitted for a degree at a

college, and to the best of my knowledge there is no work or opinion ever written or

published by any other person, except as expressly referred to in this text and

mentioned in the bibliography.

If it later proves that I am doing an act of copying or imitating someone else's writing

as a result of my own thoughts, then the degree and diploma I have been given by the

university is void of my acceptance.

Denpasar, 25 January 2018

Stated by

Materai

Rp 6.000,-

.............................................................

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 ABSTRAK

Hipertensi adalah salah satu penyakit yang paling umum di kalangan pasien usia

lanjut dan juga dikenal sebagai ‘silent killer’. Hal ini bisa terjadi karena stres

berlebihan yang menyebabkan tekanan darah naik. Gejalanya bisa muncul tanpa

disadari terjadi terus selama bertahun-tahun akan penyakit mereka. Penelitian ini

menggunakan metode cross sectional descriptive. Penelitian ini bertujuan untuk

mengetahui jumlah penderita hipertensi dengan usia di atas 55 tahun dan gambaran

obat yang digunakan untuk pengobatan di pada pasien usia lanjut di Rumah Sakit

Sanglah Denpasar Bali. Berdasarkan hasil penelitian didapatkan meningkatnya

penderita hipertensi seiring bertambahnya umur. Berdasarkan jenis kelamin,

didapatkan hasil perempuan memiliki prevalensi yang lebih tinggi dibandingkan laki-

laki. Di Rumah Sakit Sanglah, kami menemukan bahwa kebanyakan obat yang

diberikan adalah amlodipine dan captopril untuk orang lanjut usia karena obat ini

bekerja efektif untuk pasien. Obat lain seperti valsartan, furosemid dan bisoprolol

juga diberikan kepada pasien hipertensi tergantung pada penyakit penyerta.

Kata kunci: hipertensi, kesadaran, pengobatan, prevalensi

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 ABSTRACT

Hypertension is one of the most common disease among elderly patients and it is also

known as a silent killer. It could be due to excessive stress which causes the blood

pressure to rise up. The symptoms could be appeared and people could go on for

years without having any awareness of their disease. In this study descriptive cross

sectional study method were being used. This study is to determine the total number

of hypertension patient with age above 55 years old and the drug used for treatment

among patients in Sanglah Hospital, Denpasar, Bali. Based on the results, we could

find as the age increases the number of individuals with hypertension increases. In

gender, we could see that female has higher prevalence compare to male. In Sanglah

hospital, we found that the mostly given drugs are amlodipine and captopril for

elderly people as this drugs works effectively for the patients. Other drugs such as

valsartan, furosemide and bisoprolol are also given to patients with hypertension

depending on their associated diseases.

Keyword: hypertension, treatment, awareness, prevalence

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 LIST OF CONTENT

Page

INNER COVER ………………………………..…………………… i

SHEET OF APPROVAL ………………………..………………. ii

COMMITTEE OF EXAMINERS ………..…………………………...….. iii

PREFACE ……………….…………………..………...…........ iv

STATEMENT OF ORIGINALITY ……………………………………….. v

ABSTRACT ……………………………………………………. vi

LIST OF CONTENT ……………….....………………….……..…..…... viii

LIST OF TABLE ……....……………………………...….….……… x

LIST OF FIGURE .…………………………………………..……...… xi

LIST OF ATTACHMENT ………….………………………………….. xii

LIST OF ABBREVIATIONS ………………………………………… xiii

CHAPTER I: INTRODUCTION

1.1 Background ………..………………..……………………...….. 1

1.2 Problem Identification ….…..……………..................……….. 3

1.3 Aim .........…………………….……....………...…........ 3

1.4 Benefit of Research …………………………..……………. 3

CHAPTER II: LITERATURE REVIEW

2.1 Prevalence of Hypertension in Elderly ..……………....…………… 4

2.2 Operational Definition …………..…….………………............. 5
2.3 Criteria of Hypertension ..…..…………………................……... 5
2.4 Causes of Hypertension ….……………………..…………..….. 6
2.5 Diagnosis of Hypertension .................................................……….. 7

2.6 Treatment and Management of Hypertension .……………..……… 8

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CHAPTER III: RESEARCH FRAMEWORK, CONCEPT & HYPOTHESIS

3.1 Research Frame Work ..…..…………………...……..…….…. 14

3.2 Research Concept ………...……..……………….……..… 15

CHAPTER IV: METHOD OF RESEARCH
4.1 Design of Research .................……......................…............ 16
4.2 Population and Sample of Research ………………………………. 16
4.2.1 Population of Research ..............................…........................ 16
4.2.2 Criteria of Sample .….........................……............................ 16
4.2.3 Size of Sample ……..….…………….………..….…..... 17
4.3 Research Variables ........………..…….……..…………...…….. ... 17
4.3.1 Operational definition …………….……………….…..…... 17
4.4 Research Instruments and Materials ……..….………….......…… .. 17
4.5 Time and Place of Survey……………………………….…......…… 18
4.6 Research Protocol …………………………………...….…......…… 18
4.7 Data Analysis…………………………..…………...….…….…….. 18
CHAPTER V: RESEARCH RESULTS AND DISCUSSION
5.1 Research Frame Work ...…..……..………………...……….. 19
5.2 Research Results …………………………………………........ 19
5.3 Research Discussion ………………………..............…….….…… 20
5.3.1 Age ………………………………………….......….…… 20
5.3.2 Gender……………………………………………….……… 21
5.3.3 Classifications……………………………………….…….... 22
5.3.4 Stages………..…………………………………….……….. 23
5.3.5 Drugs………………………………………..……………… 24
CHAPTER VI: CONCLUSION AND RECOMMENDATION
6.1 Conclusion …………………………...…………………………… 28
6.2 Recommendation……………………………...…………………… 28
REFERENCE……………………………………………………………… 30

ATTACHMENT…………………..……………………………………….. 32

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 LIST OF TABLE

Page

Table 2.1 Stages of hypertension ……………………………………........... 6

Table 2.2 Dosage of Drug…………………………………………..………. 13

Table 5.1 Total Patients Based on Characteristic of Samples.……….…….. 19

Table 5.2 Total Hypertension Patients According to Gender…….……...… . 21

Table 5.3 Total Number of Patients According to Stages…………………... 24

Table 5.4 Drugs Used for Treatment...………………………………..…...... 24

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 LIST OF FIGURE

Page

Figure 3.1 Conception of framework of Hypertension…………………..… 15

Figure 5.1 Age range from 55 years old from January-June 2017………… 20

Figure 5.2 Classification of Hypertension from January-June 2017..……… 23

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 LIST OF ATTACHMENT

Page

Research schedule…………………………..………………………….. 32

xii
 LIST OF ABBREVIATIONS

ACCF : American College of Cardiology Foundation

ACE : Angiotensin Converting Inhibitors
AHA : American Heart Association
ARB : Angiotensin Receptor Blockers
ASA : Acetylsalicylic Acid
BP : Blood Pressure
CAD : Coronary Artery Disease
CCB : Calcium Channel Blockers
CKD : Chronic Kidney Disease
CVD : Cardiovascular Disease
DBP : Diastolic Blood Pressure
ESH : European Society of Hypertension
ESC : European Society of Cardiology
HF : Heart Failure
RCT : Randomized Control Trial
SBP : Systolic Blood Pressure
TIA : Transient Ischemic Attack

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