Perbedaan Gambaran Elektrokardiografi pada Remaja Obes dengan Hipertensi dan Tanpa Hipertensi
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Latar belakang. Prevalensi obesitas remaja semakin meningkat. Obesitas berhubungan dengan hipertensi yang dapat menyebabkan perubahan struktur mekanik dan listrik jantung. Elektrokardiografi (EKG) merupakan alat pemeriksaan aktivitas listrik jantung yang mudah dan tersedia luas.
Tujuan. Mengetahui gambaran EKG pada anak obes dengan hipertensi dibandingkan dengan tanpa hipertensi.
Metode. Penelitian cross-sectional dilakukan pada siswa SMA obes usia 15-18 tahun di Yogyakarta. Subjek dengan data tidak lengkap, menderita penyakit diabetes melitus, ginjal, jantung, infeksi akut, serta riwayat penyakit sistemik atau menggunakan steroid dieksklusi. Analisis bivariat menggunakan uji t test dan chi square.
Hasil. Subjek penelitian adalah 177 remaja obes terdiri dari 100(56,5%) laki-laki dan 77(43,5%) perempuan. Didapatkan subjek hipertensi sebesar 30%. Pada analisis bivariat tidak didapatkan perbedaan signifikan rerata frekuensi jantung, durasi gelombang P, interval PR, interval QTc, durasi QRS, amplitudo gelombang R, dan gelombang S serta prevalens left ventricular hyperthrophy (LVH); strain pattern; pemanjangan durasi gelombang P, kompleks QRS, interval QTc; dan pergeseran axis P, QRS, dan T ke kiri (p>0,05).
Kesimpulan. Penelitian ini belum bisa membuktikan adanya perbedaan bermakna gambaran EKG pada remaja obes dengan hipertensi dibandingkan tanpa hipertensi.
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WHO.int. Facts and figures on chilhood obesity (updated 2017 October 13. Disitasi pada tanggal 19 Juli 2018. Didapat dari: http://www.who.int.
Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas 2013). Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2013.
Flynn JT, Falkner BE. Obesity hypertension in adolescent : epidemiology, evaluation, and management. J Clin Hypertens 2011;13:323-31.
Barlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120:S164-92.
Benson L, Baer HJ, Kaelber DC. Trends in the diagnosis of overweight and obesity in children and adolescents: 1999-2007. Pediatrics 2009;123:e153-8.
Awazu M. Epidemiology of hypertension. Dalam: Avner ED, Harmon WE, Niaudet P, Yoshikawa E, Emma F, Goldstein Sl, penyunting. Pediatric nephrology. Edisi 7. New York: Springer-Verlag; 2007.
Flynn JT. The changing face of pediatric hypertension in the era of chilhood obesity epidemic. Pediatr Nephrol 2013;28:1059-66.
Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002;40: 441-7
Sekarwana N. Rachmadi D, Hilmanto D. Konsensus tata laksana hipertensi pada anak. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011.
Bang CN, Okin PM. Does electrocardiography still have a place in hypertension? J Hypertens 2016;34:842-4.
Sun GZ, Li Y, Zhou XH, dkk. Association between obesity and ECG variables in children and adolescents: A cross-sectional study. ExpTher Med 2013;6:1455–62.
Frank S, Colliver JA, Frank A. The electrocardiogram in obesity: Statistical analysis of 1,029 patients. J A Coll Cardiol 1986;7:295–9.
Paech C, Anhalt M, Gebauer RA, dkk. New normal limits for pediatric ECG in childhood obesity? Influence of childhood obesity on the ECG. Progress in Ped Cardiol 2018;48:119-23.
Cozzolino D, Grandone A, Cittadini A, dkk. Subclinical myocardial dysfunction and cardiac autonomic dysregulation are closely associated in obese children and adolescents: The potential role of insulin resistance. Plos One 2015;0:e0123916.
George CF, Breckenridge AM, Dollery CT. Value of routine electrocardiograhy in hypertensive patient. Br Heart J 1972;34:618-22.
Lehtonen AO, Puukkaa P, Varisb J, Porthanc K, Tikkanend JT, Nieminenc MS. Prevalence and prognosis of ECG abnormalities in normotensive and hypertensive individuals. J Hypertens 2016;34:959-66.
Newaz ASM, Huda SQ, Ali SM, Maula G, Islam S. Electrocardiographic changes in different grades of hypertensive patients: experience of 400 cases in Bangladesh. J Sci Found 2016;4:26-9.
Modak S, Mehta P, Patnaik J. Study on ECG changes in chronic hypertensive patients in medical college hospital of odisha. JMSCR 2016;04:10473-7.
Mule G, Nardi E, Guarneri M, Cottone S. Electrocardiography for assesment of hypertensive heart disease : a new role for an old tool. J Clin Hypertens 2016;18:843-5.
Vaidean GD, Manczuk M, Magnani JW. Atrial electrocardiography in obesity and hypertension : clinical insights from the polish-norwegian study (pons). Obesity 2016;4:2608-14.
Murni IK, Sulistyoningrum DC, Susilowati R, Julia M. Risk of metabolic syndrome and early vascular markers for atherosclerosis in obese Indonesian adolescents. Paediatr Int Child Health 2020;40:117-23.
Anigbogu CN, Isichei CV, Ajuluchukwu JN. Blood pressure, heart rate, cardiovascular reflexes and electrocardiographic changes in some hypertensive Nigerians. Niger J Physiol Sci 2012;27:023-7.
Ahmed H, Czosek RJ, Spar DS, Knilans TK, Anderson JB. Early repolarization in normal adolescents is common. Pediatr Cardiol 2017;38:864-72.
Irawan B, Setianto BY, Dinarti LK, Hariawan H, Taufiq N, Arso IA, Mumpuni H. Pelatihan Interpretasi EKG. Yogyakarta: Bagian Kardiologi FK UGM; 2007.
Zema MJ, Kligfield P. ECG poor R wave progression: review and synthesis. Arch Intern Med 1982;142:1145-8.
Morris F, Edhouse J, Brady WJ, Camm J. ABC of Clinical Electrocardiography. Edisi ke-1. London: BMJ Publishing Group; 2003.
Falkner B, Daniels SR, Flynn JT, Gidding S, Green LA, Ingelfinger JR. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. US Department Of Health And Human Services National Institutes Of Health National Heart Lung And Blood Institute; 2005.
Wirix AJG, Nauta J, Groothoff JW, dkk. Is the prevalence of hypertension in overweight children overestimated?. Arch Dis Child 2016;101:998-1003.
Juhasz M, Katona E, Settakis G, Paragh G, Molnar C, Fulesdi B, Pall D. Gender related differences in adolescent hypertension and in target organ effects. J Woman Health 2010;19:759-65
DOI: http://dx.doi.org/10.14238/sp24.1.2022.16-22
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