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Papers by Tunggul Situmorang

European Heart Journal Supplements, Aug 1, 2020

Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardiocerebro-ren... more Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardiocerebro-reno-vascular morbidity and mortality. For the second year of the May Measurement Month (MMM) campaign in Indonesia in 2018, we recruited 174 sites in 31 out of 34 provinces in Indonesia and screened through convenience sampling in public areas and rural primary health centres. Hypertension was defined as systolic BP 140 mmHg or diastolic BP 90 mmHg, or both, or on the basis of receiving antihypertensive medication. Blood pressure was measured three times followed the standard global MMM protocol, multiple imputation was used to estimate the mean of the 2nd and 3rd BP readings if these were not recorded. A total of 91 222 individuals were screened, and after multiple imputations, 27 331 (30.0%) had hypertension. Of individuals not receiving antihypertensive medication, 14 367 (18.4%) were hypertensive. Among the 47.4% of hypertensive individuals on antihypertensive medication, 10 106 (78.0%) had uncontrolled BP. MMM17 and MMM18 were still the most extensive standardized screening campaigns for BP measurement in Indonesia. Compared to the previous study, the proportion with uncontrolled BP on medication was significantly higher and provided the substantial challenges in managing hypertension in the rural community.

Universa Medicina

BackgroundHypertension is a significant mortality risk factor. The knowledge and practice among p... more BackgroundHypertension is a significant mortality risk factor. The knowledge and practice among physicians of hypertension management and home blood pressure monitoring (HBPM) in blood pressure control is important. We aimed to investigate the awareness and practice of HBPM among physicians in Indonesia after publishing of the local 2019 HBPM guidelines. MethodsThis was a cross-sectional study involving 611 physicians in Indonesia that was conducted between February and October 2020. The questionnaire covered awareness, knowledge, and practice of HBPM. ResultsA total of 330 male physicians (54.0%) aged 20-49 years participated in the survey. More than half were specialists (51.6%) and recommended HBPM to their patients with hypertension (89.0%). The awareness of HBPM benefits was substantial among the physicians; however, the knowledge of the home blood pressure (HBP) reference values of was low (7.9%). Around 54% of the respondents thought that the barriers to low recognition of HB...

Indonesian Journal of Kidney and Hypertension, Apr 20, 2020

Background: Bone mineral disorders in chronic kidney disease (CKD-MBD) is one of the complication... more Background: Bone mineral disorders in chronic kidney disease (CKD-MBD) is one of the complications that occurs due to systemic disorders of minerals and bones in chronic kidney disease (CKD). This syndrome is one or a combination of laboratory abnormalities (phosphate, parathyroid hormone, and vitamin D), bone disorders (turnover, mineralization, volume, linear growth, and strength), and/ or vascular calcification or other soft tissue. It is associated with high mortality and morbidity in CKD patients. To determine the relationship of vitamin D levels and bone mineral density (BMD) examination with the hemodialysis vintage in CKD patients undergoing hemodialysis at RSUD Dr. Zainoel Abidin. Methods: This study is a cross-sectional study held in Zainoel Abidin Hospital, Banda Aceh, Indonesia, from January until May 2017. We include all patients who received twice-weekly hemodialysis for at least 3 months. Patients who received corticosteroids in the past 2 weeks, pregnant, suffering from endocrine disorders or malignancy, autoimmune diseases, and thalassemia, and menopausal women, were excluded. Laboratory examination and Bone Densitometry were performed before a single hemodialysis session. Data were analyzed using the Spearman Rank Correlation test. Results: Thirty patients were analyzed from 196 hemodialysis patients. The proportion of patients that have vitamin D insufficiency was 56.6%. The proportion of patients that have with normal vitamin D was 43.3%. The proportion of patients that have osteoporosis was 30% and 56.6% were osteopenia based on bone densitometry examination. The magnitude of the Spearman Rank Correlation coefficient between vitamin D levels and the duration of hemodialysis in CKD patients is-0.552 with a p-value

European Heart Journal Supplements : Journal of the European Society of Cardiology, 2020

Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardio-cerebro-re... more Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardio-cerebro-reno-vascular morbidity and mortality. For the second year of the May Measurement Month (MMM) campaign in Indonesia in 2018, we recruited 174 sites in 31 out of 34 provinces in Indonesia and screened through convenience sampling in public areas and rural primary health centres. Hypertension was defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or both, or on the basis of receiving antihypertensive medication. Blood pressure was measured three times followed the standard global MMM protocol, multiple imputation was used to estimate the mean of the 2nd and 3rd BP readings if these were not recorded. A total of 91 222 individuals were screened, and after multiple imputations, 27 331 (30.0%) had hypertension. Of individuals not receiving antihypertensive medication, 14 367 (18.4%) were hypertensive. Among the 47.4% of hypertensive individuals on antihypertensive medication, 10 106 (78...

European Heart Journal Supplements

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths eac... more Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. According to Non-communicable disease (NCD) Risk Factors Survey Bangladesh 2010, one-fifth (21.9%) of adults aged 25 years or more have hypertension. Almost one-third of the adult population did not have their BP measured in their lifetime in Bangladesh. National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2018 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes nationally. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the MMM protocol. Data were collected from 10 screening sites in 9 districts in Bangladesh. A total of 5208 individuals were screened during MMM18. After multiple imputation, 1750 (33.6%) had hypertensio...

Indonesian Journal of Kidney and Hypertension

European Heart Journal Supplements

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths eac... more Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Our previous primary health surveys in 2013 and 2018 show that 25.8% to 34.1% of adults have raised BP, which is associated with cardiovascular, cerebrovascular, and renovascular morbidity and mortality. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged 18 was carried out in May 2017. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. We recruited 292 sites in all 34 provinces in Indonesia, and screened in public areas and offices as well as health centres. A total of 69 307 individuals were screened. After multiple imputation, 23 892 (34.5%) had hypertension. Of individuals not receiving antihypertensive medication, 20.0% were hypertensive. Among individuals receiving antihypertensive medication, 7885 (62.8%) had uncontrolled BP. MMM17 was the largest standardized screening campaign for BP measurement in our country. The proportion of individuals identified with hypertension and the percentage of those with uncontrolled BP on medication provide evidence of the substantial challenges in managing hypertension in the community. These results suggest that opportunistic screening can identify significant numbers of individuals with raised BP.

Journal of Hypertension, 2015

European Heart Journal Supplements, Aug 1, 2020

Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardiocerebro-ren... more Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardiocerebro-reno-vascular morbidity and mortality. For the second year of the May Measurement Month (MMM) campaign in Indonesia in 2018, we recruited 174 sites in 31 out of 34 provinces in Indonesia and screened through convenience sampling in public areas and rural primary health centres. Hypertension was defined as systolic BP 140 mmHg or diastolic BP 90 mmHg, or both, or on the basis of receiving antihypertensive medication. Blood pressure was measured three times followed the standard global MMM protocol, multiple imputation was used to estimate the mean of the 2nd and 3rd BP readings if these were not recorded. A total of 91 222 individuals were screened, and after multiple imputations, 27 331 (30.0%) had hypertension. Of individuals not receiving antihypertensive medication, 14 367 (18.4%) were hypertensive. Among the 47.4% of hypertensive individuals on antihypertensive medication, 10 106 (78.0%) had uncontrolled BP. MMM17 and MMM18 were still the most extensive standardized screening campaigns for BP measurement in Indonesia. Compared to the previous study, the proportion with uncontrolled BP on medication was significantly higher and provided the substantial challenges in managing hypertension in the rural community.

Universa Medicina

BackgroundHypertension is a significant mortality risk factor. The knowledge and practice among p... more BackgroundHypertension is a significant mortality risk factor. The knowledge and practice among physicians of hypertension management and home blood pressure monitoring (HBPM) in blood pressure control is important. We aimed to investigate the awareness and practice of HBPM among physicians in Indonesia after publishing of the local 2019 HBPM guidelines. MethodsThis was a cross-sectional study involving 611 physicians in Indonesia that was conducted between February and October 2020. The questionnaire covered awareness, knowledge, and practice of HBPM. ResultsA total of 330 male physicians (54.0%) aged 20-49 years participated in the survey. More than half were specialists (51.6%) and recommended HBPM to their patients with hypertension (89.0%). The awareness of HBPM benefits was substantial among the physicians; however, the knowledge of the home blood pressure (HBP) reference values of was low (7.9%). Around 54% of the respondents thought that the barriers to low recognition of HB...

Indonesian Journal of Kidney and Hypertension, Apr 20, 2020

Background: Bone mineral disorders in chronic kidney disease (CKD-MBD) is one of the complication... more Background: Bone mineral disorders in chronic kidney disease (CKD-MBD) is one of the complications that occurs due to systemic disorders of minerals and bones in chronic kidney disease (CKD). This syndrome is one or a combination of laboratory abnormalities (phosphate, parathyroid hormone, and vitamin D), bone disorders (turnover, mineralization, volume, linear growth, and strength), and/ or vascular calcification or other soft tissue. It is associated with high mortality and morbidity in CKD patients. To determine the relationship of vitamin D levels and bone mineral density (BMD) examination with the hemodialysis vintage in CKD patients undergoing hemodialysis at RSUD Dr. Zainoel Abidin. Methods: This study is a cross-sectional study held in Zainoel Abidin Hospital, Banda Aceh, Indonesia, from January until May 2017. We include all patients who received twice-weekly hemodialysis for at least 3 months. Patients who received corticosteroids in the past 2 weeks, pregnant, suffering from endocrine disorders or malignancy, autoimmune diseases, and thalassemia, and menopausal women, were excluded. Laboratory examination and Bone Densitometry were performed before a single hemodialysis session. Data were analyzed using the Spearman Rank Correlation test. Results: Thirty patients were analyzed from 196 hemodialysis patients. The proportion of patients that have vitamin D insufficiency was 56.6%. The proportion of patients that have with normal vitamin D was 43.3%. The proportion of patients that have osteoporosis was 30% and 56.6% were osteopenia based on bone densitometry examination. The magnitude of the Spearman Rank Correlation coefficient between vitamin D levels and the duration of hemodialysis in CKD patients is-0.552 with a p-value

European Heart Journal Supplements : Journal of the European Society of Cardiology, 2020

Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardio-cerebro-re... more Elevated blood pressure (BP) is a significant burden worldwide, leading to high cardio-cerebro-reno-vascular morbidity and mortality. For the second year of the May Measurement Month (MMM) campaign in Indonesia in 2018, we recruited 174 sites in 31 out of 34 provinces in Indonesia and screened through convenience sampling in public areas and rural primary health centres. Hypertension was defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or both, or on the basis of receiving antihypertensive medication. Blood pressure was measured three times followed the standard global MMM protocol, multiple imputation was used to estimate the mean of the 2nd and 3rd BP readings if these were not recorded. A total of 91 222 individuals were screened, and after multiple imputations, 27 331 (30.0%) had hypertension. Of individuals not receiving antihypertensive medication, 14 367 (18.4%) were hypertensive. Among the 47.4% of hypertensive individuals on antihypertensive medication, 10 106 (78...

European Heart Journal Supplements

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths eac... more Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. According to Non-communicable disease (NCD) Risk Factors Survey Bangladesh 2010, one-fifth (21.9%) of adults aged 25 years or more have hypertension. Almost one-third of the adult population did not have their BP measured in their lifetime in Bangladesh. National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2018 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes nationally. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the MMM protocol. Data were collected from 10 screening sites in 9 districts in Bangladesh. A total of 5208 individuals were screened during MMM18. After multiple imputation, 1750 (33.6%) had hypertensio...

Indonesian Journal of Kidney and Hypertension

European Heart Journal Supplements

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths eac... more Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Our previous primary health surveys in 2013 and 2018 show that 25.8% to 34.1% of adults have raised BP, which is associated with cardiovascular, cerebrovascular, and renovascular morbidity and mortality. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged 18 was carried out in May 2017. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. We recruited 292 sites in all 34 provinces in Indonesia, and screened in public areas and offices as well as health centres. A total of 69 307 individuals were screened. After multiple imputation, 23 892 (34.5%) had hypertension. Of individuals not receiving antihypertensive medication, 20.0% were hypertensive. Among individuals receiving antihypertensive medication, 7885 (62.8%) had uncontrolled BP. MMM17 was the largest standardized screening campaign for BP measurement in our country. The proportion of individuals identified with hypertension and the percentage of those with uncontrolled BP on medication provide evidence of the substantial challenges in managing hypertension in the community. These results suggest that opportunistic screening can identify significant numbers of individuals with raised BP.

Journal of Hypertension, 2015