1. Hub factor genetic dgn hipertensi

Hereditary Determinants of Human HypertensionStrategies in the Setting of Genetic ComplexityPei-an Betty ShihandDaniel T. OConnorAuthor informationCopyright and License informationThe publisher's final edited version of this article is available free atHypertensionSee other articles in PMC thatcitethe published article.Essential hypertension is characterized by chronically elevated blood pressure with no specific underlying medical cause. Data on family history of affected individuals coupled with disease concordance rate in twins has established that both genetic and environmental factors determine susceptibility to hypertension. The heritability of hypertension is often cited in the range of 30% to 60%, with multiple contributory genes; additionally, ethnic and genetic heterogeneity participate in variable clinical presentation and drug response in hypertension, rendering genetic study of this disease a challenging task. Human population and animal studies have implicated several important etiologic pathways contributing to the clinical presentation of essential hypertension that enable functional candidate gene association studies, in addition to more comprehensive genome wide linkage or association studies. Recent results also suggest a complex genetic architecture for hypertension and its associated risk traits, including evidence for pleiotropy (one genemultiple traits), epistasis (gene-by-gene interaction), and on occasion molecular heterosis (a more extreme phenotype for heterozygotes than either homozygote class)Genetics of hypertension. Current status.Butler MG1.Author informationAbstractGenetics of hypertension is complex with no known single gene playing a major role, but rather many genes each with mild effects reacting to different environmental stimuli contribute to blood pressure. The heritable component of blood pressure has been documented in familial and twin studies suggesting that 30%-50% of the variance of blood pressure readings are attributable to genetic heritability and about 50% to environmental factors. Early studies in hypertension identified specific enzymes, channels and receptors implicating sodium handling in the regulation of blood pressure including genes involved with the renin-angiotensin-aldosterone system controlling blood pressure and salt-water homeostasis, proteins in hormonal regulation of blood pressure (enzymes and receptors of the mineralo- and glucocorticoid pathways) and proteins coded by genes involved in the structure and/or regulation of vascular tone (endothelins and their receptors).

Pemeriksaan Fisik Hipertensi

Pengukuran dilakukan 2 kali, dengan sela antara 1 5 menit , pengukuran tambahan dilakukan jika hasil ke-2 pengukuran sebelumnya sangat berbeda . Pengukuran denyut jantung dengan menghitung nadi (30 detik) dilakukan saat duduk segera sesudah pengukuran tekanan darahEvaluasi untuk menentukan adanya penyakit penyerta : Aterosklerosis (melalui pemeriksaan profil lemak) Diabetes (pemeriksaan gula darah) Fungsi ginjal (pemeriksaan proteinuria, kreatinin serum, serta memperkirakan laju filtrasi glomerulus.Pemeriksaan untuk mengevaluasiadanya kerusakan organ target1. Jantung Pemeriksaan fisis Foto polos dada (untuk melihat pembesaran jantung, kondisi arteri intratoraks & sirkulasi pulmoner) Elektrokardiografi (untuk deteksi iskemia, gangguan konduksi, aritmia, serta hipertrofi ventrikel kiri) Ekokardiografi2. Pembuluh darah Pemeriksaan fisis termasuk penghitungan pulse pressure USG karotis Fungsi endotel (masih dalam penelitian)

3. Otak Pemeriksaan neurologis Diagnosis strok CT Scan / MRI (untuk pasien dengan gangguan neural, kehilangan memori, atau gangguan kognitif)4. Mata Funduskopi5. Fungsi ginjal Pemeriksaan fungsi ginjal & penentuan adanya proteinuria/ mikro-makroalbuminuria serta rasio albumin kretinin urin Perkiraan laju filtrasi glomerulus.

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