Abstract
Introduction. Hypertension is one of the important problems in elderly due to high impact of cardiovascular complications. Education and antihypertensive medication adherence are considered as influence factors in a holistic and comprehensive hypertension treatment. This study was conducted to determine the effect of structured education and antihypertensive medication adherence in decreasing blood pressure as part of the hypertension treatment in elderly patients. Methods. A randomized clinical trial was conducted in October 2012 to February 2013 on hypertensive elderly patients at Cipto Mangunkusumo hospital, Jakarta. Subjects were divided into 3 groups: group I was received structured education and checklist, group II was received structured education, and group III was received checklist without structured education. Structured education was given 3 times per month for 90 days. Systolic and diastolic blood pressure (SBP and DBP) were measured on day-1 and day-90, then analyzed with anova test. Results. A total of 182 subjects that consisted of 60 subjects in group I, 61 subjects in group II and 61 subjects in group III was included in this study. Analysis results showed a decrease of SBP in group I, II and III to 130 (range 90-179) mmHg, 135 (range 80-174) mmHg and 133 (range 102-209) mmHg, respectively (p=0.04). Diastolic blood pressure (DBP) in group I, II, and III decreased to 70 (range 48-100) mmHg, 74 (range 45-103) mmHg and 78 (range 60-102) mmHg, respectively (p <0.001). Conclusions. Structured education significantly decreased systolic and diastolic blood pressure in elderly hypertensive patients, while adherence to antihypertensive medication did not affect signicifantly.
References
1. Badan Pusat Statistik. Proyeksi penduduk Indonesia (Indonesia Population Projection) 2000-2025. Badan Perencanaan Pembangunan Nasional. Jakarta: BPS; 2005 2. World Health Report 2002: Reducing risks, promoting healthy life [Internet]. Geneva, Switzerland: World Health Organization, 2002 [cited 2013 Feb 23]. Available from: http://www.who.int/ whr/2002. 3. Chobanian A, Bakris G, Black H, Cushman W, Green L. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treament of High Blood Pressure. Hypertension. 2003;42:1206-52. 4. Gunawan D. Proporsi hipertensi pada usia lanjut dan faktorfaktor yang mempengaruhi keterkontrolannya [Tesis]. Jakarta: Universitas Indonesia; 2010. 5. Oliveria SA, Chen RS, McCarthy BD, Davis CC, Hill MN. Hypertension knowledge, awareness, and attitudes in a hypertensive population. J Gen Intern Med. 2005;20(3):219-25. 6. Lien YP, Huang YH, Yang YC, Wu JS, Chang CJ, Lu FH. Adherence to Antihypertensive Medications among the Elderly: A Communitybased Survey in Tainan City, Southern Taiwan. Taiwan Geriatr Gerontol. 2007;2(3):176-89. 7. Rizka A, Setiati S, Lydia A, Dewiasty E. Pengaruh Ekstrak Biji Nigella sativa terhadap Penurunan Tekanan Darah Pasien Usia Lanjut dengan Hipertensi: Uji Klinis Acak Tersamar Ganda [Tesis]. Jakarta: Universitas Indonesia; 2011. 8. Figar, S, Galarza, C, Petrlik, E, Hornstein L. Effect of education on blood pressure control in elderly persons. Am J Hypertens. 2006;19(7):737–43. 9. Lien YP, Huang YH, Yang YC, Wu JS, Chang CJ, Lu FH. Adherence to Antihypertensive Medications among the Elderly: A Communitybased Survey in Tainan City, Southern Taiwan. Taiwan Geriatr Gerontol. 2007;2(3):176-89. 10. National Kidney Foundation. Clinical Practice Guidelines for Chronic Kidney Disease: Education on Self Management Behavior. New York: National Kidney Foundation; 2002. 11. The ALLHAT officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid Lowering Treatment to prevent heart attack trial (ALLHAT). JAMA. 2002;288(23):2981-87. 12. Wing LM, Reid CM, Ryan P et al. A comparison of outcomes with Angiotensin converting enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. 2003;348(7):583-92. 13. Coope J, Warrender TS. Randomised trial of treatment of hypertension in elderly patients in primary care. Br Med J (Clin Res Ed). 1986;293(6555):1145-51. 14. Lloyd Jones D, Adams R, Carnethon M. Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Commitee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):e21-181. 15. National Center for Health Statistics. Health, Unites States, 2007, with Chartbook on Trends in the Health of Americans. Hyatsville, Md: National Center for Health statistics; 2007. 16. Burt VL, Whelton P, Rocella EJ. Prevalence of hypertension in US adult population: Result from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension. 1995;25(3):305-13. 17. Franklin SS, Gustin W, Wong ND. Hemodynamic pattern of agerelated changes in blood pressure: the Framingham Heart study. Circulation. 1997;96(1):308-15. 18. Aronow W, Flegg J, Pepine C, Artinian N, Bakris G, Brown A et al. ACCF/AHA Expert Consensus document on hypertension in the elderly. J Am Soc Hypertension. 2011;5(4):259-352. 19. National Health and Nutrition Examination Survey. NHANES 2011- 2012. Atlanta; Centers for Disease Control and Prevention; 2013. 20. Osteberg L. Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-97. 21. Franke RH, Kaul JD: The Hawthorne experiments: First statistical interpretation. Am Sociol Rev. 1978;43(5):623-43.
Recommended Citation
Khomaini, Ayatullah; Setiati, Siti; Lydia, Aida; and Dewiasty, Esthika
(2017)
"Effect of Structured Education and Antihypertensive MedicationsAdherence to Decrease Blood Pressure for Hypertension inElderly: a Randomized Controlled Trial,"
Jurnal Penyakit Dalam Indonesia: Vol. 4:
Iss.
1, Article 2.
DOI: 10.7454/jpdi.v4i1.106
Available at:
https://scholarhub.ui.ac.id/jpdi/vol4/iss1/2