Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
e 28
Initial anti-hypertensive treatment should start off with low dose, and increased
gradually till desired BP achieved. If this is inadequate in controlling BP, a combi-
nation therapy can be used. Drug trials in pediatrics are more difficult to conduct;
nevertheless, it is important to be mindful of potential adverse side effects, drug
interactions, and possibly different pharmacokinetics of anti-hypertensives in chil-
dren.
Achieving good control of BP in children is important to avoid end-organ damage
and to prevent morbidity associated with HT in adulthood.
L-ARGININE DECREASES HYPERTENSION IN PREECLAMPSIA
MODEL OF RATS
Ratna Kusumawati
1
, Sinu Andhi Jusup
1
, Heru Sulastomo
2
.
1
Department of
Physiology, Faculty of Medicine, Sebelas Maret University, Surakarta,
Indonesia,
2
Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Sebelas Maret University, Surakarta, Indonesia
Background: Preeclampsia is a major causeof maternal mortality. Numerous stud-
ies indicate defective of nitric oxide synthesis inpreeclampsia. Nitric oxide is a
major endothelium derived vasodilator and smooth muscle relaxation mediator.
Endothelium has capacity to synthesis nitric oxide from the substrate L-arginine.
Previous studies report that concentration of L-arginine in preeclampsia is lower
than healthy women.
Objective: Theaim of this study was to investigate L-arginine efficacy to decrease
hypertension in preeclampsia model of pregnant rats.
Method: Thirty two pregnant rats were randomized into4 groups (n = 8 in each
group). All groups were exposed to the sonicstimulation between at days 7 and
14 of pregnancy and exposed to acute stress at day 14 of pregnancy. Each group
was treated with oral L-arginine (25 mg, 50 mg, and 75 mg per day)and distilled
water(control) between at days 14 and 20 of pregnancy. On days 14 and 20 of
pregnancy, the blood pressures were measured.
Results: On day 20 of pregnancy, blood pressures were decreased in all groups
except the control group had persistent high blood pressure (171.13 ± 9.39 mmHg),
followed by the treatment group with 25 mg/day (132.38 ± 4.57 mmHg), 50 mg/day
(121.00 ± 2.78 mmHg) and 75 mg/day (110.50 ± 2.45 mmHg). L-arginin treate-
ment resulted significant decrease in blood pressure when compared with the control
group (p < 0.05).
Conclusions: These results suggest that L-arginine treatment may be beneficial in
decreasing the hypertension in preeclampsia.
Keywords: arginine; blood pressure; hypertension; preeclampsia
CAROTID DOPPLER PROFILE IN PATIENT WITH HYPERTENSIVE
RETINOPATHY
Rima Anindita Primandari
1
, Rahmi Ulfah
2
, Eva Dewati
3
,
Mohammad Kurniawan
4
.
1,2
Neurology Department Faculty of Medicine
University of Indonesia – Cipto Mangunkusumo Hospital, Jakarta,
3
Neuro-Ophthalmology Division of Neurology Neurology Department
Faculty of Medicine University of Indonesia – Cipto Mangunkusumo
Hospital, Jakarta,
4
Neuro-Sonology and Neuro-Vascular Division of
Neurology Department Faculty of Medicine University of Indonesia –
Ciptomangunkusumo Hospital, Jakarta
Background: Retinal vasculature is a unique part of the brain that visualized, which
can show microvascular abnormality related to atherosclerosis process. Hyper-
tension can caused vascular sclerosis either in large vessels of carotid or retinal
microvasculature which showed in fundoscopic examination.
Objective: This study aims to obtain the carotid abnormality with Carotid Doppler
ultrasonography in hypertensive retinopathy patients and its contributing factors.
Methods: This was a cross-sectional retrospective study using consecutive
sampling from Neuro-Ophthalmology Division of Neurology Clinic of Cipto Man-
gunkusumo Hospital in January to December 2014. All patients, aged 40–80 years
old with hypertensive retinopathy and had done Carotid Doppler examination.
Hypertensive retinopathy graded according to Wong & Mitchell Classification.
Statistical analysis was done using SPSS 15.0 for windows.
Results: There were 35 subjects, men slightly more than women with both age mean
is 60.5 ± 11.8 years old. Hypertension duration known mostly 10 years or bellow
in 27 subjects (77.1%) and uncontrolled blood pressure in 28 subjects (80%). There
were 25 subjects (71.4%) with carotid abnormality, mostly non stenotic plaque
(54,3%). Mild hypertensive retinopathy occured in 32 subjects (81,4%) and the rest
of it were moderate (3 subjects, 8.6%).
Conclusion: Fundoscopic abnormality assumed may predict large vessels abnor-
mality, hypertensive retinopathy in this study. This study suggested advanced,
more-focused study, larger sample, and analytical method to obtain the correlation
between retinal microvasculature and large vessels abnormality, especially carotid
artery.
Keywords: Carotid Doppler; hypertensive retinopathy; hypertensive fun-
doscopy
IS BLOOD MAGNESIUM LEVEL ASSOCIATED WITH TOTAL OF
ANTIHYPERTENSIVE DRUGS IN CHRONIC HEMODIALYSIS
PATIENT?
Riri A. Muzasti
1
, H.R. Lubis
2
.
1
Department of Internal Medicine,
2
Division
of Nephrology-Hypertension, Sumatera Utara University College of
Medicine, Medan, Indonesia
Introduction: In management of hypertension, the degree of blood pressure (BP)
reduction to reach recommended BP targets, is the cornerstone of successful to
antihypertensive therapy (AHT) response. However, it is unclear why the two peo-
ple whose same control of BP consume different amount of antihypertensive drugs
(AHD).
Hypomagnesemia has been linked with hypertension. Epidemiological studies have
demonstrated an inverse association between BP and serum magnesium. The aim
of this study was to evaluate the BP- response to AHT which is assessed by
total of AHD can be predicted by the serum magnesium in chronic hemodialysis
patient.
Methods: This cross-sectional study was conducted on 121 outpatient in Rasyida
Hemodialysis Center. Laboratory assessment was performed before hemodialysis
session. The independent t test was used to compare of quantitative data. The cat-
egorical outcome variables were compared using the chi-square test. The Pearson
correlation test was used for quantitative variables. Differences were significant
when P value <0.05.
Results: The mean age was 54.2 ± 9.2 years, and 81 (66.9%) were men. The mean
serum magnesium was 2.56 ± 0.67 mg/dL (range, 1.2 to 5.3 mg/dL). Of the 121
patients, 13 (10.7%) had hypomagnesemia, 68 (56.2%) had normomagnesemia and
40 (33.1%) had hypermagnesemia. There were no differences in serum magnesium
between patients with a few and many drugs of AHD, sex, history of hypertension
and diabetes. Serum magnesium significantly different in dialysis frequency, mean
2.71 ± 0.64 (two times a week, 5 hours) compare 2.31 ± 0.66 (three times a week,
4 hours).
There were no correlations between serum magnesium and body mass index,
calcium, phosphorus, albumin, phase angle and urea reduction ratio. Serum mag-
nesium significantly correlated with age (r = -0.29, P < .05) and dialysis duration
(r = -0.20, P< .02).
Conclusion: There were no association between serum magnesium levels and total
of AHD as evaluation of the BP- response to AHT.
BLOOD PRESSURE REDUCTION WITH TELMISARTAN, BUT NOT
VALSARTAN, IN ANGIOTENSINOGEN G-217A POLYMORPHISM
HYPERTENSIVE PATIENTS
Risa Ramadhiani
1
, Muhammad Saifur Rohman
2
, Valerinna Yogibuana S. Putri
2
,
Mifetika Lukitasari
3
, Supono
2
, Bagus Hery Kuncahyo
2
, Lowry Yunita
2
,
Wella Karolina
2
, Y.F. Galuh Retno
2
, Indra Wahyu Saputra
2
, Wira Kimahesa
2
,
Ikhwan Handi
2
, Lenny Kartika Sari
2
, Muhammad Afies Sjughiarto
2
,
Lina Haryati
2
.
1
Departement of Biomedical Science, Faculty of Medicine
Brawijaya University, Malang, Indonesia,
2
Departement of Cardiology and
Vascular Medicine, Faculty of Medicine Brawijaya University, Malang,
Indonesia,
3
Departement of Nursing, Faculty of Medicine Brawijaya
University, Malang, Indonesia
Background: Angiotensin II type I receptor blocker (ARB) exhibit large
interindividual variability of antihypertensive response that may caused by phar-
macogenomic of renin-angiotensin system (RAS) component and pharmacologic
properties of ARB.
Objective: We investigated whether the angiotensinogen (AGT) G-217A polymor-
phism affects blood pressure response of temisartan and valsartan in hypertensive
patients.
Methods: A total of 46 primary hypertensive patients, 23 patients received telmisar-
tan 80 mg and 23 patients received valsartan 160 mg, were observed and followed up
for 4 months. The AGT G-217A polymorphism was determined by direct sequenc-
ing method. Blood pressure response was measured during daytime, night-time, and
24 hours blood pressure using twenty-four hour ambulatory blood pressure (ABP)