According to WHO, 1 of 3 people suffer from hypertension or high blood pressure

and 1 of 10 people suffering from hypertension and diabetes too. Statistical released by WHO
in 2012 mentions it can trigger a stroke caused by the death of up to 51% and trigger a
coronary artery that caused the death up to 45% . hypertension prevalention in Indonesia
reached 31.7%.
High blood pressure is a common condition the blood fluid in the body suppress the
wall arterial is enough to eventually caused health problems, like heart disease. Blood
pressure is determined by the amount of blood the heart pumped and the amount of resistance
to blood flow in the artery. The more blood is pumped in heart and arteries are narrowed, and
the blood pressure will rise.
Djoko Santoso (2010) say Blood pressure is the pressure which the blood circulates in
the blood vessels. This pressure has continued in the blood vessels and allowing blood to
flow constant. Blood pressure in the body is essentially a measure of the pressure or force
inside the artery to be balanced with the heart rates, heart rates through the blood to be
pumped through the veins were then taken to all parts of the body. Blood pressure is affected
blood volume and blood vessel elasticity (Rusdi, 2009).
According to a team of researchers from the University of Cambridge and Nottingham
England, the blood pressure is controlled by hormones called angiotensis (Anna, 2010) since
left ventricle of the heart pumps blood into the arteries is called systolic pressure. Diastolic
pressure is the lowest pressure when the heart is rest or relax. Blood pressure described as the
ratio of systolic pressure against diastolic pressure. In adults, normal pressure ranges from
120/80 mmHg (Santoso, 2010).
Basic Health Research In 2013 showed that the hypertensives age differences 18
Years 25.8 % of Term overall population of Indonesia. From the figure, Women MORE Lots
6 percent compared to men in hipertension deases. While undiagnosed by healthcare provider
only reaches About 9.4%.
The concept of hypertension in the elderly
2.2.1 Definition of Hipertensi
According to Sylvia’s theory (2005), hypertension is an increase in systolic blood pressure of 140
mmHg or a diastolic pressure of at least 90 mmHg. Meanwhile, according to Rusdi’s theory
(2009) Hypertension is a heart disorders characterized by increased blood pressure in the our
body. Someone who contracted the disease usually potentially disease - another disease, such
as stroke and heart disease.
According to Djoko Santoso’s theory (2010) Hypertension shows the condition in which the blood
flow in the artery pressure is too high for a healthy body. Hypertension is the same for all age
groups and the treatments not based on age but on the level of blood pressure and the
presence of cardiovascular risk existing in patients (Aru, 2010). Isolated systolic hypertension
 of the most prominent forms of hypertension in the elderly, by definition if the systolic blood
pressure of 140 mmHg or diastolic blood pressure less than 90 mmHg. Along with age,
everyone almost has experienced an increase in blood pressure (Potter and Perry, 2005).

2.2.2 Etiology
hypertension caused by divided into two types according to Dr.Iskandar Junaidi’s theory 2010:
1. Hypertension / Essential
Essential hypertension is a hypertension that has several possible causes. Primary hypertension
occurs because of the condition of people who have a fairly high salt intake, more than 6.8
grams per day, as well as genetic factors. (Found in approximately 90% of all hypertension)
2. Secondary hypertension
Secondary hypertension is hypertension caused by blood vessel disorders or certain organs, such as
kidneys, adrenal glands, and the aorta. The cause of secondary hypertension about 5-10% it
comes from kidney disease, and about 1-2% due to hormonal abnormalities or use of certain
medications. Another rare cause is a pheochromocytoma, which is a tumor of the adrenal
glands that produce hormones.

2.2.3 Symptoms of Hypertension

There was an increase of blood pressure is sometimes the only symptom. Other symptoms are
perceived: headache, fatigue, shortness of breath, anxiety, the view becomes blurry, dizzy
eyes, irritability, ringing in the ears, difficulty sleeping, heaviness in the neck, pain in the
back, pain in the chest, strong and fast heart beats, dizziness. And other complaints will arise
in the event of complications in the kidneys, brain and heart (Widian, 2009).
2.2.4 Affecting factors of Elderly Hypertension
According Darmojo’s theory (2006), affecting hypertension factors in the elderly are:
1. Renin
High levels of renin lead to vasoconstriction and increased blood volume (due to increased
retention of salt and fluid in the kidneys), resulting in high levels of blood pressure.
2. Increased sensitivity to salt intake.
With increasing age the more sensitive to an increase or decrease in the levels of sodium. This led
to a decline in kidney function with decreased renal perfusion and glomerular filtration rate.
3. Decreased peripheral blood vessel elasticity
due to the aging process will increase the resistance of blood vessels
resulting peripheral hypertension systolic.
4. Changes ateromatous
As a result of the aging process causes endothelial dysfunction persists
the establishment of various cytokines and other chemical substances which then causes by sodium
in the renal tubules, increasing the peripheral vascular sclerosis and other conditions
associated with elevated blood pressure.
2.2.5 Occurrence Factors of Hypertension
According to Rusdi’s theory (2009) factors and causes of hypertension, is:
Factors that can not be changed:
1. Family factor
Families whose members has a history of higher blood pressure, cardiovascular disease or diabetes,
the disease usually it will decrease to their children.
2. Gender
In general, men more likely to develop hypertension than women. Hypertension based on gender
can also be influenced by psychological factors. women is often triggered by unhealthy
behaviors, such as smoking and being overweight, depression, and low jobs. However, the
men more in touch with work and unemployment.
3. The age factor
The age factor also trigger off hypertension. The eldery person with 60 years old or more than that,
has the potential of developing hypertension. Systolic pressure continues to increase up to 80
years and diastolic pressures continue to rise until the age of 55-60 years.
Factors that can be changed:
1. Obesity
survey has shown that power the heart and circulation pumps blood volume of obese people with
hypertension than those with patients who have a normal weight. They are at risk two to six
times more likely to develop hypertension than people with normal weight. The side effects
of obesity include: Respiratory disorders, complaints on the bone, skin disorders, swelling /
edema (Iskandar, 2010)
2. The consumption of high salt intake
Based on the statistical it is known that hypertension often suffered by tribes or people with low
salt intake. salt (sodium) is binding the water when salt is consumed, then the salt binds water
so that the water will be absorbed into the intravascular cause increased blood volume. If the
increased blood volume, heart work will increase and consequently the blood pressure also
increases. The medical world has shown that limiting the consumption of salt (sodium) by
diuretics (facilitating urine) will reduce the pressure.
3. Smoking
Smoking can stimulate the adrenergic system and increase blood pressure. And also cause
narrowing of the canal lungs can trigger kidney and heart work faster, so the rise in blood
 pressure can not be avoided (Rusdi, 2009). Nicotine contained in cigarettes can boost the
release of epinephrine, which can lead to narrowing of the artery wall due to a strong
contraction (Iskandar, 2010).
4. Drinking alcohol
Consuming alcohol can disrupt and destroy the function of several organs including the liver one.
Liver function will be disturbed affecting the performance or function of the heart eventually
lead to hypertension. Alcohol can stimulate the release of epinephrine, or adrenaline, which
makes the arteries to shrink and cause the accumulation of water and sodium.
5. Stress
The relationship between stress and hypertension caused by activation of the sympathetic nerves
(the nerves that work on exertion). Sympathetic nerve activity it works actively and increases
lead to increased blood pressure was erratic.
6. Less Sport
Lack of exercise and movement can cause the blood pressure in the body increases. Sports aims to
accelerate blood circulation and accelerate the spread of nerve impulses or vice versa so that
the body gets always fit.
7. Drugs
Factor of hypertension due to the influence of drugs . drugs basically more potential experienced by
women, especially those who are taking medications - oral contraceptives. Consumption of
oral contraceptives (pills) may be risk of changes in metabolism of fats (lipids) in blood. This
effect depends on the type and dose of the hormones in oral contraceptives when estrogen,
the effect is better because it raises HDL cholesterol (the good cholesterol) and lower LDL
cholesterol (bad cholesterol). Progestin with estrogen have an adverse effect so that
incidence of high blood pressure (Santoso, 2010)

Blood Pressure classification

According to Gunawan’s theory (2001), human blood pressure can be classified into three groups,
as follows:
1. Low blood pressure (hypotension)
2. Normal blood pressure (normotensive)
3. High blood pressure (hypertension)
Meanwhile, the father of medicine. NM Kaplan to limit or certain sizes in deciding people said to
be suffering from hypertension or not. These limits are based mainly on differences in the age
and sex of each person. Kaplan made a provision of this kind:
1. A man aged <45 years can suffer from hypertension when blood pressure at rest> 130/90 mmHg.
2. A man aged> 45 years may also be suffer from hypertension when blood pressure> 145/95
mmHg.
 3. For a woman whose blood pressure> 160/95 mmHg, then declared hypertension. (Santoso,
2010).
According to Nugroho’s theory (2008) hypertension in the elderly distinguished by:
1. Hypertension in systolic blood pressure equal or greater than 140 mmHg or diastolic pressure
equal or greater than 90 mmHg.
2. isolated systolic hypertension: systolic blood pressure greater than 160 mmHg and diastolic
blood pressure lower than 90 mmHg.
Table 2.1 According to Sutanto (2010) classification of human blood pressure is as follows:
Sistolic pressure Diastolic pressure
Category (mmHg) (mmHg)
Optimal tension < 120 mmhg < 80 mmhg
Normal tension < 130 mmhg < 85 mmhg
Normal high tension 130 – 139 mmhg 85 – 89 mmhg
Mild hypertension 140 – 159 mmhg 90 – 99 mmhg
Moderate
160 – 179 mmhg 100 – 109 mmhg
hipertension
severe hypertension 180 – 209 mmhg 110 – 119 mmhg
malignant
hypertension >210 mmhg >120 mmhg

2.2.7 Komplikasi Hipertensi

1. Causes aterosklersis so it can accelerate the occurrence of ischemic heart disease.
2. Heart failure
3. nerves system causing intracerebral hemorrhage
4. Renal glomerular or cause necrosis, proteinuria.
5. Impaired vision
6. Neurology disorders
7. Heart Failure
8. Impaired renal function
9. Impaired cerebral
10. thromboembolism and transient cerebral ischemia attack

2.2.8 Non-Pharmacological Management of Hypertension

Management is a non pharmacological treatment without drugs that can applied in hypertension. In this way,
can changes blood pressure through prevention pursued by leading a healthy behavior (Junaedi,
2010) such as:
1. Lose weight to the ideal limit
2. Change your diet and eat a balanced diet
3. Reducing the use of salt
4. Reduce / do not drink alcoholic -Drinks
5. do some sports
6. stop smoking
Reference

DAFTAR PUSTAKA

1. Chandra, Budiman (2008). Metodologi Penelitian Kesehatan. Jakarta: EGC

2. Darmojo, Boedhi dan Martono (2004). Geriatri. Edisi 3. Jakarta: Balai
Penerbit Fakultas Kedokteran Universitas Indonesia (FKUI)
3. Gunawan (2001). Hipertensi Tekanan Darah Tinggi. Yogyakarta: penerbit
kansius
4. Indriyani, Widian (2009). Deteksi dini kolestrol, hipertensi, dan stroke. Jakarta
: milistone
5. Junaidi, Iskandar (2010). Hipertensi ( Pengenalan, pencegahan, dan
pengobatan). Jakarta : PT Bhuana Ilmu Populer
6. Lapau, Buchari (2009). Prinsip dan Metode Epidemiologi. Jakarta : Balai
Penerbit FKUI
7. Machfoedz, Ircham (2005). Pendidikan Kesehatan dan Promosi Kesehatan.
Jakarta : Tramaya
8. Notoatmodjo, Soekidjo (2007). Promosi Kesehatan dan Ilmu Perilaku. Jakarta
: Rineka Cipta
9. Notoatmodjo, Soekidjo (2010). Ilmu Perilaku Kesehatan . Jakarta : Rineka
Cipta
10. Notoatmodjo, Soekidjo (2010). Metodologi Penelitian Kesehatan. Jakarta:
Rineka Cipta