PENGARUH PEMBERIAN OBAT ANTIHIPERTENSI TERHADAP PENURUNAN TEKANAN DARAH PASIEN STROKE ISKEMIK AKUT YANG MENJALANI RAWAT INAP DI RSUP DR. SARDJITO YOGYAKARTA

Stroke is the second leading cause of death in the world and the third leading cause of death in the United States, under cardiovascular disease and cancer. Strokes can be either ischemic or bleeding. The report from the American Heart Association (AHA) shows the incidence for ischemic stroke was 88%, while haemorrhagic stroke was 12%. One focus of acute stroke management is the management of hypertension. Blood pressure reduction in ischemic stroke patients could potentially reduce the risk of brain edema, the risk of hemorrhage, and prevent further vascular damage. However, an aggressive blood pressure reduction can cause a decrease in perfusion pressure to the ischemic area. Most hypertensive patients require two or more antihypertensive drugs to achieve blood pressure targets. This study used observational study design with retrospective data collection, to determine the management of antihypertensive drug therapy in patients with acute ischemic stroke, the effect of antihypertensive drugs on blood pressure reduction in acute ischemic stroke patients and compared the ability of a single antihypertensive medication and the combination of antihypertensive medication to lower blood pressure of acute ischemic stroke patients. The effectiveness of therapy was measured by looking at the number of acute ischemic stroke patients who experienced a decrease in blood pressure. Inclusion criteria included: patients with a diagnosis of acute ischemic stroke by age 35 years or older who is hospitalized in RSUP Dr. Sardjito Yogyakarta who meet indication for three days antihypertensive drug therapy during hospitalization. Therapeutic effectiveness in lowering blood pressure analyzed with chi square test. Initial antihypertensive drug use in patients with acute ischemic stroke in RSUP Dr. Sardjito are 13 types of five classes of antihypertensive drugs. Effect of antihypertensive drug to acute ischemic stroke patients is not always a decline in blood pressure, but there is a fixed or even increase. a. After getting a single antihypertensive drug, patients who experienced a decrease in systolic blood pressure on day-3 is 60%, while 17% fixed and 23% rise. b. After getting a combination of antihypertensive drugs, patients who experienced a decrease in systolic blood pressure on day-3 is 75%, while 10% fixed and 15% rise. Antihypertensive drug therapy alone or in combination have the same ability to lower systolic blood pressure (p = 0.260) and diastolic (p = 0.567) in patients with acute ischemic stroke in RSUP Dr. Sardjito Yogyakarta