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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Medical Journal of Indonesia Indonesian Journal of Cardiology Jurnal Integrasi Kesehatan dan Sains Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation
Badai Bhatara Tiksnadi
Universitas Padjadjaran
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Controlled Resistant Hypertension Following A Successful Renal Artery Stenting: A Rare Case Report in A Developing Country Munita, Fatihatul Firdaus; Tiksnadi, Badai Bhatara; Martha, Januar Wibawa; Ratna, Margareta Ginanti
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1687

Abstract

Background Renal artery stenosis is among the etiologies of secondary hypertension in which the diagnosis and therapy are difficult. We report a case of a patient with uncontrollable hypertension with frequent episodes of malignant hypertension, treated with renal artery stenting. Case Illustration A 36-year-old female visited the cardiovascular polyclinic on a common control for her hypertension. She was diagnosed with hypertension two years, and she had several episodes of malignant hypertension. At the beginning of her treatment, she has prescribed an angiotensin-converting-enzyme inhibitor, yet her pressure was uncontrolled and worsened. By the visit, she was treated using two alpha-2-adrenergic agonists, a loop diuretic, a beta-blocker, a calcium-channel blocker, an angiotensin-receptor blocker, and an aldosterone-receptor antagonist without any satisfactory outcome on her blood pressure status. She had a blood pressure of 196/130 mmHg with tachycardia of 112 times/minute. We found cardiomegaly on physical examination, which was proven by a chest x-ray. Echocardiography indicated hypertensive heart disease. Screening for secondary hypertension, including laboratory tests (complete blood count, potassium, sodium, creatinine, fasting glucose, lipid profile, urinalysis, thyroid-stimulating hormone, and 24-hour urinary-free cortisol), suggested normal results. Renal ultrasound and doppler were also conducted and showed a suspicion of right renal artery stenosis. Therefore, angiography of the renal artery was performed for diagnosis and therapy when indicated. The angiography suggested a normal left renal artery, while the right artery had a 95% stenosis on the proximal part. An intravascular ultrasound-guided percutaneous transluminal angioplasty on her right renal artery was conducted, and two vascular stents were implanted. The patient showed a remarkable development following her decreasing blood pressure on follow-up. After one week, her blood pressure is controllable on a single antihypertensive and antiplatelet therapy. Conclusion The diagnosis and management of a patient with resistant hypertension might be challenging, particularly in the setting of a developing country. Renal artery angiography, among other examinations, might be crucial in the diagnosis sequence, yet it was only sometimes readily available. We present a case in which a diagnosis of renal artery stenosis was made, followed by a definite treatment resulting in unprecedented hypertension control. An identifiable etiology is the key to a proper and the best treatment option for the patient.
Smoking Parameters in Coronary Heart Disease Patients Treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesia Prabhaswara, Agastya; Ikhsani, Rizkania; Bijaksana, Transiska Liesmadona; Wahjoepramono, Nicolaus Novian Dwiya; Tarsidin, Najmi Fauzan; Tiksnadi, Badai Bhatara
Majalah Kedokteran Bandung Vol 56, No 2 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3367

Abstract

The association between smoking and coronary heart disease (CHD) has been studied extensively, though smoking parameters that contribute to the development of CHD may still need to be studied further. This cross-sectional study aimed to describe the characteristics of smoking parameters, including the number of cigarettes smoked, age when started smoking, duration of smoking, and cessation of smoking, in CHD patients treated at Dr. Hasan Sadikin General Hospital, Indonesia. CHD patients aged ≥18 years were included from the cardiology outpatient clinic and hospital wards. Smokers (current smokers/quit smoking <6 months) and ex-smokers (quit smoking ≥6 months) were considered patients who had a history of smoking. The Brinkman index, i.e., duration of smoking x number of cigarettes/day, was used to measure the degree of smoking that were categorized into mild, moderate, and severe smokers. Eighty-seven subjects diagnosed with CHD were recruited in this study. Seventy-seven percent of the subjects were male, and the mean age of subjects studied was 58.5±10.4 years. Among all subjects, a history of smoking was found in 66.7% (37.9% smokers and 28.7% ex-smokers), with all composed of male subjects. The age of subjects who had a history of smoking was 20 (15-35) years. Most were moderate smokers (74.1%) from Brinkman Index measurement. Smoking history has a significant association with male sex, lower total cholesterol, and lower LDL levels (p-value <0.05).
Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Co-Authors Achmad Fauzi Yahya, Achmad Fauzi Ade Meidian Ambari Adi Imam Cahyadi Alberta Claudia Undarsa Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Arif Ridha Arityanti, Dean Augustine Purnomowati Bijaksana, Transiska Liesmadona Caepy Gomer Cholid Tri Tjahjono Desandri, Dwita Rian Dewi Nur Fiana Dwiputra, Bambang Erwan, Nabila Erina Faris Yuflih Fihaya Fatihatul Firdaus Munita, Fatihatul Firdaus Febrianora, Mega Fitra, Maha Hasan, Harris Hergaf, Indah Widyasari Ikhsani, Rizkania Ina Marita Irsad Andi Arso, Irsad Andi Januar Wibawa Martha Krevani, Citra Kiki Makes, Indira Kalyana Marita, Ina Meity Adriana Mohammad Rizki Akbar Muhammad Ridwan Muhammad Rizki Akbar, Muhammad Rizki Nova Sylviana Paulus Anam Ong Prabhaswara, Agastya Putri Wulandari Qhabibi, Faqrizal Ria Ratna, Margareta Ginanti Raynaldo, Abdul Halim Rien Afrianti Rita Hamdani Rully Marsis Amirullah Roesli Sobaryati Sobaryati Sunaryo B Sastradimaja Sunaryo B. Sastradimaja Sunaryo B. Sastradimaja, Sunaryo B. Susilowati, Eliana Syaoqi, Muhammad Syarief Hidayat Tarsidin, Najmi Fauzan Toni Mustahsani Aprami, Toni Mustahsani Tony S. Djajakusumah Wahjoepramono, Nicolaus Novian Dwiya Yasmine Fitrina Siregar Yulia Sofiatin