Klinik KITA

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Mengubah Gaya Hidup, Terapi Tambahan untuk Pasien Hipertensi

Mengubah pola hidup bertujuan untuk mencegah dan menangani hipertensi, direkomendasikan untuk orang dengan pre-hipertensi dan sebagai terapi tambahan untuk pasien hipertensi.

Karena prevalensi hipertensi dan resiko komplikasi yang semakin besar, perubahan gaya hidup sebagai upaya mencegah terjadinya hipertensi perlu dilakukan.

Kendala perubahan gaya hidup :

  • · Kurangnya perhatian dari tenaga kesehatan
  • · Terbatasnya akses untuk melakukan aktifitas fisik rutin
  • · Besarnya porsi makanan di rumah makan
  • · Keterbatasan jenis makanan sehat yang tersedia di sekolah, tempat kerja, dan rumah makan
  • · Kurangnya kegiatan olahraga di sekolah
  • · Tingginya jumlah garam yang ditambahkan ke dalam makanan di rumah makan maupun industry
  • · Tingginya harga makanan rendah garam dan kalori
Tabel 241-7 Modifikasi gaya hidup untuk mengatasi hipertensi
Menurunkan berat badan Menjaga BMI < 25 kg/m2 Mengurangi konsumsi garam < 6 g NaCl/hari Menyesuaikan rencana konsumsi DASH Konsumsi makanan kaya buah, sayuran, danproduk susu rendah lemak dengan menurunkan kandungan lemak total dan lemak jenuh Mengurangi konsumsi alkohol Membatasi konsumsi alcohol 2 kali/hari untuklaki-laki dan 1 kali/hari pada wanita Aktivitas fisik Aktivitas aerobic teratur, contohnya jalancepat 30 menit/hari
DASH = Dietary Approaches to Stop Hypertension

Pencegahan dan penanganan obesitas penting untuk menurunkan tekanan darah dan resiko penyakit jantung dan pembuluh darah. Efek penurunan berat badan terhadap turunnya tekanan darah melalui berbagai cara :

–       Meningkatkan sensitivitas insulin

–       Menurunkan aktivitas saraf simpatetik

–       Menurunkan aktivitas RAA sistem

–       Menurunkan kadar leptin dalam plasma

–       Mengurangi sitokin inflamasi

–       Memperbaiki disfungsi sel endothel

–       Menurunkan kekakuan arteri

Aktivitas fisik yang teratur dapat membantu menurunkan berat badan, menurunkan tekanan darah, mengurangi resiko penyakit kardiovaskular.

Aktivitas sedang 80 menit / hari atau aktivitas berar 35 menit / hari sebaikya dilakukan setelah berhasil menurunkan berat badan untuk menjaga agar berat badan tetap stabil.

Efek antihipertensi dari aktivitas aerobic :

–  Meningkatkan jumlah nitric oxide yang berperan sebagai vasodilator

–  Menurunkan aktivitas saraf simpatetik

–  Menurunkan kekakuan arteri

–  Meningkatkan sensitifitas insulin

–  Menurunkan lemak abdomen

Variasi individu terhadap NaCl dalam meregulasi tekanan darah dipengaruhi oleh faktor genetic.

Keuntungan mereduksi konsumsi garam

–     Meningkatkan efektivitas obat anti hipertensi

–     Menurunkan ekskresi potassium yang disebabkan oleh diuretic

–     Mengembalikan ventrikel kiri yang hipertropi

–     Menurunkan kejadian proteinuria

–     Mengurangi jumlah kalsium yang terekskresi

–     Menurunkan kejadian osteoporosis

–     Menurunkan kejadian kanker lambung

–     Menurunkan mortalitas dari stroke

–     Menurunkan kejadian asma

–     Menurunkan prevalensi katarak

–     Mencegah onset hipertensi

Diet rendah potassium, kalsium, dan magnesium berkaitan dengan tingginya tekanan darah. Pemberian suplemen kalsium dan magnesium bisa memberikan efek antihipertensi.

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