HUBUNGAN PENGENDALIAN GLUKOSA DARAH DAN MORNING BLOOD PRESSURE SURGE DENGAN KEJADIAN PENYAKIT JANTUNG KORONER PADA PASIEN DIABETES MELITUS TIPE 2 DI RUMAH SAKIT UMUM CUT MEUTIA

Maulina Debbyousha, Harvina Sawitri, Anna Millizia, Erwin Siregar, Muhammad Jailani

Abstract


Pasien diabetes melitus (DM) cenderung menujukkan percepatan proses aterosklerotik dan akibatnya risiko penyakit kardiovaskular lebih tinggi seperti penyakit jantung koroner.DM sering dipersulit dangan komorbiditas lainnya yang berkontribusi terhadap peningkatan risiko penyakit kardiovaskular (seperti, hipertensi, penyakit ginjal kronis, dan dislipidemia).  Kontrol glikemik yang tidak adekuat atau terjadinya resistensi insulin mengaktifkan saraf simpatis, yang memicu MBPS berlebihan pada pasien DM.MBPS berlebihan terlibat dalam patogenesis kejadian kardiovaskular pada pagi hari  dengan mencetuskan stres hemodinamik. Tujuan umum dari penelitian ini adalah untuk mengetahui hubungan antara  pengendalian glukosa darah dan MBPS, serta hubungan antara MBPS dan kejadian penyakit jantung koroner pada pasien diabetes melitus di Rumah Sakit Umum Cut Meutia. Penelitian ini merupakan penelitian observasional analitik dengan rancangan potong lintang (cross sectional). Sumber data dalam penelitian ini diperoleh dari data primer berdasarkan hasil identifikasi karakteristik pasien, pengukuran morning blood pressure surge, kadar gula darah puasa dan pemeriksaan EKG. Hasil penelitian menunjukkan sebesar 75% responden pada penelitian ini (n = 32) memiliki kadar gula darah puasa yang tidak terkontrol, 53,1% responden dengan morning hypertension dan 62,5% responden mengalami Penyakit Jantung Koroner (PJK).  Pada analisis bivariat, hasil menunjukkan terdapat hubungan antara kontrol gula darah puasa dengan morning hypertension (p value = 0.024%). Secara umum terdapat hubungan timbal balik antara DM dengan hipertensi.


Keywords


diabetes-mellitus, morning-blood-pressure-surge, penyakit-jantung-koroner

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References


Billo G, Grillo A, Guida V, Parati G. Morning blood pressure surge: pathophysiology, clinical relevance and therapeautic aspects. Dove Medical Press 2018;11:47-56.

Mancia G, Ferrari A, Gregorini L, Parati G, Pomidossi G, Bertinieri G, et al. Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circ Res 1983;53:96‑104.

Nuthalapati RK, Indukuri BR. Association between glycemic control and morning blood surge with vascular endothelial dysfunction in type 2 diabetes mellitus patients. Indian J Endocr Metab 2016;20:182-8.

Kario K, Pickering TG, Umeda Y, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation. 2003;107: 1401–1406.

Metoki H, Ohkubo T, Kikuya M, et al. Prognostic significance for stroke of a morning pressor surge and a nocturnal blood pressure decline: the Ohasama study. Hypertension. 2006;47:149–154

Marfella R, Siniscalchi M, Nappo F, Gualdiero P, Esposito K, Sasso FC, et al. Regression of carotid atherosclerosis by control of morning blood pressure peak in newly diagnosed hypertensive patients. Am J Hypertens 2005;18:308‑18..

Kannel WB, Schwartz MJ, McNamara PM. Blood pressure and risk of coronary heart disease: The Framingham Study 1969. Chest 2009;136 5 Suppl: e23.

Del Rio G, Carani C, Baldini A, Marrama P, Della Casa L. Chronobiology of catecholamine excretion in normal and diabetic men. J Endocrinol Invest 1990;13:575‑80.

Smith MM, Minson CT. Obesity and adipokines: Effects on sympathetic overactivity. J Physiol 2012;590(Pt 8):1787‑801.

Marfella R, Siniscalchi M, Portoghese M, Di Filippo C, Ferraraccio F, Schiattarella C, et al. Morning blood pressure surge as a destabilizing factor of atherosclerotic plaque: Role of ubiquitin‑proteasome activity. Hypertension 2007;49:784‑91.

Yan Z-P, Ma J-X. Risk Factors for Diabetic Retinopathy in Northern Chinese Patients with Type 2 Diabetes Mellitus. Int J Ophthalmol. 2016;9(8). doi:10.18240/ijo.2016.08.17.

Kuwajima I, Mitani K, Miyao M, Suzuki Y, Kuramoto K, Ozawa T. Cardiac implications of the morning surge in blood pressure in elderly hypertensive patients: relation to arising time. Am J Hypertens. 1995;8:29‐33.

White WB. The risk of waking-up: impact of the morning surge in blood pressure. Hypertension 2010;55:835–837

Lambert EA, Chatzivlastou K, Schlaich M, Lambert G, Head GA. Morning surge in blood pressure is associated with reactivity of the sympathetic nervous system. Am J Hypertens. 2014;27:783‐792.

Juhanoja EP, Puukka PJ, Johansson JK, Niiranen TJ, Jula AM. The impact of the day of the week on home blood pressure: the Finn-Home study. Blood Press Monit. 2016;21:63‐68.

Sheng CS, Cheng YB, Wei FF, et al. Diurnal blood pressure rhythmicity in relation to environmental and genetic cues in untreated referred patients. Hypertension. 2017;69:128‐135.

Strazzullo P, Barbato A, Galletti F, et al. Abnormalities of renal sodium handling in the metabolic syndrome. Results of the Olivetti Heart Study. J Hypertens 2006;24: 1633–1639

Matheus AS, Tannus LR, Cobas RA, Palma CC, Negrato CA, Gomes MB. Impact of diabetes on cardiovascular disease: an update. Int J Hypertens. 2013;2013:653789.

Centers for Disease Control and Prevention. National diabetes statistics report: Estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014.

Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J diabetes. 2015; 6(13): 1246-1258.

King RJ, Grant PJ. Diabetes and cardiovascular disease: pathophysiology of life-threatening epidemic. Herz. 2016; 41: 184-192

Vinik AI, Erbas T, Park TS, Nolan R, Pittenger GL. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001;24:1476–1485.

Vischer UM, Emeis JJ, Bilo HJ, Stehouwer CD, Thomsen C, Rasmussen O, Hermansen K, Wollheim CB, Ingerslev J. von Willebrand factor (vWf) as a plasma marker of endothelial activation in diabetes: improved reliability with parallel determination of the vWf propeptide (vWf: AgII) Thromb Haemost. 1998;80:1002–1007.

Sobel BE, Woodcock-Mitchell J, Schneider DJ, Holt RE, Marutsuka K, Gold H. Increased plasminogen activator inhibitor type 1 in coronary artery atherectomy specimens from type 2 diabetic compared with nondiabetic patients: a potential factor predisposing to thrombosis and its persistence. Circulation. 1998;97:2213–2221.

Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, Wright AD, Turner RC, Holman RR. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000 Aug 12; 321(7258):412-9.

Ohishi, M. Hypertension with diabetes mellitus: physiology and pathology. Hypertens Res (2018).

Yaogai Lv, Yao Y, Ye J, Guo X, Dou J, Shen L, Zhang A, Xue z, Yu Y, Jin L, Association of Blood Pressure with Fasting Blood Glucose Levels in Northeast China: A Cross-Sectional Study. Sci Rep 2018; 8: 7917.

Ramadhan N, Hanum S. Kontrol Glikemik pada penderita Diabetes melitius tipe 2 di puskesmas jayabaru Kota Banda Aceh. SEL;2016.3(1):1-9.

Yan Z-P, Ma J-X. Risk Factors for Diabetic Retinopathy in Northern Chinese Patients with Type 2 Diabetes Mellitus. Int J Ophthalmol. 2016;9(8). doi:10.18240/ijo.2016.08.17.

Marler JR, Price TR, Clark GL, et al. Morning increase in onset of ischemic stroke. Stroke. 1989;20: 473-476.

Muller JE, Stone PH, Turi ZG, et al. The MILIS Study Group. Circadian variation in the frequency of onset of acute myocardial infarction. N Engl J Med. 1985;313:1315‐1322.

Osanai T, Okuguchi T, Kamada T, et al. Salt-induced exacerbation of morning surge in blood pressure in patients with essential hypertension. J Hum Hypertens. 2000;14:57‐64

Wang YP, Li ZP, Bai Q, et al. Current status of morning blood pressure control and medication of hypertensive patients in Beijing. Chin J Cardiol. 2013;41:587‐588.

Oh SW, Han SY, Han KH, et al. APrODiTe investigators. Morning hypertension and night non-dipping in patients with diabetes and chronic kidney disease. Hypertens Res. 2015;38:889‐894.

Hoshide S, Yano Y, Haimoto H, et al. J-HOP Study Group. Morning and evening home blood pressure and risks of incident stroke and coronary artery disease in the Japanese general practice population: the Japan Morning Surge-Home Blood Pressure Study. Hypertension. 2016;68:54‐61.

Kario K, Saito I, Kushiro T, et al. Home blood pressure and cardiovascular outcomes in patients during antihypertensive therapy: primary results of HONEST, a large-scale prospective, real-world observational study. Hypertension. 2014;64:989‐996.

Yoda Koichiro, et al. Association between glycemic control and morning blood pressure surge with vascular dysfunction endothelial in type 2 diabetc patients. Diabetes Care. 2014. 37; 644-650

Hishikawa K, L¨uscher TF. Pulsatile stretch stimulatessuperoxideproductioninhuman aortic endothelial cells. Circulation 1997; 96:3610–3616

Eto M, Toba K, Akishita M, et al. Reduced endothelial vasomotor function and enhanced neo intimal formation after vascular injury in a rat model of blood pressure lability. Hypertens Res 2003;26:991–998.




DOI: https://doi.org/10.29103/averrous.v5i1.1625

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