CHAPTER I

INTRODUCTION

A. Background
High blood disease known as hypertension is a disease that gets attention from
all circles of society, considering its impact both short and long term and thus require
long-term response that fully. Hypertension cause morbidity (illness) and mortality
(death) is high.
Hypertension is a disease resulting from the interaction of various risk factors a
person has. Various studies have linked between the various risk factors on the
incidence of hypertension.
Based on the research that has been conducted poorer prevalence (incidence) of
hypertension increases with age.From various epidemiological studies conducted in
Indonesia showed 1.8 to 28.6% of the population aged over 20 years are hypertensive.
Hypertension, currently there is a trend that more urban than rural communities suffer
from hypertension. This is partly attributed to the urban lifestyle associated with the risk of
hypertension such as stress, obesity (overweight), lack of exercise, smoking, alcohol, and
eating foods high in fat content.
Along with age, almost everyone has experienced an increase in blood pressure,
systolic blood pressure continues to increase until the age of 80 years and diastolic
pressures continue to increase until the age of 55-60 years, then decrease slowly or even
decreased dramatically.
B. Problem Formulation
1. How does the definition of hypertension?
2. How to measure blood pressure?
3. Explaining the causes of hypertension?
4. Explain the symptoms of hypertension?
5. Describe the effect of hypertension?
6. How hypertension prevention?
7. Explain the treatment of hypertension?
C. The purpose
1. To find definitions of hypertension.
2. To learn how to measure blood pressure.
3. To determine the cause of hypertension.
4. To know the symptoms that caused.
5. To know the result of hypertension.
6. To know the prevention of hypertension.
7. To determine the treatment of hypertension.

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 CHAPTER II
DISCUSSION

A. Definitions
Hypertension or high blood pressure, is increased blood pressure or force of
blood pressing on the walls of the cavity where the blood was. High Blood Pressure
(hypertension) is an increase in blood pressure in the arteries. (Hiper means
Overrated, tension means pressure / t egangan; j adi, hipertensi is p system
disorders that cause blood eredaran rise in blood pressure above the normal value.
Blood pressure in a person's life varies naturally. Infants and children normally have a
blood pressure that is much lower than adults. Blood pressure is also affected by
physical activity, which will be higher at the time of the activity and lower when
resting. Blood pressure is also different in one day, the highest in the morning and
mostre ndah during nighttime sleep.
B. Measuring Blood Pressure
On examination the blood pressure will get two points. A higher figure obtained
when the heart contracts (systolic), a lower number obtained when the heart relaxes
(diastolic).Blood pressure is written as systolic pressure diastolic pressure slash, eg
120/80 mmHg, read a hundred and twenty eighty. Along with age, almost everyone has
experienced an increase in blood pressure , systolic blood pressure continues to
increase until the age of 80 years and diastolic pressures continue to increase until the
age of 55-60 years, then decrease slowly or even decreased dramatically.
Blood pressure is written with two numbers, the number units mmHg (millimeters of
mercury) in blood pressure tool / tension meter, the systolic and diastolic. Is the highest
systolic blood pressure is when the heart is doing contract or contraction. Diastolic is
the lowest figure at the heart expands in the final relaxation.
For example, blood pressure 120/80 mmHg mean systolic pressure of 120 and diastolic
pressure of 80 mmHg.
Blood pressure is the pressure generated by:
1. Strength buds urgent cardiac left ventricle to insert the contents of the blood into
the arterial trunk.
2. Resistance in the arterial blood flow.
3. Autonomic nerves are made up of the sympathetic and the sympathetic system.

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Classification of blood pressure

No Classification Systolic Diastolic

1 Optimal <120 mmHg <80 mmHg
2 Normal <130 mmHg <85 mmHg
3 Normal high 130-139 mmHg 85-89 mmHg
4 Mild hypertension 140-159 mmHg 90-99 mmHg
5 Hypertension was 160-179 mmHg 100-109 mmHg
6 Severe hypertension > 180 mmHg > 110 mmHg

Normal blood pressure

Blood pressure varies per person per day, depending on the circumstances, and
are affected by the activities of a person, so normalpun blood pressure varies.
Adults when the blood pressure showed the number 140/90 mmHg is considered normal
upward. There is a perception of low blood pressure is not good, it is less
precise.Because statistics show that people with low blood pressure have the same age
with so-called normal. The best thing is to maintain normal blood pressure and the
assumption that increasing age is higher blood pressure is not a problem, is the
assumption that needs to be clarified, because based on statistics of parents whose blood
pressure in the normal range, the trend gets low stroke disorders. Check your blood
pressure regularly at least once every 6 months or whenever the doctor / health facility.
2 classification known hypertension (by cause), namely:
a) primary hypertension (hypertension idiophatik), in which the cause is not known
with certainty. It also said that hypertension is the impact of lifestyle and
environmental factors.
b) secundary hypertension, is hypertension that occurs due to the disease from other
diseases such as abnormalities in the kidneys or keruskanan of the hormone
system.
WHO classifies hypertension based on the presence or absence of abnormalities
in other organs, namely:
a) hypertension without abnormalities in other organs.
b) hypertension with cardiac enlargement.
c) hypertension with abnormalities in other organs in addition to the heart.
Classification of hypertension by high blood pressure are:
a) borderline hypertension: blood pressure between 140/90 mmHg and 160/95
mmHg.
b) mild hypertension: blood pressure between 160/95 mmHg and 200/110 mmHg.
c) Moderate Hypertension: Blood pressure between 200/110 mmHg and 230/120

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 mmHg.
d). severe hypertension: blood pressure between 230/120 mmHg and 280/140 mmHg.
C. Causes of hypertension
There are 2 kinds of hypertension, essential and secondary.
1. hypertension Essential hypertension is the most not known cause. There are 10
- 16% of adults suffer from high blood pressure.
2. hypertension Secondary hypertension is a known cause and why. Hypertension
kind is only a small part, which is only about 10%.
Some of the causes of hypertension, among others:
a) Because hormonal, for example, from the adrenal glands.
b) The use of drugs.
c) smoking because the nicotine contained in tobacco.
d) Alcoholic beverages.
e) Abnormalities in the kidneys.
f) Intracranial Abnormalities resulting in increased intracranial pressure or because
of its location near the center of persyarafan that affect blood pressure.
g) Abnormalities of the large blood vessels (aorta) that koartasio aorta where the
aortic arch aorta is continuous with decendens.
D. Anatomy
1. Heart
Measuring about one fist and is located within the chest, the limit on the right is
right and apeksnya sternum in the fifth intercostalis space midclavicular left linea.
Relation of heart is:
Above: large blood vessels
Bottom: diaphragm
Each side: lung – lung
Rear: the descending aorta, esophagus, vertebral Columna
2. Arteries
Is the tube through which the blood flow in tissues and organs.Consists of layers of
the arteries: a slippery layer, the middle layer of elastin tissue / muscle: the aorta
and major branches have laposan center consisting of a network of elastin (to deliver
blood to the organs), smaller arteries have a muscular middle layer (regulating the
amount of Blood delivered to an organ).
3. Arterioles
Are the blood vessels with smooth muscle wall is relatively thick. Arteriolar wall
muscles to contract. Contractions caused kontriksi diameter blood vessels. When
kontriksi localized, blood supply to the tissues/organs is reduced. If there kontriksi
general, blood pressure will increase.

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 4. Major blood vessels and capillaries
The main blood vessels are thin-walled vessels that run directly from arterioles to
venul. Capillaries are the network of small blood vessels open major blood vessels.
5. Sinusoids
There are spleen, liver, bone marrow, and endocrine glands.Sinusoids three to four
times greater than in capillaries and partially coated with reticulo-endothelial
system cells. In places the sinusoid, having direct contact with the blood cells and
the exchange does not take place through the network space.
6. Vena and venul
Venul is a combination of small veins formed capillaries. Veins formed by the
combined venul. Veins have three walls that are not adjacent to each other perfectly.
(Gibson, John. Issue 2 2002, p 110)
E. Physiology
The heart has the function as a pump oxygenated blood in the arterial system,
which was brought into the cell and the entire body to collect blood deoxygenation
(blood oxygen levels less) of the vein system are delivered to the lungs for reoksigenasi
(Black, 1997)
F. Pathophysiology of hypertension
The mechanisms that control the constriction and relaxation of blood vessels
located in the vasomotor center, the medulla of the brain.This stems from the central
vasomotor sympathetic nerve pathway, which continues down to the spinal cord and
the spinal cord out of the column to the sympathetic ganglia in the thorax and
abdomen.stimulation of the vasomotor center is delivered in the form of impulse moves
down through the sympathetic nerves to the sympathetic ganglia. At this point, neurons
release acetylcholine preganglion, which will stimulate post-ganglion nerve fibers to
the blood vessels, which resulted in the release of norepinephrine constriction of blood
vessels. Various factors such as anxiety and fear can affect vascular response to stimuli
vasokontriktor. Individuals with hypertension are very sensitive to norepinephrine,
although it is not clear why it could happen.
At the same time stimulate the sympathetic nervous system in which the blood
vessels in response to emotional stimuli, the adrenal glands are also stimulated
vasoconstriction resulting in additional activities. Secreting adrenal medullary
epinephrine causes vasoconstriction. Adrenal cortex secrete cortisol and other steroids,
which DAPT strengthen blood vessels vasokontriktor response.vasoconstriction
resulting in decreased blood flow to the kidneys, causing the release of renin. Renin
stimulates the formation of angiotensin I, which is then converted to angiotensin II, a
potent vasoconstrictor, which in turn stimulates aldosterone secretion by the adrenal
cortex. hormone causes retention of sodium and water by the kidney tubules, causing

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 an increase in intravascular volume. All of these factors tend to provoke a state of
hypertension.
Structural and functional changes in the peripheral vascular system responsible
for the changes in blood pressure that occurs in the elderly. These changes include
atherosclerosis, loss of elasticity of the connective tissue, and a decrease in vascular
smooth muscle relaxation, which in turn lowers the ability of tensile strength distension
and blood vessels. Consequently, the aorta and large arteries less able to accommodate
the volume of blood pumped by the heart (volume sekuncup), resulting in decreased
cardiac output and increased peripheral resistance (Smeltzer, Bare, 2002).
G. The symptoms of hypertension
The symptoms of hypertension, among others:
1. Much of no symptoms.
2. Pain in the back of the head.
3. stiff neck.
4. Fatigue.
5. Nausea.
6. Shortness of breath.
7. Restless.
8. Vomiting.
9. easily offended.
10. hard to sleep.
Complaints are not always going to be experienced by a patient with
hypertension. Often a person with symptoms of pain behind his head, irritability and
difficulty sleeping, when the blood pressure measured showed a normal blood pressure
numbers. The only way to determine the presence or absence of hypertension only by
measuring blood pressure.
H. The effects of hypertension
Hypertension if not controlled can lead to serious complications, such as:
1. kidney damage.
2. damages blood vessels.
3. brain hemorrhage / stroke.
4. Paralysis.
5. enlarged heart / heart trouble.
6. Narrowing of the coronary arteries / heart attack.

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I. Prevention of hypertension
Person's risk for hypertension (except essential), can be reduced by:
1. Checking blood pressure regularly .
2. Maintain ideal weight .
3. Reducing salt intake .
4. Do not smoke .
5. Exercising regularly .
6. regular life .
7. Reducing stress .
8. Do not rush .
9. Avoid fatty foods
Primary Prevention:
1. Adequate sleep, between 6-8 hours per day.
2. Reduce high cholesterol foods and multiply physical activity to lose weight.
3. Reduce alcohol consumption.
4. Consumption of fish oil.
5. The supply of calcium, although only slightly lower blood pressure but calcium is
also quite helpful.
Secondary Prevention
1. Pattern whice food healthy.
2. Reduce salt and sodium in your diet.
3. Physical active.
4. Reduce intake Alcohol.
5. Stop smoking.
Tertiary Prevention
1. Control of blood on a regular basis.
2. Sports regularly and adjusted to body condition.
J. Treatment of hypertension
Treatment of hypertension is best:
1. Always control your blood pressure checked regularly by a doctor .
2. Always take medication regularly even without a complaint .
3. Reducing salt intake .
4. Increase consumption of vegetables and fruit .
5. Obeying doctor's advice.

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 CHAPTER III
CLOSING

A. Conclusion
Hypertension or high blood pressure, is increased blood pressure or force of
blood pressing on the walls of the cavity where the blood was.
Blood pressure in a person's life varies naturally. Infants and children normally have a
blood pressure that is much lower than adults. Blood pressure is also affected by
physical activity, which will be higher at the time of the activity and lower when
resting. Blood pressure is also different in one day, the highest in the morning and
lowest at night during sleep.
B. Suggestion
How to set up a diet for people with hypertension is to improve the taste by
adding sugar fresh red / white onion (red / white), ginger, and other spices kencur are
not salted or salt contains less sodium. Food can be sauteed to improve the taste. Put
salt at the table above can be taken to avoid excessive use of salt. It is recommended to
always use iodized salt and salt use no more than 1 teaspoon per day.

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 REFERENCE

Carretero OA, Oparil S (January 2000). "Essential hypertension. Part I: Definitionand

etiology". Circulation 101 (3): 329–35. doi:10.1161/01.CIR.101.3.329. PMID 10645931.
Chobanian AV, Bakris GL, Black HR, et al. (December 2003). "Seventh report of the
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High
Blood Pressure". Hypertension 42 (6): 1206–
52. doi:10.1161/01.HYP.0000107251.49515.c2. PMID 14656957.

National Clinical Guidance Centre (August 2011). "7 Diagnosis of Hypertension, 7.5
Link from evidence to recommendations". Hypertension (NICE CG 127). National
Institute for Health and Clinical Excellence. hlm. 102. Diakses 2011-12-22.