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Overview of Drugs Used for the Treatment of Hypertension for Elderly Patients in Sanglah General Hospital, Denpasar, Bali

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Overview of Drugs Used for the Treatment of Hypertension for Elderly Patients in Sanglah General Hospital, Denpasar, Bali ORIGINAL ARTICLE Intisari Sains Medis 2019, Volume 10, Number 2: 184-187 P-ISSN: 2503-3638, E-ISSN: 2089-9084 Overview of drugs used for the treatment of ORIGINAL ARTICLE hypertension for elderly patients in Sanglah General Hospital, Denpasar, Bali CrossMark Doi: 10.15562/ism.v10i2.215 Published by DiscoverSys Archana Laxmi Pathmanathan,1* I Nyoman Gede Wardana,2 I Gusti Ayu Widianti,2 Volume No.: 10 ABSTRACT Background: Hypertension is one of the most common diseases Method: In this study, a descriptive cross sectional study method was Issue: 2 among elderly patients and it is also known as a silent killer. It could being used. be due to excessive stress which causes the blood pressure to rise. The Result: As the age increases, the number of individuals with symptoms could appear, and people could go on for years without hypertension increases. In gender, we could see that the female having any awareness of their disease. has a higher prevalence compared to male. In Sanglah, we found First page No.: 184 Aim: This research was conducted to determine the prevalence that the mostly given drugs are amlodipine and captopril for of hypertension cases of elderly patients and the drugs used as a elderly people as this drug works effectively for the patients. treatment for hypertension in Sanglah Hospital, Denpasar, Bali. The Other drugs such as valsartan, furosemide, and bisoprolol are research was carried on in the Sanglah Hospital, Denpasar, Bali as of also offered to patients with hypertension depending on their P-ISSN.2503-3638 January until June 2017. associated diseases. E-ISSN.2089-9084 Keywords: Hypertension, treatment, awareness, drugs Cite This Article: Pathmanathan, A.L., Wardana, I.N.G., Widianti, I.G.A. 2019. Overview of drugs used for the treatment of hypertension for elderly patients in Sanglah General Hospital, Denpasar, Bali. Intisari Sains Medis 10(2): 184-187. DOI: 10.15562/ism.v10i2.215 1Medical Science Study Program, INTRODUCTION Medical Faculty, Udayana University Hypertension is a prevalent condition worldwide strategy is utilized the first and fifth Korotkoff 2Department of Anatomy, Medical and contributes major risk factor for cardiovascular sounds. It is the appearance and vanishing of sounds Faculty, Udayana University diseases. Mortality from stroke and ischemic heart compared to the systolic and diastolic blood weights. disease doubles with the increase of each 20 mm Hg There are two sorts of treatment should be in systolic blood pressure (SBP) from levels as low possible for patients with hypertension. One is a as 115 mm Hg, and with the increase of each 10 mm nonpharmacologic way and another way is medical Hg in diastolic blood pressure (DBP) from levels as treatment. The nonpharmacologic way is used for low as 75 mm Hg.1 non-extreme cases, similar to stage 1 with no rela- Hypertension is one of the highest ranked chronic tionship with another severe cardiovascular disease; diseases in elderly people. It is either primary hyper- sometime they should begin their medical treat- tension or secondary hypertension. The reason ment. However when there is no any movement in of primary hypertension is not known, the factor the blood pressure for around six months after the that affect blood pressure regulation are now being way of life change, then it is unequivocally prescribed studied, even though genetic and environmental to continue with medical treatment. The way of life factors are said to be the factors. Secondary hyper- changes that is as specified above are, for example, tension the main types are chronic kidney disease, weight reduction, salt decrease, practice consistently, renal artery stenosis, excessive aldosterone secre- constrained liquor utilization and quit smoking. This tion, pheochromocytoma, and sleep apnea. This would help in decreasing the blood pressure.3 secondary hypertension can be identified and can Angiotensin-Converting Inhibitors (ACE), these * be treated sometimes. It is very rare where about 5% operators decrease blood pressure by obstructing the Corespondence to: 2 Archana Laxmi Pathmanathan, of adult only have this secondary type. Blood pres- renin-angiotensin framework. The principal symp- Medical Science Study Program, sure is normally measured by either a conventional tom is hacked particularly for ladies. These medi- Medical Faculty, Udayana University sphygmomanometer utilizing a stethoscope or by cations build serum creatinine, however, as of the [email protected] an electronic device. The electronic device, if acces- diminishing pressure inside the renal glomerulus and sible, is favored because it gives more reproducible reduction filtration. Angiotensin receptor blockers Received: 2018-04-08 outcomes than the more established strategy and (ARB), like angiotensin-converting enzyme inhib- Accepted: 2018-08-09 is not impacted by varieties in the system or by the itors, threaten the renin-angiotensin framework. Published: 2019-08-01 predisposition of the spectators. The auscultatory Angiotensin receptor blockers can expand serum 184 Open access: http://isainsmedis.id/ ORIGINAL ARTICLE creatinine, yet as common this is a practical change number of hypertension patient with age above that is reversible and not hurtful. Try not to combine 55 years old and the drug used for treatment among angiotensin receptor blockers with angiotensin-con- patients in Sanglah Hospital, Denpasar, Bali. This verting inhibitors, each of these medication sorts is study involves the target population of people diag- helpful in patients with kidney disease, yet in the nosed with hypertension that are elderly in Sanglah mix, they may effectively affect renal occasions.4 Hospital Denpasar, Bali. Thiazide and Thiazide-like Diuretic are special- Research data is based on the secondary data that ists work by expanding discharge of sodium by the will be collected from the Medical record in Sanglah kidneys and may have some vasodilator impacts. It General Hospital, Denpasar, Bali. The investigator benefits from lessening of strokes and major cardio- collects the data of hypertension patients who are vascular occasions. The fundamental symptoms of elderly from the hospital from January until June these medications are metabolic (hypokalemia, 2017. hyperglycemia, and hyperuricemia). Calcium Channel Blockers agents reduce blood pressure by RESULTS blocking the inward flow of calcium ions through the L channels of arterial smooth muscle cells. Characteristics of the sample The main side effect of calcium channel blockers In Sanglah the total number of patients with hyper- is peripheral edema. Nondihydropyridine calcium tension in 6 months had 173 and there are only channel blockers are not recommended in patients 96 patients with above 55 years old. According to with heart failure, but amlodipine appears to be safe the data collected and had been divided into few when given to heart failure patients receiving stan- characteristics such as age, gender, classification, dard therapy with ACE inhibitors. The dihydropy- stages, and drugs. Table 1 shows the total number ridine, but not the nondihydropyridine, agents can of patients divided into their components and the be safely combined with β-blockers.5 percentage. β-blockers reduce cardiac output and also The hypertension case is in the age group of decrease the release of renin from the kidney. They 55-64 and 65-74. Where out of total 96 patients have strong clinical outcome benefits in patients with hypertension 76 of them are from the age with histories of myocardial infarction and heart group of 55-64 and 65-74. We could find as the age failure. Their main side effects could reduce sexual increases the number of individuals with hyper- function, fatigue, and reduced exercise tolerance. tension increases too. Out of the total 96 elderly α-Blockers reduce blood pressure by blocking arte- patients with hypertension 45 were males and 51 rial α-adrenergic receptors and thus preventing the were females. It shows that women have a higher vasoconstrictor actions of these receptors.6 rate of having hypertension at the elderly age than For hypertension without other convincing men. signs, diastolic with or without systolic hyperten- However, elderly patients in Sanglah Hospital it sion with those over 60 years Thiazide/thiazide-like shows that most individuals have primary hyper- diuretics, ACE inhibitors, ARBs, or long-acting tension which could be caused by an unknown CCBs (consider ASA and statins in chose patients) cause. There is no proper study shows whether as the underlying treatment and mix of first-line which stage 1 or stage 2 hypertension are promi- drugs treatment for second-line therapy. For nent among elderly patients, but it is important to patients with cardiovascular disease, patients with identify the types of hypertension to provide proper CAD or recent myocardial infarction ACE or ARB management.7 and β-blockers for the first line. Long-acting CCB Based on the table above, captopril been used to at the point when combined treatment is being treat 23 elderly hypertensive patients, amlodipine utilized for high-chance patients for CAD second been used to treat 13 patients, valsartan been used line and long-acting CCBs if β-blocker contrain- to treat 8 patients, furosemide been used to treat dicated for myocardial infarction. For heart failure 5 patients, combination of captopril and amlodip- patients, ACE inhibitors (ARBs if ACE inhibitor-in- ine been used on 21 patients, combination of tolerant) and β-blockers. Aldosterone antagonist
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