CHAPTER 1

INTRODUCTION
1. Background
Today, about one in three American adults is considered to be obese, but
obesity is also becoming an increasing health problem globally. Obesity increases
the risk for hypertension.
In developed countries, such as in the United States is estimated to
approximately 50 million Americans have high blood pressure. Incidence of
hypertension clients continues to increase along with age and hypertension are
usually more often attacks children younger than 65 years
In countries - developing countries such as Southeast Asia, hypertension is
also an experienced health problems with a prevalence of 6.3 percent figure in
until 9.17 percent. Hypertension or high blood pressure is a cause of high
mortality and morbidity. High blood are often given the title of The Silent Killer
since hypertension is the hidden killer.
Household Health Survey (Household Health Survey) in 1995, prevalence of
hypertension in Indonesia is 8.3%. According to WHO in Jakarta prevalence of
hypertension with blood pressure of 160/90 mmHg in the year 1988, respectively
- each reached 13.6% in men, whereas in women reached 16%, in the year 1993
reached 16.5% in men, women sedankan reached 17%, and in 2000 reached 12%
in men, whereas in women reached 12.2%
Household Health Survey 1995 showed that the prevalence of hypertension or
high blood pressure in Indonesia is quite high, ie 83 per 1000 member
households. In general, more women than men suffer from hypertension. Where,
prevalence in areas outside Java is bigger than the island of Java. It is closely
related to diet, especially salt intake, which is generally higher outside Java, such
as the Batak ethnic group that tends to develop hypertension due to dietary and
Java on tribe is more likely due to problems including Psychic distress or stress.
2. Problems
Diet and health transition in Indonesia has been following the developed
countries. Many eating habits have on the adoption by the Indonesian people who
actually make things worse nutritional status. Changes in eating patterns as
today's modern lifestyles lead to ready to eat meal that contains fat, protein, high
salt and low-fiber food but have consequences on the development of diseases
such as obesity and hypertension.
1

3. Limitation of Problem
In this paper, the writer makes a limitation for what will discuss about
the relationship betweem obesity and hypertention. The limitation is about:
1. What is obesity?
2. Where does it come from?
3. What is the dangerous of it?
4. What is hypertension?
5. How we prevent hypertension?
6. How it happen in Indonesia especially in men the age above 50 in West
Jakarta in 2008?
7. What is the relationship between obesity and hypertention?
With this limitation, the writer hope that, the reader can understand
about the correlation between obesity and hypertention, and also can help we
self to prevent the hypertention.

4. Objective
The objective of this paper are because there is an important
correlation between obesity and hypertention, which people have to know.
Besides that, this paper can help the reader to aware more about obesity and
hypertention and as fast as tey can to get a preventation and an early treatment.
5. Methods of Writing
The way for the writer to complete this paper is by find information
from library literature. Writer found about the teory about both of the disease,
about what is the disease, how it will happen in our body or in another person.
Writer also find this information from book and internet, that make the
information witers get will complete.
Internet literature will also writer use for find out how this disease
happen in society especially in West Jakarta that make people know how this
disease attack our life.
6. Frame of writing
To make the reader understand this paper easily, writer make some frame of
writing like this:
CHAPTER 1

INTRODUCTION
1. Background
2. Problems
3. Limitation of problem
4. Objectives

5. Methods of writing
6. Frame of writing
CHAPTER II

DISCUSSION I
1. The theory about obesity
2. How it happen in men above 50 in West Jakarta,
2008

CHAPTER III

DISCUSSION II
1. The theory about hypertension
2. How it happen in men above 50 in West Jakarta,
2008

CHAPTER IV

THE CORRELATION BETWEEN OBESITY AND

HYPERTENSION IN MEN ABOVE 50 IN WEST JAKARTA, 2008

CHAPTER V

CONCLUSION

CHAPTER VI

REFERENS

CHAPTER II
DISCUSSION I
1. The theory of obesity
A. Definition
The definition of obesity varies depending on what one reads, but in general, it
is a chronic condition defined by an excess amount body fat. A certain amount of
body fat is necessary for storing energy, heat insulation, shock absorption, and
other functions. 1
Obesity is more than just a cosmetic concern, though. It increases risk factor of
diseases and health problems such as diabetes and high blood pressure
(hypertention). 2
The normal amount of body fat (expressed as percentage of body fat) is
between 25%-30% in women and 18%-23% in men. Women with over 30% body
3

fat and men with over 25% body fat are considered obese. 1
The calculation of body mass index (BMI) has also been used in the definition
of obesity. Body mass index (BMI) is a simple index of weight-for-height that is
commonly used in classifying overweight and obesity in adult populations and
individuals. It is defined as the weight in kilograms divided by the square of the
height in meters (kg/m2). 3
BMI provides the most useful population-level measure of overweight and
obesity as it is the same for both sexes and for all ages of adults. However, it
should be considered as a rough guide because it may not correspond to the same
degree of fatness in different individuals.
The World Health Organization (WHO) defines "overweight" as a BMI equal
to or more than 25, and "obesity" as a BMI equal to or more than 30. These cutoff points provide a benchmark for individual assessment, but there is evidence
that risk of chronic disease in populations increases progressively from a BMI. 3

See the following table for an example. 4

Height

5' 9"

Weight Range

BMI

Considered

124 lbs or less

Below 18.5

Underweight

125 lbs to 168 lbs

18.5 to 24.9

Healthy weight

169 lbs to 202 lbs

25.0 to 29.9

Overweight

203 lbs or more

30 or higher

Obese

Extreme obesity, also called severe obesity or morbid obesity, occurs when you
have a BMI of 40 or more. With morbid obesity, you are especially likely to have
serious health problems. 2
B. Etiology
The balance between calorie intake and energy expenditure determines a person's
weight. If a person eats more calories than he or she burns (metabolizes), the
person gains weight (the body will store the excess energy as fat). If a person eats
fewer calories than he or she metabolizes, he or she will lose weight. Therefore

the most common causes of obesity are overeating and physical inactivity. At
present, we know that there are many factors that contribute to obesity, some of
which have a genetic component:

Genetics
A person is more likely to develop obesity if one or both parents are obese.

Genetics also affect hormones involved in fat regulation. For example, one
genetic cause of obesity is leptin deficiency. Leptin is a hormone produced in fat
cells, and also in the placenta. Leptin controls weight by signaling the brain to
eat less when body fat stores are too high. If, for some reason the body cannot
produce enough leptin, or leptin cannot signal the brain to eat less, this control
is lost, and obesity occurs. The role of leptin replacement as a treatment for
obesity is currently being explored. 2
A diet high in simple carbohydrates
The role of carbohydrates in weight gain is not clear. Carbohydrates increase
blood glucose levels, which in turn stimulate insulin release by the pancreas,
and insulin promotes the growth of fat tissue and can cause weight gain. Some
scientists believe that simple carbohydrates (sugars, fructose, desserts, soft
drinks, beer, wine, etc.) contribute to weight gain because they are more rapidly
absorbed into the blood-stream than complex carbohydrates (pasta, brown rice,
grains, vegetables, raw fruits, etc.) and thus cause a more pronounced insulin
release after meals than complex carbohydrates. This higher insulin release,
some scientists believe, contributes to weight gain.
Frequency of eating
The relationship between frequency of eating (how often you eat) and weight
is somewhat controversial. There are many reports of overweight people eating
less often than people with normal weight.
Slow metabolism
Women have less muscle than men. Muscle burns (metabolizes) more calories
than other tissue (which includes fat). As a result, women have a slower
metabolism than men, and hence, have a tendency to put on more weight than
men, and weight loss is more difficult for women.
Physical inactivity and Leading a sedentary lifestyle
Physical activity has an effect on how your hormones work, and hormones
have an effect on how your body deals with food. Several studies have shown
that physical activity has a beneficial effect on your insulin levels - keeping
them stable. Unstable insulin levels are closely associated with weight gain. 5
5

Medications
Medications associated with weight gain include certain antidepressants, anti-

convulsants [medications used in controlling seizures], diabetes medications.

Weight gain may also be seen with some high blood pressure medications and
antihistamines.1

Psychological factors
For some people, emotions influence eating habits. Many people eat

excessively in response to emotions such as boredom, sadness, stress or anger.

While most overweight people have no more psychological disturbances than
normal weight people, about 30 percent of the people who seek treatment for
serious weight problems have difficulties with binge eating. 1

Diseases
Obesity can sometimes be traced to a medical cause, such as Prader-Willi

syndrome, Cushing's syndrome, polycystic ovary syndrome, and other diseases

and conditions. Some medical problems, such as arthritis, can lead to decreased
activity, which may result in weight gain. A low metabolism is unlikely to cause
obesity, as is having low thyroid function. 2

Not sleeping enough

If you do not sleep enough your risk of becoming obese doubles, according to

research carried out at Warwick Medical School at the University of Warwick. The
risk applies to both adults and children. If you do not sleep enough you produce
Ghrelin, a hormone that stimulates appetite. Lack of sleep also results in your
body producing less Leptin, a hormone that suppresses appetite. 5

Lower rates of smoking (smoking suppresses appetite)5

Pregnancy
During pregnancy a woman's weight necessarily increases. Some women find

this weight difficult to lose after the baby is born. This weight gain may contribute
to the development of obesity in women. 2

Environment
Our environment doesn't support healthy lifestyle habits; in fact, it encourages

obesity. 6

Age
As you get older, you tend to lose muscle, especially if you're less active.

Muscle loss can slow down the rate at which your body burns calories. If you
don't reduce your calorie intake as you get older, you may gain weight.
Midlife weight gain in women is mainly due to aging and lifestyle, but
menopause also plays a role. Many women gain around 5 pounds during
menopause and have more fat around the waist than they did before. 6

Ethnicity.
Ethnicity factors may influence the age of onset and the rapidity of weight

gain. African American women and Hispanic women tend to experience weight
gain earlier in life than Caucasians and Asians. Hispanic men tend to develop
obesity earlier than African American and Caucasian men.

Childhood weight.
A person's weight during childhood, the teenage years, and early adulthood

may also influence the development of adult obesity. For example:

-

Being mildly overweight in the early 20's was linked to a substantial

incidence of obesity by age 35.

Being overweight during older childhood is highly predictive of adult

obesity, especially if a parent is also obese.

Being overweight during the teenage years is even a greater predictor of
adult obesity.

C. Symptom
Symptoms associated with obesity can include:

Difficulty sleeping

Snoring

Sleep apnea

Pain in your back or joints

Excessive sweating

Always feeling hot

Rashes or infection in folds of your skin

Feeling out of breath with minor exertion

Daytime sleepiness or fatigue

Depression 2

D. Risk 6
Being overweight or obese isn't a cosmetic problem. It greatly raises the risk in
adults for many diseases and conditions.

Coronary Heart Disease

Coronary heart disease (CHD) is a condition in which a substance called
plaque (plak) builds up inside the coronary arteries. These arteries supply
oxygen-rich blood to your heart. Plaque is made up of fat, cholesterol, calcium,
and other substances found in the blood. As your body mass index (BMI)
increases, so does your risk of having CHD and a heart attack. Obesity also can
lead to heart failure.
Heart attack
A prospective study found that the risk of developing coronary artery disease
increased three to four times in women who had a BMI greater than 29. A Finnish
study showed that for every one kilogram (2.2 pounds) increase in body weight,
the risk of death from coronary artery disease increased by one percent. In
patients who have already had a heart attack, obesity is associated with an
increased likelihood of a second heart attack.
High Blood Pressure
Blood pressure is the force of blood pushing against the walls of the arteries as
the heart pumps out blood. If this pressure rises and stays high over time, it can
damage the body in many ways. Your chances of having high blood pressure are
greater if you're overweight or obese.
Stroke

Being overweight or obese can lead to a buildup of plaque in your arteries.

The risk of having a stroke rises as BMI increases.
Insulin Resistance
Insulin is necessary for the transport of blood glucose (sugar) into the cells of
muscle and fat (which is then used for energy). By transporting glucose into cells,
insulin keeps the blood glucose levels in the normal range. Insulin resistance (IR)
is the condition whereby the effectiveness of insulin in transporting glucose
(sugar) into cells is diminished. Fat cells are more insulin resistant than muscle
cells; therefore, one important cause of insulin resistance is obesity. The pancreas
initially responds to insulin resistance by producing more insulin. As long as the
pancreas can produce enough insulin to overcome this resistance, blood glucose
levels remain normal. This insulin resistance state (characterized by normal blood
glucose levels and high insulin levels) can last for years. Once the pancreas can
no longer keep up with producing high levels of insulin, blood glucose levels
begin to rise, resulting in type 2 diabetes, thus insulin resistance is a pre-diabetes
condition. In fact scientists now believe that the atherosclerosis (hardening of the
arteries) associated with diabetes likely develops during this insulin resistance
period.
Type 2 Diabetes
Diabetes is a leading cause of early death, CHD, stroke, kidney disease, and
blindness. Most people who have type 2 diabetes are overweight.
Abnormal Blood Fats
If you're overweight or obese, you're at increased risk of having abnormal
levels of blood fats. These include high levels of triglycerides and LDL ("bad")
cholesterol and low levels of HDL ("good") cholesterol.
Cancer
While not conclusively proven, some observational studies have linked obesity
to cancer of the colon in men and women, cancer of the rectum and prostate in
men, and cancer of the gallbladder and uterus in women. Obesity may also be
associated with breast cancer, particularly in postmenopausal women. Fat tissue
is important in the production of estrogen, and prolonged exposure to high levels

of estrogen increases the risk of breast cancer.

Osteoarthritis
Osteoarthritis is a common joint problem of the knees, hips, and lower back.
The condition occurs if the tissue that protects the joints wears away. Extra
weight can put more pressure and wear on joints, causing pain.
Sleep Apnea
Reproductive Problems
Obesity can cause menstrual irregularity and infertility in women.
Gallstones
Gallstones are hard pieces of stone-like material that form in the gallbladder.
They're mostly made of cholesterol. Gallstones can cause abdominal or back
pain. People who are overweight or obese are at increased risk of having
gallstones. Also, being overweight may result in an enlarged gallbladder that
doesn't work right.
Respiratory problems 5
Obesity can also cause respiratory problems. Breathing is difficult as the lungs
are decreased in size and the chest wall becomes very heavy and difficult to lift.
E. Diagnosis
The most common way to find out whether you're overweight or obese is to
figure out your body mass index (BMI). BMI is an estimate of body fat, and it's a
good gauge of your risk for diseases that occur with more body fat. The higher
your BMI, the higher your risk of disease.
Body Mass Index for Adults 6
Use this table to learn your BMI. First, find your height on the far left column.
Next, move across the row to find your weight. Weight is measured with
underwear but no shoes.
Once you've found your weight, move to the very top of that column. This
number is your BMI.
Height

21

22

23

24

25

26

27

28

29

30

31

10

4'10"

100

105

110

115

119

124

129

134

138

143

148

5'0"

107

112

118

123

128

133

138

143

148

153

158

5'1"

111

116

122

127

132

137

143

148

153

158

164

5'3"

118

124

130

135

141

146

152

158

163

169

175

5'5"

126

132

138

144

150

156

162

168

174

180

186

5'7"

134

140

146

153

159

166

172

178

185

191

198

5'9"

142

149

155

162

169

176

182

189

196

203

209

5'11"

150

157

165

172

179

186

193

200

208

215

222

6'1"

159

166

174

182

189

197

204

212

219

227

235

6'3"

168

176

184

192

200

208

216

224

232

240

248

Waist Circumference 6
If you have abdominal obesity and most of your fat is around your waist rather
than at your hips, you're at increased risk for coronary heart disease and type 2
diabetes. This risk goes up with a waist size that's greater than 35 inches for
women or greater than 40 inches for men.
A general physical exam 2
This includes measuring your height, checking vital signs, such as heart rate,
blood pressure and temperature, listening to your heart and lungs, and examining
your abdomen.
Laboratory tests 2
They may include a complete blood count (CBC), a check of cholesterol and
other blood fats, liver function tests, fasting glucose, a thyroid test, and others
depending on your health situation.

F. Therapy and treatment

Successful weight-loss treatments include setting goals and making lifestyle
changes, such as eating fewer calories and doing physical activity regularly.

11

Set Realistic Goals 6

Setting realistic weight-loss goals is an important first step to losing and
maintaining weight.
Lifestyle Changes 6

Focus on balancing energy IN (calories from food and drinks) and energy
OUT (physical activity)

Follow a healthy eating plan

Learn how to adopt healthy lifestyle habits

Dietary changes 6

Reducing your calorie intake.

Feeling full on less.

Adopting a healthy eating plan, such as the Mayo Clinic Healthy Weight
Pyramid.

Following a very low calorie liquid diet if medically recommended.

Increases Exercise and activity
Behavior change
Prescription weight-loss medications
Weight-loss surgery 2
The surgery is usually for men who are at least 100 pounds overweight and
women who are at least 80 pounds overweight. Type of weigh-loss surgery is
as follows:

Gastric bypass surgery.

Laparoscopic adjustable gastric banding (LAGB).

Biliopancreatic diversion with duodenal switch.

G. Prevention 2
Whether you're at risk of becoming obese, currently overweight or at a healthy
weight, you can take steps to prevent unhealthy weight gain and related health

12

problems. Not surprisingly, the steps to prevent weight gain are the same as the
steps to lose weight: daily exercise, a healthy diet, a long-term commitment to
watch what you eat and drink.

Exercise regularly.
One of the most important things you can do to prevent weight gain is to
exercise regularly. According to the American College of Sports Medicine, you
need to get 150 to 250 minutes of moderate-intensity activity per week to prevent
weight gain. Moderately intense physical activities include fast walking and
swimming.

Eat healthy meals and snacks.

Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and
whole grains. Avoid saturated fat and limit sweets and alcohol. Remember that no
one food offers all the nutrients you need. Choose a variety of foods throughout
the day. You can still enjoy small amounts of high-fat, high-calorie foods as an
infrequent treat. Just be sure to choose foods that promote a healthy weight and
good health more often than you choose foods that don't.

Know and avoid the food traps that cause you to eat.
Identify situations that trigger out-of-control eating. Try keeping a journal and
write down what you eat, how much you eat, when you eat, how you're feeling
and how hungry you are. After a while, you should see patterns emerge. You can
plan ahead and develop strategies for handling these types of situations and stay
in control of your eating behaviors.
Monitor your weight regularly.
People who weigh themselves at least once a week are more successful in
keeping off excess pounds. Monitoring your weight can tell you whether your
efforts are working and can help you detect small weight gains before they
become big problems.
Be consistent.

13

Sticking to your healthy-weight plan during the week, on the weekends, and
amidst vacation and holidays as much as possible increases your chances of longterm success.
If you really want to prevent weight gain, the best approach is to focus on an
active lifestyle that includes an eating plan that's enjoyable, yet healthy and low
in calories.

2. How it happen in men the age above 50 in West Jakarta 2008

Evidence is now emerging to suggest that the prevalence of overweight and
obesity is already a massive global pattern including Indonesia, and increasing
worldwide at an alarming rate. Indonesia has limited information for overweight of
all age groups. The first national survey was in 2008 colleted data on BMI of adult
male and female in urban areas (27 cities), this is included west Jakarta. It was found
that the rate of overweight (BMI >251) among adult male (above 50) was 14.9%
while adult female was 24.0%. The problem of overweight was also found higher
among the older age group. The overweight problem in rural areas was estimated
based on NSS-HKI data in 1999 to 2001 only for adult female. The same pattern as
in urban areas was observed, however, the magnitude of problem was lower than
their counterpart in rural areas.
Over-nutrition is a significant risk factor for a range of serious noncommunicable diseases, e.g cardiovascular disease (CVD), hypertension and stroke,
diabetes mellitus, various forms of cancer, and other gastrointestinal and liver
diseases, and other serious health problems.
National survey on morbidity for the non-communicable diseases has never been
conducted; however, the national health and household survey 1990 to 2008 estimated
the specific mortality rate of non-communicable disease increase from 15.41% (1980)
to 48.53% (2001). The proportion of death because of CVD increased from 9.1%
(1986) to 26.3% (2001); Ishaemic heart disease from 2.5% (1986) to 14.9% (2001);
stroke from 5.5% (1986) to 11.5% (2001) and cancer from 3.4% (1986) to 6% (2001).

14

CHAPTER III
DISCUSSION II
1. The theory of hypertention
A. Definition
Blood pressure numbers include systolic and diastolic pressures. Systolic blood
pressure is the pressure when the heart beats while pumping blood. Diastolic blood
pressure is the pressure when the heart is at rest between beats. Blood pressure
numbers written with the systolic number above or before the diastolic, such as
120/80 mmHg. (The mmHg is millimeters of mercurythe units used to measure
blood pressure.) 7
Blood pressure is determined by the amount of blood the heart pumps and the
amount of resistance to blood flow in the arteries. Heart blood pump and the more
narrow the arteries, can cause high blood pressure. High blood pressure typically
develops over many years, and eventually affect almost everyone. 8
Blood pressure based on the Seventh Report of the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) is
as follows: 9
Category of Blood Pressure (BP) *
Category

SBP mmHg

DBP mmHg

Normal

< 120

< 80

Prehypertension

120-139

80-89

Hypertension, Stage 1

140-159

90-99

Hypertension, Stage 2

160

100

See Blood Pressure Measurement Techniques (reverse side)

Key: SBP = systolic blood pressure

15

DBP = diastolic blood pressure

B. Etiology
There are two type of high blood pressure:
Primary (essential) hypertension
In 90 to 95 percent of high blood pressure cases in adults, there's no
identifiable cause. This type of high blood pressure, called essential hypertension
or primary hypertension, tends to develop gradually over many years.
Secondary hypertension
The other 5 to 10 percent of high blood pressure cases are caused by an
underlying condition. This type of high blood pressure, called secondary
hypertension, tends to appear suddenly and cause higher blood pressure than does
primary hypertension. Various conditions and medications can lead to secondary
hypertension, including: Kidney abnormalities, Tumors of the adrenal gland,
Certain congenital heart defects, Certain medications, such as birth control pills,
cold remedies, decongestants, over-the-counter pain relievers and some
prescription drugs, and Illegal drugs, such as cocaine and amphetamines. 10

C. Symptom
Most of the time, there are no symptoms. Symptoms that may occur include:
Chest pain
Confusion
Ear noise or buzzing
Irregular heartbeat
Nosebleed
Tiredness
Vision changes 11
D. Risk Factors
High blood pressure has many risk factors. High blood pressure risk factors include:

16

Age
Through early middle age, high blood pressure is more common in men.
Women are more likely to develop high blood pressure after menopause.
Race.
High blood pressure is particularly common among blacks, often
developing at an earlier age than it does in whites. Serious complications,

such as stroke and heart attack, also are more common in blacks.
Family history.
High blood pressure tends to run in families.
Being overweight or obese.
The more you weigh, the more blood you need to supply oxygen and
nutrients to your tissues. As the volume of blood circulated through your

blood vessels increases, so does the pressure on your artery walls.

Not being physically active.
People who are inactive tend to have higher heart rates. The higher your
heart rate, the harder your heart must work with each contraction and
the stronger the force on your arteries. Lack of physical activity also

increases the risk of being overweight.

Using tobacco.
Not only does smoking tobacco immediately raise your blood pressure
temporarily, but the chemicals in tobacco can damage the lining of your
artery walls. This can cause your arteries to narrow, increasing your blood

pressure.
Too much salt (sodium) in your diet.
Too much sodium in your diet can cause your body to retain fluid, which

increases blood pressure.

Too little potassium in your diet.
Potassium helps balance the amount of sodium in your cells. If you don't
consume or retain enough potassium, you may accumulate too much

sodium in your blood.

Too little vitamin D in your diet.
It's uncertain if having too little vitamin D in your diet can lead to high
blood pressure. Researchers think vitamin D may affect an enzyme
produced by your kidneys that affects your blood pressure. More studies

are necessary to determine vitamin D's role in blood pressure.

Drinking too much alcohol.
Over time, heavy drinking can damage your heart. Having more than two
or three drinks in a sitting can also temporarily raise your blood pressure,
as it may cause your body to release hormones that increase your blood

17

flow and heart rate.

Stress.
High levels of stress can lead to a temporary, but dramatic, increase in

blood pressure.
Certain chronic conditions.
Certain chronic conditions also may increase a risk of high blood pressure,
including high cholesterol, diabetes, kidney disease and sleep apnea.

E. Complications
The excessive pressure on your artery walls caused by high blood pressure can
damage your blood vessels, as well as organs in your body. The higher your blood
pressure and the longer it goes uncontrolled, the greater the damage. Uncontrolled
high blood pressure can lead to:

Damage arteries.
This can result in hardening and thickening of the arteries (atherosclerosis),
which can lead to a heart attack, stroke or other complications.

Aneurysm.
Increased blood pressure can cause blood vessels to weaken and bulge,
forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.

Heart failure.
To pump blood against the higher pressure in a vessels, a heart muscle
thickens. Eventually, the thickened muscle may have a hard time pumping
enough blood to meet body's needs, which can lead to heart failure.

A blocked or ruptured blood vessel in your brain.

High blood pressure in the arteries leading to brain can either slow the blood
flow to brain or cause a blood vessel in brain to burst, causing a stroke.

Thickened, narrowed or torn blood vessels in the eyes.

Metabolic syndrome.
This syndrome is a cluster of disorders of your body's metabolism
including increased waist circumference, high triglycerides, low high-density
lipoprotein (HDL), or "good," cholesterol, high blood pressure, and high
18

insulin levels. If you have high blood pressure, you're more likely to have
other components of metabolic syndrome. The more components you have, the
greater your risk of developing diabetes, heart disease or stroke.10

F. Diagnosis
The most common way to find out whether you're hypertension is to figure
out your blood pressure. The higher blood pressure, the higher your risk of
disease.
G. Treatment
High blood pressure (HBP) is treated with lifestyle changes and medicines.
Goals of Treatment
The treatment goal for most adults is to get and keep blood pressure below
140/90 mmHg. For adults who have diabetes or chronic kidney disease, the goal
is to get and keep blood pressure below 130/80 mmHg.
Lifestyle Changes
Healthy habits can help you control HBP. Healthy habits include: Following a
healthy eating plan, Doing enough physical activity, Maintaining a healthy
weight, Quitting smoking, and Managing your stress and learning to cope with
stress.
Medicines
Blood pressure medicines work in different ways to lower blood pressure.
Some remove extra fluid and salt from the body to lower blood pressure. Others
slow down the heartbeat or relax and widen blood vessels. Often, two or more
medicines work better than one.
Several types of antihypertensive drugs are: Diuretics, Beta Blockers, ACE
Inhibitors, Angiotensin II Receptor Blockers, Calcium Channel Blockers, Alpha
Blockers, Alpha-Beta Blockers, Nervous System Inhibitors, and Vasodilators. 10

H. Prevention
Adults over 18 should have their blood pressure checked routinely. Lifestyle
19

changes may help control your blood pressure:

Lose weight if you are overweight. Excess weight adds to strain on the

heart. In some cases, weight loss may be the only treatment needed.
Exercise regularly. If possible, exercise for 30 minutes on most days.
Eat a diet rich in fruits, vegetables, and low-fat dairy products while
reducing total and saturated fat intake (the DASH diet is one way of

achieving this kind of dietary plan).

Avoid smoking.
If you have diabetes, keep your blood sugar under control.
Do not consume more than 1 or 2 alcoholic drinks per day.
Try to manage your stress. 11

2. How it happen in men the age above 50 in West Jakarta 2008

Household Health Survey (SKRT) 1972, 1986, 1992, and 2008 showed an
increased prevalence of cardiovascular disease as the cause of death and blatant
since 2009 alleged as the number one cause of death. These diseases arise due to
various risk factors such as smoking, hypertension, disiplidemia, diabetes
mellitus, obesity, old age and family history. From the above risk factors are very
closely related to nutrition are hypertension, obesity, displidemia, and diabetes
mellitus. 17 Of Household Health Survey (Household Health Survey) in 2008,
the prevalence of hypertension in Indonesia is 8.3%.
Survey of risk factors for cardiovascular disease (PKV) by the WHO project in
West Jakarta, showed prevalence of hypertension with blood pressure 160 / 90
respectively in men abouve 50 is 13.6% (1988), 16.5% (1993), 18,3 % (2000) and
21.1 % (2008). In women above 50, the prevalence reached 16% (1988), 17%
method (1993), 12.2% (2000), and 16.8% (2008). In general, the prevalence of
hypertension in more than 50 years of age ranged between 15% -20%. 12

CHAPTER IV
THE CORELATION BETWEEN OBESITY AND HYPERTENSI IN MEN
ABOVE 50 IN WEST JAKARTA IN 2008
lifestyle changes is a factor influencing the occurrence of obesity and
hypertension. As we know, West Jakarta is a metropolitan area and have a large

20

population. Socioeconomic status, education, health, governance, employment,

transportation access, and information is good enough. But along with these
developments, the level of competition increased and the possibility of life impact on
the emergence of different shift in lifestyle, ranging from diet, physical activity, and
stress. This shift in lifestyle has a great opportunity to cause a variety of health
problems, especially obesity and hypertension.
Habits of life or one person's life style is determined by culture and beliefs in a
region (prohibition to eat, the myths about the food, the provision of food, food
preferences and the kind of basic livelihoods of the population) An area or region
sometimes have problems unique nutritional and health, is associated with a lifestyle
that is applied in the region. Given the large prevalence of hypertension in the
district / city, which almost reached 50% of the total population, the need for further
attention and treatment. What risk factors may be preventive (protective factor) and
trigger (trigger factor) in the area of hypertension, is associated with lifestyle and
nutritional status.
With the significant rise in obesity in this last decade comes a corresponding
increase in the prevalence of hypertension. Almost 29 percent of the population is
hypertensive (having a blood pressure (BP) greater than 140/90 mmHg or using
hypertensive medications). The relationship between obesity and BP appears to be
linear and exists throughout the non-obese range. But the strength of the association
of obesity with hypertension varies among different racial and ethnic groups.
Generally, risk estimates suggest that approximately 75 and 65 percent of the cases of
hypertension in men and women, respectively, are directly attributable to an
overweight condition and obesity.
It is important to recognize that long-duration obesity does not appear
necessary to elevate BP, as demonstrated by obesity in children without a condition of
hypertension. Therefore, rather than a special case, obesity hypertension should be
considered the most common form of hypertension due to unknown reasons.
Many but not all studies suggest that abdominal adiposity or beer gut is
more closely associated with high blood pressure rather than overall obesity. Obese
individuals with elevated intra-abdominal (visceral) fat demonstrate a clustering of
coronary heart disease risk factors (i.e., the Metabolic Syndrome). Heretofore,

21

medical researchers believed the accumulation of visceral fat is the central feature of
this syndrome. However, recent evidence favors a role for ectopic or inappropriate fat
storage as a cause of the metabolic syndrome. In this regard, both the accumulation of
visceral fat and ectopic fat storage in a number of tissues and organs may be important
in the cause and consequences of obesity hypertension.

CHAPTER V
CONCLUSION
Obesity is a chronic condition defined by an excess amount body fat, The normal
amount of body fat (expressed as percentage of body fat) is between 25%-30% in

22

women and 18%-23% in men. Women with over 30% body fat and men with over
25% body fat are considered obese. 1
The calculation of body mass index (BMI) has also been used in the definition of
obesity. Body mass index (BMI) is a simple index of weight-for-height that is
commonly used in classifying overweight and obesity in adult populations and
individuals. It is defined as the weight in kilograms divided by the square of the
height in meters (kg/m2). 3
The World Health Organization (WHO) defines "overweight" as a BMI equal to or
more than 25, and "obesity" as a BMI equal to or more than 30. These cut-off points
provide a benchmark for individual assessment, but there is evidence that risk of
chronic disease in populations increases progressively from a BMI. 3
Being overweight or obese isn't a cosmetic problem. It greatly raises the risk in
adults for many diseases and conditions, which one is hypertension/high blood
pressure. Blood pressure is the force of blood pushing against the walls of the arteries
as the heart pumps out blood. If this pressure rises and stays high over time, it can
damage the body in many ways. Through early middle age, high blood pressure is
more common in men. Women are more likely to develop high blood pressure after
menopause.
The continuing problem of weight gain and obesity in the West Jakarta shows no
sign of abating. With obesity a major cause of hypertension, and associated illnesses,
there is growing support that sympathetic nervous system activation and reninangiotensin-aldosterone system activation have an important role in the cause of
obesity hypertension.
Todays experts also believe that the enlarged abdomen, resulting from visceral fat,
has a role in the activation of these systems, thereby increasing the risk for the
development of hypertension. The abnormal deposition of fat may also contribute to
the BP raising effect of weight gain and the accompanying cardiac, vascular, and renal
dysfunction.
This comprehensive review reveals that there is much we do know about the
association between high blood pressure and obesity. But the most effective treatment
for obesity hypertension remains the tried and true method that leads to weight loss
and other lifestyle modification.

23

CHAPTER VI
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25