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Abstract
Background: Preeclampsia in pregnant women can occur with elevated blood pressure >140/90 mmHg. Nifedipine and methyldopa can be used as antihypertensive therapy in pre-eclampsia patients. These two drugs have differences in their mechanisms of action to decrease blood pressure.
Objective: To evaluate the effects of nifedipine and methyldopa in hospitalized pregnant female patients at RSUD Dr. H. Moch. Ansari Saleh from January to December 2018.
Method: This research method was descriptive-observational, obtaining data retrospectively. This research included 30 hypertensive pregnant women who were divided into the nifedipine group or the methyldopa group. The blood pressure measurements of the patients were documented before and after therapy. The data was evaluated with an independent sample t-test.
Result: The outcomes of this research indicated that nifedipine reduced the systolic blood pressure from the average of 159.33 to 127.66 mmHg and in the methyldopa group from the average of 162.67 to 137.33 mmHg (p < 0.05). The mean arterial pressure (MAP) after using nifedipine was 99.44 ± 10.15 mmHg, and after using methyldopa, it was 106.22 ± 7.65 mmHg (p <0.05).
Conclusion: Nifedipine was more effective than methyldopa in lowering blood pressure in pre-eclampsia subjects.
Keywords: Nifedipine, methyldopa, hypertension, blood pressure
Intisari
Latar belakang: Ciri-ciri hipertensi pada ibu hamil ditandai dengan peningkatan tensi darah diatas 140/90 mmHg yang dapat menyebabkan terjadinya preeklampsia. Nifedipin dan metildopa digunakan sebagai terapi antihipertensi khususnya pada pasien preeklampsia. Kedua obat tersebut memiliki perbedaan pada mekanisme kerja untuk mengurangi tekanan pada pembuluh arteri.
Tujuan: Menganalisa efek pemakaian obat nifedipin dan metildopa pada subyek wanita hamil dan dirawat inap di RSUD Dr. H. Moch. Ansari Saleh di tahun 2018.
Metode: Jenis penelitian ini adalah observasional deskriptif dengan memperoleh data secara retrospektif. Jumlah subyek sebanyak 30 pasien ibu hamil dengan kondisi hipertensi dibagi menjadi kelompok nifedipin atau kelompok metildopa. Data tekanan darah diambil sebelum dan sesudah pengobatan yang diperoleh dari rekam medis pasien yang kemudian diuji dengan independent sample t-test.
Hasil: Nifedipin dapat mengurangi tekanan darah sistolik dari rerata 159,33 mmHg ke 127,66 mmHg dan pada grup metildopa dari rerata 162,67 mmHg ke 137,33 mmHg (p <0,05). Hasil rerata tekanan arteri (MAP) subyek setelah menggunakan nifedipin yaitu 99,44 ± 10,15 mmHg dan pada metildopa yaitu 106,22 ± 7,65 mmHg (p <0,05).
Kesimpulan: Nifedipin lebih efektif dibandingkan dengan metildopa dalam menurunkan tensi darah pada wanita hamil dengan preeklampsia.
Kata kunci: Nifedipin, metildopa, hipertensi, tekanan darah
Keywords
Article Details
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References
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- Butalia S., Audibert F., Côté A.-M., Firoz T., Logan A. G., Magee L. A., Mundle W., Rey E., Rabi D. M., Daskalopoulou S. S., & Nerenberg K. A. (2018). Hypertension Canada’s 2018 Guidelines for the Management of Hypertension in Pregnancy. Canadian Journal of Cardiology, 34(5), 526–531. https://doi.org/10.1016/j.cjca.2018.02.021
- Dayani T. R., & Widyantari K. Y. (2023). Faktor-Faktor Yang Berhubungan Dengan Kejadian Hipertensi Pada Ibu Hamil. Journal of Language and Health, 9(1), 1–10. https://jle.hse.ru/issue/view/1099/Volume 9 Issue 1
- Dublin S., Idu A., Avalos L. A., Cheetham T. C., Easterling T. R., Chen L., Holt V. L., Nance N., Bider-Canfield Z., Neugebauer R. S., Reynolds K., Badon S. E., & Shortreed S. M. (2022). Maternal and Neonatal Outcomes of Antihypertensive Treatment In Pregnancy: A Retrospective Cohort Study. PLoS ONE, 17, 1–14. https://doi.org/10.1371/journal.pone.0268284
- Easterling T., Mundle S., Bracken H., Parvekar S., Mool S., Magee L. A., von Dadelszen P., Shochet T., & Winikoff B. (2019). Oral Antihypertensive Regimens (Nifedipine Retard, Labetalol, And Methyldopa) For Management of Severe Hypertension In Pregnancy: An Open-Label, Randomised Controlled Trial. The Lancet, 394(10203), 1–11. https://doi.org/10.1016/S0140-6736(19)31282-6
- Garovic V. D., Dechend R., Easterling T., Karumanchi S. A., Baird S. M., Magee L. A., Rana S., & Vermunt J. V. (2022). Hypertension in Pregnancy : Diagnosis, Blood Pressure Goals, and Pharmacotherapy : In Hypertension (Vol. 79, Issue 2). https://doi.org/10.1161/HYP.0000000000000208.Hypertension
- Kundarto W., & Faizah R. N. (2021). Evaluasi Terapi Antihipertensi Pada Pasien Preeklampsia Berat di Instalasi Rawat Inap RSUD Dr. Moewardi Periode Januari - Juni Tahun 2017. JPSCR: Journal of Pharmaceutical Science and Clinical Research, 6(2), 228–237. https://doi.org/10.20961/jpscr.v6i2.39487
- Ngene N. C., & Moodley J. (2020). Pre-eclampsia With Severe Features: Management of Antihypertensive Therapy In The Postpartum Period. Pan African Medical Journal, 36(216), 1–15. https://doi.org/10.11604/pamj.2020.36.216.19895
- Okamoto T., Watanabe K., Banno T., Saitou T., Sugiura K., Iwasaki A., Matsushita H., & Wakatsuki A. (2022). Amount of Proteinuria As Associated With Severity Classification of Pregnant Women With Preeclampsia. Pregnancy Hypertension, 29, 30–35. https://doi.org/10.1016/j.preghy.2022.05.009
- Purwanti S. (2022). Risiko Preeklampsia pada Ibu Bersalin di RSUD dr. Moch Ansari Saleh. JIKES: Jurnal Ilmu Kesehatan , 1(1), 47–52. http://qjurnal.my.id/index.php/jik/article/view/89
- Togarikar S. M. (2017). Efficacy of Methyldopa Versus Nifedipine In Mild and Severe Pregnancy Induced Hypertension. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6(10), 4544–4548. https://doi.org/10.18203/2320-1770.ijrcog20174439
- Vanwye W. R., Weatherholt A. M., Winchester L. J., Owens J. G., & Spears M. (2023). Cardiovascular Responses During Light-intensity Aerobic Exercise with Varying Levels of Limb Occlusion Pressures. International Journal of Exercise Science, 16(2), 676–687. https://digitalcommons.wku.edu/ijes/vol16/iss2/12
- Yana A. U., Brata C., & Irawati S. (2023). Studi Penggunaan Antihipertensi pada Pasien Preeklampsia Rawat Jalan di Poliklinik Rumah Sakit Ibu dan Anak Surabaya. Jurnal Kesehatan, 14(2), 319–326. https://doi.org/10.26630/jk.v14i2.3893
References
Brown M. A., Magee L. A., Kenny L. C., Karumanchi S. A., McCarthy F. P., Saito S., Hall D. R., Warren C. E., Adoyi G., & Ishaku S. (2018). Hypertensive Disorders of Pregnancy. Hypertension, 72(1), 24–43. https://doi.org/10.1161/HYPERTENSIONAHA.117.10803
Butalia S., Audibert F., Côté A.-M., Firoz T., Logan A. G., Magee L. A., Mundle W., Rey E., Rabi D. M., Daskalopoulou S. S., & Nerenberg K. A. (2018). Hypertension Canada’s 2018 Guidelines for the Management of Hypertension in Pregnancy. Canadian Journal of Cardiology, 34(5), 526–531. https://doi.org/10.1016/j.cjca.2018.02.021
Dayani T. R., & Widyantari K. Y. (2023). Faktor-Faktor Yang Berhubungan Dengan Kejadian Hipertensi Pada Ibu Hamil. Journal of Language and Health, 9(1), 1–10. https://jle.hse.ru/issue/view/1099/Volume 9 Issue 1
Dublin S., Idu A., Avalos L. A., Cheetham T. C., Easterling T. R., Chen L., Holt V. L., Nance N., Bider-Canfield Z., Neugebauer R. S., Reynolds K., Badon S. E., & Shortreed S. M. (2022). Maternal and Neonatal Outcomes of Antihypertensive Treatment In Pregnancy: A Retrospective Cohort Study. PLoS ONE, 17, 1–14. https://doi.org/10.1371/journal.pone.0268284
Easterling T., Mundle S., Bracken H., Parvekar S., Mool S., Magee L. A., von Dadelszen P., Shochet T., & Winikoff B. (2019). Oral Antihypertensive Regimens (Nifedipine Retard, Labetalol, And Methyldopa) For Management of Severe Hypertension In Pregnancy: An Open-Label, Randomised Controlled Trial. The Lancet, 394(10203), 1–11. https://doi.org/10.1016/S0140-6736(19)31282-6
Garovic V. D., Dechend R., Easterling T., Karumanchi S. A., Baird S. M., Magee L. A., Rana S., & Vermunt J. V. (2022). Hypertension in Pregnancy : Diagnosis, Blood Pressure Goals, and Pharmacotherapy : In Hypertension (Vol. 79, Issue 2). https://doi.org/10.1161/HYP.0000000000000208.Hypertension
Kundarto W., & Faizah R. N. (2021). Evaluasi Terapi Antihipertensi Pada Pasien Preeklampsia Berat di Instalasi Rawat Inap RSUD Dr. Moewardi Periode Januari - Juni Tahun 2017. JPSCR: Journal of Pharmaceutical Science and Clinical Research, 6(2), 228–237. https://doi.org/10.20961/jpscr.v6i2.39487
Ngene N. C., & Moodley J. (2020). Pre-eclampsia With Severe Features: Management of Antihypertensive Therapy In The Postpartum Period. Pan African Medical Journal, 36(216), 1–15. https://doi.org/10.11604/pamj.2020.36.216.19895
Okamoto T., Watanabe K., Banno T., Saitou T., Sugiura K., Iwasaki A., Matsushita H., & Wakatsuki A. (2022). Amount of Proteinuria As Associated With Severity Classification of Pregnant Women With Preeclampsia. Pregnancy Hypertension, 29, 30–35. https://doi.org/10.1016/j.preghy.2022.05.009
Purwanti S. (2022). Risiko Preeklampsia pada Ibu Bersalin di RSUD dr. Moch Ansari Saleh. JIKES: Jurnal Ilmu Kesehatan , 1(1), 47–52. http://qjurnal.my.id/index.php/jik/article/view/89
Togarikar S. M. (2017). Efficacy of Methyldopa Versus Nifedipine In Mild and Severe Pregnancy Induced Hypertension. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6(10), 4544–4548. https://doi.org/10.18203/2320-1770.ijrcog20174439
Vanwye W. R., Weatherholt A. M., Winchester L. J., Owens J. G., & Spears M. (2023). Cardiovascular Responses During Light-intensity Aerobic Exercise with Varying Levels of Limb Occlusion Pressures. International Journal of Exercise Science, 16(2), 676–687. https://digitalcommons.wku.edu/ijes/vol16/iss2/12
Yana A. U., Brata C., & Irawati S. (2023). Studi Penggunaan Antihipertensi pada Pasien Preeklampsia Rawat Jalan di Poliklinik Rumah Sakit Ibu dan Anak Surabaya. Jurnal Kesehatan, 14(2), 319–326. https://doi.org/10.26630/jk.v14i2.3893