vi

DAFTAR ISI

LEMBAR PENGESAHAN
ABSTRAK ........... iii
KATA PENGANTAR ......... iv
DAFTAR ISI ................................................................................................ vi
DAFTAR GAMBAR ................................................................................... ix
DAFTAR TABEL ........................................................................................ x

BAB I PENDAHULUAN
1.1 Latar Belakang ................................................................................. 1
1.2 Identifikasi Masalah ........................................................................

1.3 Maksud dan Tujuan .........................................................................

1.4 Kegunaan Penelitian ......................................................................... 4

1.5 Kerangka Penelitian .......................................................................... 5
1.6 Hipotesis penelitian ........................................................................... 6
BAB II TINJAUAN PUSTAKA
2.1 Definisi hipertensi ............................................................................ 7
2.2 Etiologi ............................................................................................. 10
2.2.1 Hipertensi essensial atau Hipertensi primer ......................

11

2.2.2 Hipertensi sekunder ............................................................... 12

2.3 Klasifikasi Hipertensi ...................................................................... 15
2.4 Patogenesis ........................................................................................17
2.5 Gejala Hipertensi .............................................................................. 49
2.6 Diagnosis Hipertensi .........................................................................50
2.6.1 Anamnesis ................................................................................50
2.6.2 Pemeriksaan fisik .................................................................... 52

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2.7 Penatalaksanaan .............................................................................. 53

2.7.1 Preventif ................................................................................... 53
2.7.2 Kuratif ...................................................................................... 56
BAB III BAHAN DAN METODE PENELITIAN
3.1 Bentuk Penelitian ...........................................................................

66

3.2 Subjek Penelitian ............................................................................

66

3.3 Ukuran Sampel ...................................................................................66

3.4 Definisi Operasional .......................................................................... 67
3.4.1 Karakteristik .............................................................................67
3.4.1.1 Usia ..............................................................................67
3.4.1.2 Jenis kelamin ............................................................... 67
3.4.1.3 Status gizi .................................................................... 67
3.4.1.4 Penghasilan ..................................................................68
3.4.1.5 Pekerjaan ..................................................................... 68
3.4.1.6 Pendidikan terakhir ..................................................... 68
3.4.2 Riwayat penyakit ......................................................................68
3.4.2.1 Penyakit jantung .......................................................... 68
3.4.2.2 Penyakit ginjal ............................................................. 68
3.4.2.3 Diabetes melitus .......................................................... 68
3.4.3 Kebiasaan hidup .......................................................................68
3.4.3.1 Kebiasaan merokok ..................................................... 68
3.4.3.1.1 Perokok aktif .................................................68
3.4.3.1.2 Perokok pasif ................................................ 68
3.4.3.1.3 Tidak merokok ..............................................69
3.4.3.1.4 Rasa kesukaan ...............................................69
3.4.4 Hipertensi ................................................................................. 69
3.5 Variabel penelitian ............................................................................. 69
3.6 Prosedur penelitian .............................................................................70
3.6.1 Persiapan .................................................................................. 70

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3.6.2 Pengumpulan data .................................................................... 70

3.6.3 Pengolahan data & penyusunan laporan ..............................

70

3.7 Cara pemeriksaan / pengukuran ........................................................ 71

3.7.1 Wawancara .............................................................................. 71
3.7.2 Pemeriksaan fisikis .................................................................. 71
3.7.3 Kuisioner ..................................................................................71
3.8 Analisis data ....................................................................................... 71
3.9 Tempat dan waktu penelitian ............................................................. 73
3.10 Jadwal penelitian ..............................................................................73
3.11 Alur penelitian ..................................................................................74
BAB IV HASIL PENELITIAN DAN PEMBAHASAN
4.1 Hasil penelitian ...................................................................................75
4.2 Pembahasan penelitian ....................................................................... 82
4.3 Uji hipotesis ....................................................................................... 88
BAB V KESIMPULAN DAN SARAN
5.1 Kesimpulan ........................................................................................ 89
5.2 Saran .................................................................................................. 89
DAFTAR PUSTAKA .................................................................................. 90
LAMPIRAN ................................................................................................. 92

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DAFTAR GAMBAR
Gambar 2.1

Mekanisme terjadinya hipertensi .............................................

21

Gambar 2.2

Peranan sistem saraf simpatis pada genesis hipertensi.............

24

Gambar 2.3

Mekanisme kontraksi dan relaksasi pada otot polos vaskuler. .

26

Gambar 2.4

Interaksi endotelium dan platelet vasculer (Kidney Int, 1999).

28

Gambar 2.5

Kerja endotelium pada otot polos vasculer ..............................

28

Gambar 2.6

Biosintesis ET ..........................................................................

29

Gambar 2.7

Peranan RA jaringan (Opie LH, 1992).....................................

32

Gambar 2.8

Peranan Angiotensin II (Hsuh WA, 1992)...............................

33

Gambar 2.9

Peranan reseptor angiotensin II terhadap mekanisme

Hipertensi
................................................................................................
................................................................................................
34

Gambar 2.10 Mekanisme HVK (Opie LH,1992)...........................................

35

Gambar 2.11 Mekanisme Vascular growth (Opie LH,1992).........................

37

Gambar 2.12 Peranan stres mekanis dan stimulasi smooth muscle growth
(Opie LH,1992).........................................................................
38
Gambar 2.13 Perubahan PA dinding arteriol..................................................

38

Gambar 2.14 Hubungan sodium (Na+) homeostasis dan plasma renin..........

39

Gambar 2.15 Peranan sistem renin angiotensin sistemik...............................

40

Gambar 2.16 Proses oklusi vaskuler pada hipertensi maligna.......................

41

Gambar 3.1

74

Alur penelitian..........................................................................

DAFTAR TABEL
Tabel 2.1 Klasifikasi hipertensi berdasarkan JNC (Joint National
Committe)
VII,
2003
......................................................................................................
......................................................................................................
15
Tabel 2.2 Klasifikasi tekanan darah berdasarkan sumber dari wikipedia
Indonesia,
ensiklopedia
bebas
berbahasa
Indonesia
......................................................................................................
......................................................................................................
16
Tabel 2.3 Karakteristik dari dua faktor natriuretik.........................................

22

Tabel 3.1 Klasifikasi status gizi menurut WPRO...........................................

67

Tabel 3.2 Klasifikasi hipertensi berdasarkan JNC .........................................

72

Tabel 3.3 Jadwal penelitian ...........................................................................

73

Tabel 4.1 Prevalensi hipertensi berdasarkan faktor resiko individu di

Puskesmas
Cimahi
Selatan
......................................................................................................
......................................................................................................
75
Tabel 4.2 Prevalensi hipertensi berdasarkan faktor resiko kebiasaan hidup
di
Puskesmas
Cimahi
selatan
......................................................................................................
......................................................................................................
77
Tabel 4.3 Prevalensi hipertensi berdasarkan faktor resiko penyakit di
Puskesmas

Cimahi

Selatan

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......................................................................................................
......................................................................................................
78
Tabel 4.4 Hubungan karakteristik individu dengan derajat hipertensi di
Puskesmas

Cimahi

selatan

79
Tabel 4.5 Hubungan kebiasaan hidup dengan derajat hipertensi di
Puskesmas
Cimahi
Selatan
......................................................................................................
......................................................................................................
81
Tabel 4.6 Hubungan riwayat penyakit dengan derajat hipertensi di
Puskesmas
Cimahi
selatan
......................................................................................................
......................................................................................................
81
Tabel 4.7 Faktor-faktor yang berpengaruh terhadap derajat hipertensi di
Puskesmas
Cimahi
Selatan
......................................................................................................
......................................................................................................
82
Tabel 4.8 Faktor-faktor

yang

tidak

berpengaruh

terhadap

derajat

hipertensi
di
Puskesmas
Cimahi
Selatan
......................................................................................................
......................................................................................................
86