PERBEDAAN TINGKAT KEPATUHAN DIET MEDITERANIA TERHADAP TEKANAN DARAH PADA PASIEN HIPERTENSI
Abstract
Data World Health Organization (WHO) menetapkan pasien hipertensi di seluruh dunia yaitu sekitar 1,13 milyar orang. Riset Kesehatan Dasar (Riskesdas) 2018 menunjukkan bahwa prevalensi pasien hipertensi mencapai 34,1% di Indonesia, di Provinsi Jawa Barat sebesar 39,6%, dan di Kota Cimahi sebesar 41,83%. Salah satu penatalaksanaan hipertensi yang direkomendasikan oleh US Dietary Guideline, American Heart Association (AHA), dan European Society of Cardiology (ESC) adalah diet Mediterania. Penelitian ini bertujuan untuk mengetahui perbedaan tingkat kepatuhan diet Mediterania terhadap tekanan darah sistolik, diastolik, dan mean arterial pressure (MAP) pada pasien hipertensi. Rancangan penelitian menggunakan metode analitik observasional dengan pengamatan kohort prospektif pada 39 pasien hipertensi selama satu bulan. Pengambilan data sampel menggunakan teknik systematic random sampling. Subjek penelitian terbagi berdasarkan kepatuhan diet Mediterania yaitu rendah, sedang, dan tinggi yang diukur dengan skor alternate Mediterranean diet (AMED) setelah mengisi food frequency questionnaire (FFQ) 4 kali dalam 1 bulan, kemudian dilakukan pemeriksaan tekanan darah pada akhir bulan. Data tekanan darah sistolik dan MAP dilakukan uji analisis Anova dan Post Hoc Tukey, sedangkan data tekanan darah diastolik dilakukan uji Kruskal Wallis dan Mann Whitney. Hasil penelitian menunjukkan perbedaan tingkat kepatuhan diet Mediterania terhadap tekanan darah sistolik (p=0,001<0,05), tekanan darah diastolik (p=0,029<0,05), dan MAP (p=0,003<0,05) yang bermakna pada pasien hipertensi. Semakin tinggi tingkat kepatuhan pasien dalam menjalankan diet Mediterania, maka nilai tekanan darah sistolik, diastolik, dan MAP semakin rendah. Komposisi diet Mediterania yang mengandung monounsaturrated fatty acid (MUFA) dan polyunsaturated fatty acid (PUFA) yang tinggi berefek sebagai antiinflamasi, antioksidan, dan kardioprotektif sehingga berpotensi menurunkan tekanan darah.
Kata kunci : diastolik, diet mediterania, kepatuhan, mean arterial pressure, sistolik
DOI : 10.35990/mk.v6n1.p22-33
References
2. Perhimpunan Dokter Hipertensi Indonesia. Konsensus Penatalaksanaan Hipertensi 2021 : Update Konsensus PERHI 2019. Lukito AA, Harmeiwaty E, Situmorang TD, Hustrini NM, Kuncoro AS, Barack R, et al., editors. Jakarta: Perhimpunan Dokter Hipertensi Indonesia; 2021.
3. Mancia G, de Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension. 2018;25(6):3048.
4. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1342.
5. Eve E. Stoody, Julie Obbagy, TusaRebecca Pannucci, Stephenie L, Elizabeth Rahavi, Jean Altman, et al. Dietary guidelines for Americans 2020 - 2025. 9th ed. Washington DC: U.S. Department of Agriculture and U.S. Department of Health and Human Services; 2020. 149 p.
6. van Horn L, Carson JAS, Appel LJ, Burke LE, Economos C, Karmally W, et al. Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement from the American Heart Association. Circulation. 2016;134(22):507–9.
7. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal. 2016;37:2347–9.
8. Lăcătușu CM, Grigorescu ED, Floria M, Onofriescu A, Mihai BM. The mediterranean diet: From an environment driven food culture to an emerging medical prescription. International Journal of Environmental Research and Public Health. 2019;16:1.
9. Sanches Machado D’Almeida K, Ronchi Spillere S, Zuchinali P, Corrêa Souza G. Mediterranean diet and other dietary patterns in primary prevention of heart failure and changes in cardiac function markers: A systematic review. Nutrients. 2018;10(1).
10. Massaro M, Scoditti E, Carluccio MA, Calabriso N, Santarpino G, Caterina TV, et al. Effects of Olive Oil on Blood Pressure: Epidemiological, Clinical, and Mechanistic Evidence. Nutrients. 2020;(10):58.
11. Ahmed FS, Wade AT, Guenther BA, Murphy KJ, Elias MF. Adherence to a Mediterranean diet associated with lower blood pressure in a US sample: Findings from the Maine-Syracuse Longitudinal Study. Journal of Clinical Hypertension. 2020;22(12):2276–84.
12. Su C, Yagüe-guirao G, Santaella-pascual M, Peso-echarri P, Morales E, Garc L, et al. Adherence to the Mediterranean Diet and Determinants Among Pregnant Women : The NELA Cohort. Nutrients. 2021;13:1–17.
13. Shvetsov YB, Harmon BE, Ettienne R, Wilkens LR, Le Marchand L, Kolonel LN, et al. The influence of energy standardisation on the alternate Mediterranean diet score and its association with mortality in the Multiethnic Cohort. British Journal of Nutrition. 2016;116(9):1592–601.
14. Schwingshackl L, Morze J, Hoffmann | Georg. Mediterranean diet and health status: Active ingredients and pharmacological mechanisms. The Pharmacology of Nutraceuticals. 2019;1241–5.
15. Aridi YS, Walker JL, Roura E, Wright ORL. Adherence to the mediterranean diet and chronic disease in australia: National nutrition and physical activity survey analysis. Nutrients. 2020 May 1;12(5).
16. Steffen LM, van Horn L, Daviglus ML, Zhou X, Reis JP, Loria CM, et al. A modified Mediterranean diet score is associated with a lower risk of incident metabolic syndrome over 25 years among young adults: The CARDIA (Coronary Artery Risk Development in Young Adults) study. British Journal of Nutrition. 2014 Nov 28;112(10):1654–61.
17. Yubero-Serrano EM, Fernandez-Gandara C, Garcia-Rios A, Rangel-Zuñiga OA, Gutierrez-Mariscal FM, Torres-Peña JD, et al. Mediterranean diet and endothelial function in patients with coronary heart disease: An analysis of the CORDIOPREV randomized controlled trial. PLoS Medicine. 2020 Sep 1;17(9).
18. Toledo E, Hu FB, Estruch R, Buil-Cosiales P, Corella D, Salas-Salvadó J, et al. Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: Results from a randomized controlled trial. BMC Medicine. 2013 Sep 19;11(1).
19. Filippou CD, Thomopoulos CG, Kouremeti MM, Sotiropoulou LI, Nihoyannopoulos PI, Tousoulis DM, et al. Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition. 2021 May 1;40(5):3191–200.
20. Tyrovolas S, Haro JM, Polychronopoulos E, Mariolis A, Piscopo S, Valacchi G, et al. Factors associated with components of arterial pressure among older individuals (the multinational MEDIS study): The role of the mediterranean diet and alcohol consumption. Journal of Clinical Hypertension. 2014 Sep 1;16(9):645–51.
