Combine proper exercise and regular taking antihypertensive medicine was better to lower diastolic blood pressure among diastolic prehypertensive and hypertensive subjects.

Aim To prove that proper exercise and taking antihypertensive medicine may reduce diastolic blood pressure (DBP) by ≥ 5 mmHg. Method A quasi-experimentation study was done on employees of a government bureau in Jakarta, for 8 weeks from March to August 2008. All prehypertensive and hypertensive subjects were detected through a survey prior to the quasi-experimentation study. A talk was given at the beginning of the quasi-experimentation study, and weekly counseling sessions on exercise, taking medications, and other related topics continued for 8 weeks. Cox regression was used for calculating relative risk. Results A total 1,016 employees out of 1,300 were involved in this blood pressure survey. Of these, 318 subjects had a DBP of 80 mmHg or more. Out of 120 subjects who voluntarily participated, 104 subjects completed the quasi-experimentation study. Compared to those who did not exercise properly and did not take antihypertensive medicines, subjects who did exercise properly and took medicines regularly had a lower diastolic blood pressure DBP ≥ 5 mmHg by more than 12-fold [adjusted relative risk (RRa) = 12.32; 95% confidence interval (CI) = 0,65-234,54; P = 0.095. However subjects who exercised properly or took antyhypertensive medicines irregularly were found to lower their DBP ≥ 5 mmHg by almost 11 fold [adjusted relative risk (RRa) = 10.94; 95% confidence interval (CI) = 2.04-58.74]; P = 0.005. Subjects with DBP = 90-99mmHg had a decrease of DBP ≥ 5 mmHg 4.8 fold (RRa = 4.75; 95% CI = 1.19-18.65) compared to those with DBP = 80-89mmHg. Compared to the normal subjects, the obese, resting pulse rate bradycardia, and high average pulse pressure subjects had less probability of lowering DBP ≥ 5mmHg, by 87%, 90%, and 65%, respectively. Conclusion Combine proper exercise and taking antihypertensive medicine was reduce DBP by ≥5 mmHg among DBP (pre-) hypertensive subjects. The obese, bradycardia, or high pulse pressure subjects failed to lowering their DBP ≥5 mmHg by proper exercise and taking antihypertensive medicine.

High intensity interior aircraft noise increases the risk of high diastolic blood pressure in Indonesian Air Force pilots.

Aim: To analyze the effects of aircraft noise, resting pulse rate, and other factors on the risk of high diastolic blood pressure (DBP) in Indonesian Air Force pilots. Methods: A nested case-control study was conducted using data extracted from annual medical check-ups indoctrination aerophysiologic training records at the Saryanto Aviation and Aerospace Health Institute (LAKESPRA) in Jakarta from January 2003 – September 2008. For analysis of DBP: the case group with DBP ≥ 90 mmHg were compared with contral group with DBP < 79 mmHG. One case matched to 12 controls. Results: Out of 567 pilots, 544 (95.9%) had complete medical records. For this analysis there were 40 cases of high DBP and 480 controls for DBP. Pilots exposed to aircraft noise 90-95 dB rather than 70-80 dB had a 2.7-fold increase for high DBP [adjusted odds ratio (ORa) = 2.70; 95% confi dence interval (CI ) = 1.05-6.97]. Pilots with resting pulse rates of ≥ 81/minute rather than ≤ 80/minute had a 2.7-fold increase for high DBP (ORa = 2.66; 95% CI = 1.26-5.61). In terms of total fl ight hours, pilots who had 1401-11125 hours rather than 147-1400 hours had a 3.2-fold increase for high DBP (ORa = 3.18; 95% CI = 1.01-10.03). Conclusion: High interior aircraft noise, high total flight hours, and high resting pulse rate, increased risk for high DBP. Self assessment of resting pulse rate can be used to control the risk of high DBP.

Low physical activity work-related and other risk factors increased the risk of poor physical fitness in cement workers.

Aim Low physical activity causes poor physical fitness, which leads to low productivity. The objective of this study was to determine the effects of low work-related physical activity and other risk factors on physical fitness. Methods This study was done in February 2008. Subjects were workers from 15 departments in PT Semen Padang, West Sumatera (Indonesia). Data on physical activities were collected using the questionnaire from the Student Field Work I Guidebook and Hypertension – Geriatric Integrated Program of the Faculty of Medicine, Universitas Indonesia 2003. Physical fi tness was measured using the Harvard Step Test. Results A number of 937 male workers aged 18 – 56 years participated in this study. Poor physical fitness was found in 15.9% of the subjects. Low work-related physical activity, smoking, lack of exercise, hypertension, diabetes mellitus, and asthma were dominant risk factors related to poor physical fitness. Subjects with low compared to high work-related activity had a ten-fold risk of poor physical fitness [adjusted odds ratio (ORa) = 10.71; 95% confi dence interval (CI) = 4.71–24.33]. In term of physical exercise, subjects who had no compared to those who had physical exercise had a six-fold risk of poor physical fitness (ORa = 6.30; 95%CI = 3.69-10.75). Conclussion Low work-related physical activities, smoking, lack of exercise, hypertension, diabetes mellitus, and asthma were correlated to poor physical fitness. It is, among others, therefore necessary to implement exercises for workers with poor physical fitness.

Qualitative work overload and other risk factors related to hypertension risk among Indonesian Police Mobile Brigade (Brimob).

Members of the Police Mobile Brigade (Brimob) can suffer from hypertension which is related to work stressors and other risk factors. This study aimed to identify the relationship between work stressors and other hypertensive risk factors. The subjects of this cross-sectional study were members of the Brimob undergoing their periodic medical check-up during July-October 2007. A subject was hypertensive if systolic blood pressure (SBP) was 140 mmHg or higher, or diastolic (DBD) 90 mmHg, or higher or taking antihypertensive drugs. Normal subjects were those who had SBP less than 120 mmHg and DBP less than 80 mmHg, and have never been diagnosed with hypertension. A number of 336 Brimobs aged 21 to 51 years participated in this study, 111 had high blood pressure and 79 had normal blood pressure. Hypertension was found to be related to excessive body weight and qualitative work overload. Age, work, lifestyle, history of diabetes, hypertension in the family, and other work stressors were not found to increase the risk of hypertension. Medium to high level qualitative work overload had a two-fold risk for hypertension [relative risk adjusted (RRa) = 2.00; 95% confidence interval (CI) = 0.97-4.14; p = 0.060]. Overweight subjects had 48% increased risk to hypertension (RRa = 1.48; 95% CI = 0.98-2.22). Obese subjects had a two-fold risk of being hypertensive (RRa = 2.21; 95%CI = 1.51 - 3.14). Qualitative work overload and obesity increased the risk of hypertension. These risk factors should therefore be controlled.

Septal deviation and other factors increase the risk of barotitis media in high altitude high opening training.

Barotitis media (BM) frequently occurr in High Altitude High Opening (HAHO) training simulation as a result from rapid change of pressure. The aim of this study was to investigate septal deviation and other risk factors that increase the risk of BM. This experimental study was conducted at the Indonesian Center for Aviation Medicine and Health (Lakespra Saryanto) during May – July 2007 involving Indonesian Armed Forces (TNI) HAHO training. Medical examinations were performed before and after training. An otolaryngologist confirm the diagnosis of BM. Cox regression analysis using STATA 9.0 program was performed to identify dominant risk factors for BM. A number of 177 subjects participated in this study. We found 56.5% had BM after training. Septal deviation was found in 28.8% of the subjects and it moderately increased the risk of BM by 23% than normal septum [adjusted relative risk (RRα) = 1.23; 95% confidence interval (CI) = 0.95 – 1.60; p=0.123]. Those who have been smoking for 1-3 years had 70% increase risk for BM than non-smoking subjects (RRα= 1.68; 95% CI = 1.17 – 2.42). Those who have been in the force for 5 years or longer were 50% more at risk for BM than those who have been in the force less than 5 years. In addition, trainees had 40% higher risk than subjects with special qualifications for HAHO (RRα = 1.40; 95% CI = 0.99 – 1.97; p = 0.051). Special caution need to be applied for those who had septal deviation, longer working period, habit of smoking for 1-3 years, and trainees to minimize the risk of BM.

The prevalence of female sexual dissatisfaction and the dominant risk factors that may impair sexual satisfaction in Malaysian women.

The study aims were to investigate the prevalence of sexual dissatisfaction and the potential risk factors. This was a cross-sectional study on women attending primary care setting in Malaysia over a period of March to June 2005, and used a non-probability sampling method. A validated questionnaire for sexual function was used. A total of 230 married women aged 21 – 62 years old participated in this study. The ressults show that the majority of the respondents were less than 45 years old, predominantly Malays, and with higher academic achievement. We noted that 52.2% (120/230) study subjects had sexual dissatisfaction. Race, salary, education level, medical problems, dysmenorrhea, and menacrhe were likely not correlated with sexual dissatisfaction. The dominant risk factor related to sexual dissatisfaction was age of husband. In additional, sexual dissatisfaction was moderately (P = 0.077) related to sexual per month. The subjects who had their husbands aged 43-75 years compared with 24-42 years had 68% increased risk to experience sexual dissatisfaction [adjusted relative risk (RRa = 1.68; 95% confidence interval (CI) = 1.15 - 2.44]. In term of sexual frequency per month, those who had 1-3 times per month than 4-5 times per month had two-fold increased risk to experience sexual dissatisfaction (RRa = 2.03; 95% CI = 0.93-4.42; p = 0.077). In conclusion, the prevalence of sexual dissatisfaction was very high in Malaysian primary care population and it was strongly associated with women who married to an older husband and with infrequent sexual activity.

Delayed stool specimen collection during the early and late stages of the Polio outbreak increase the risk of negative Wild Poliovirus laboratory results in some districts in Indonesia.

In 2005, a wild poliovirus (WPV) outbreak occurred in Indonesia. Some stool specimens from acute flaccid paralysis (AFP) subjects, showed negative laboratory results for WPV. The aim of this study was to identify several risk factors associated with negative WPV laboratory results. A cross-sectional study was conducted on all AFP surveillance stool specimens taken from the three districts where 58.9% of the outbreak cases occurred. Data were obtained from Bandung and Jakarta National Polio Laboratory regarding identity of cases; onset of paralysis; data on specimen collected (timing, dispatched, received, and tested); and results of the tests. In addition, field visits were conducted to the three districts for confirmation of data collecting methods, facilities, and field personnel. The Cox regression method for relative risk (RR) was used for analysis. The prevalence of negative results was 31.5%. Negative results at the beginning of the outbreak (February–April) were 60%, at the end of the outbreak (July–December) were 66.2%, and at the height of the outbreak (May–June) were 15.5%. Negative WPV results were related to delayed specimen collection, origin of district specimen, and the period of specimen collection. Delayed versus on-time stool collection increased the risk of negative results by 70% (adjusted relative risk = 1.70; 95% confidence intervals = 1.01 - 2.88). In conclusion, inappropriate timing of specimen collection, in particular during the early and late stages of the polio outbreak, needs special attention to minimize the risk of negative WPV laboratory results.

Duration of works, flight hours, and blood pressure related to noise-induced hearing loss among Indonesian Air Force helicopter pilots.

Helicopter pilots exposed to high intensity noise and other risk factors had increased risk to be noise-induced hearing loss (NIHL). Therefore, it is beneficial to study several risk factors related to NIHL. This study was a nested case-control. Data was extracted from available medical records among helicopter pilots who performed routine aerophysiology training indoctrination (ILA) during 1980 through March 2004 at Saryanto Institute for Aviation and Aerospace Medicine (Lakespra), Jakarta. Case was those who had audiogram with a notch of 40 dB or more and of 4000 Hertz on one site or bilateral ears. A case was matched by two controls who free from NIHL up to 2004. All risk factors for cases and controls were counted as of reference date of cases diagnosed. There were 187 medical records available for this study. A number of 32 cases and 64 controls were identified. The final model reveals that NIHL was related to total duration of works, flight hours, and blood pressure. Those who had 500 hours or more than less 500 hours had a moderate increased risk for 2.5 to be NIHL [Adjusted odds ratio (ORa)= 2.50; 95% confidence intervals (CI) = 0.66-9.29; p = 0.180]. Those who had total duration works 11-24 years had a moderate increased to be NIHL for 2.7 times (ORa = 2.71; 95% CI=0.90-8.10; p = 0.075). Furthermore, prehypertension and hypertension stage 1 subjects than normal blood pressure had moderate trend increased risk to be NIHL. In conclusion total flight hours for 500 hours or more, total duration works 11-24 years, or prehypertension and hypertension stage 1 increased risk NIHL.

Job stressors and other risk factors related to the risk of hypertension among selected employees in Jakarta.

Almost everyone, including employees, may develop hypertension. Several risk factors, including stresses in the work environment, are related to hypertension. The aim of this study is to identify these work-related risk factors in hypertension. A nested case-control study was conducted among office employees in Jakarta during May 2004. Employees with stage 1 or stage 2 hypertension (based on the United States of America Joint National Committee on high blood pressure 2003), or those taking antihypertensive drugs were designated as cases. As controls were employees with no history of hypertension. One case was randomly matched by gender with two controls. All risk factors for cases and controls were counted as of the reference date of diagnosis for cases. There were 70 cases and 140 controls aged 25 to 65 years. Hypertension was found to be related to the qualitative and quantitative increase in the workload, career development, age, obesity, current and past smoking habits, and a family history of hypertension. However, it was noted that role of ambiguity, role of conflict, and personal responsibility did not increase the risk of hypertension. Compared to those with low qualitative job stressor, those who had moderate or high qualitative job stressor had a seven-fold risk to be hypertensive [adjusted odds ratio (ORa) = 7.47; 95% confidence interval (CI) = 1.40-39.76]. In addition, relative to those who had low quantitative job stressor, those with moderate or high stressors were four times at risk to be hypertensive (ORa = 4.10; 95% CI = 1.06-15.90). In conclusion moderate or high qualitative and quantitative job stressors as well as career development increased risk hypertension. Therefore these stressors need to be prevented.

Combined traditional medicine and pharmacological antihypertensive drugs in a rural community of West Java, Indonesia.

Some hypertensive subjects in Indonesia consume traditional herbal medicines in addition to the usual pharmacological drugs. This paper studied the relationship between several traditional herbal medicines, such as morinda, star fruit, garlic, or jamu, believed to control hypertension and the risk of current pharmacological antihypertensive drug users in subjects with stage 1 and 2 hypertension in a rural community West Java, Indonesia. The data were obtained from 3 field studies by the second year medical students of the Faculty of Medicine, University of Indonesia conducted in 2001, 2002, and 2003 in a subdistrict of the Bogor regency. The subjects were selected randomly from neighborhood clusters. Interviews and blood pressure measurements were conducted at the houses of the subjects by specially trained second year medical students supervised by faculty members. There were 496 subjects with stage 1 or 2 hypertension, with 11.5% under current antihypertensive drugs. Compared with the hypertension stage 1 subjects, hypertension stage 2 subjects were 5.4 times more likely to be currently taking pharmacological antihypertensive medication (adjusted odds ratio = 5.44; 95% confidence interval = 2.64-11.27). The combined of current antihypertensive medication with traditional medicines were cucumber which being the most dominant followed by star fruit and morinda. Reasons for this were probably the strong influence of culture, the limited medical facilities, and high cost of the antihypertensive drugs. It was concluded that in a rural Indonesia, it was common for hypertensive subjects to take pharmacological drugs as well as traditional medicine for antihypertensive therapy.

Air movement, gender and risk of sick building headache among employees in a Jakarta office.

Even though office buildings are usually equipped with ventilation system or air conditioning to create a comfortable working environment, yet there is still found a number of sick building syndrome (SBS) symptoms. One of the symptoms of SBS is SBS headache. Therefore, it is crucial to identify risk factors related to SBS headache. Cases were subjects who have suffered SBS headache, and controls were subjects who did not suffered headache for the last one month. Cases and controls were selected through a survey on all of employees in the said office during the period of May to August 2002. Total respondents were 240 employees including 36 people suffered SBS headache (15%). Compared to the normal air movement, faster air movement decreased the risk of SBS headache by 57% [adjusted odds ratio (OR) = 0.43; 95% confidence intervals (CI): 0.19-0.95]. Female employees, compared to the males ones, had a higher risk of getting SBS headache by almost three times (adjusted OR = 2.96: 95% CI: 1.29-6.75). Employees who had breakfast irregularly, had a lower risk to SBS headache than those who have breakfast regularly (adjusted OR=0.31; 95% CI: 0.09-0.84). Temperature, humidity and smoking habits were not noted correlated to SBS headache. Female workers had greater risk of suffering SBS headache. In addition slower air movement increased the risk of SBS headache. Therefore, it is recommended to improve the progress of air in order to reduce the risk of SBS headache, especially for female workplace.

Helicopter vibration and risk of reversible myopia among military air crews.

We assessed to what extend the risk of reversible myopia of the different degree of helicopter vibrations and other risk factors among military helicopter pilots and flight engineers. The study was a nested case-control design using medical record at the Institute of Aerospace Medicine of the Indonesian Air Force and Medical Directorate of the Indonesian Army (Flying Wing). Cases and controls were military helicopter pilots and flight engineers who had ametropic visual acuity at the time of entry into military service from 1972 until 1992. Reversible myopia means visual acuity corrected of - 0.50 dioptri or less. The final model indicates there was a relationship between vibration level, duration of work and risk of reversible myopia. Helicopter crews exposed to high vibration level had 4.5 times to develop reversible myopia [adjusted odds ratio (OR) = 4.47; 95% confidence intervals (CI) = 1.48 - 13.55] relative to those who exposed to weak vibration level. There was noted a healthy worker's survivor effect. Those who remain work for a longer peiod had less a chance to be myopia. Those who worked for 10 years or more had a lowered risk of 85% to be myopia compared with those who worked for 14 years (adjusted OR = 0.15; 95% CI = 0.03 - 0.87). Helicopter crews exposed to high helicopter vibration had 4.5 times to develop reversible myopia, and a higher risk occurred during the first four years of employment.

Some medical and other risk factors for current cesarean section in a Jakarta hospital.

For the last year the prevalence of cesarean section (CS) increased in several countries as well as in Indonesia. In Indonesia there was no comprehensive study on risk factors related to CS. This case-control study was conducted at Fatmawati Hospital in Jakarta from 1 July 200 until 31 January 2001. Data was extracted from available medical records. Ceserean section was defined as a delivery through laparotomy. The control group consisted of subjects having vaginal deliveries. For each cases were selected randomly a control based on the date before or after 18 October 2000. Subject who had fetal distress had 544-folds increased risk to be CS relative to those who did not have fetal distress [adjusted odds ratio (OR) = 544.86; 95% confidence intervals (CI) = 71.85- 4131.78]. Furthermore, relative those who did not have dystocia, those who had dystocia had 143 times increased risk to be CS (adjusted OR = 52.86; 95% CI = 52.86 - 391.17). In term of previous CS, subjects who ever had previous CS had 30 times increased risk to be CS compared with the subjects who never had CS (adjusted OR = 30.23; 95% CI = 12.06 - 75.57). In contrast, compared with those who non cash payment, those who paid in cash had a lowered risk of 80% (adjusted OR = 0.20; 95% CI = 0.11-0.34). In conclusion, previous CS, dystocia, pre eclampsia, other medical indications, fetal distress, and non cash hospitalization expences increased risk of CS.

Past antihypertensive drugs, obesity, daily light working load and risk of hypertension: An Indonesian 2001 rural study.

This study aims to identify some risk factors related to hypeertension in rural areas. The data for this study is a part af the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta, on June 27h , 2001, at Cijeruk subdistrict in Bogor regency. The subjects were seleccted randomly using neighborhood cluster which was diffirent from the previous study in 2000. Interviews and blood pressure were taken at the houses of the subjects from 1:00 PM to 4:00 PM. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 18-39 year old group, and the risk was most prominent among the 55-59 year group [adjusted odds ratio (OR)= 17.7; 95% confidence intervals (CI)=6.26-59.2). Compared to the subjects with normal body posture,those who were obese had more than two-fold increase in the risk to be hypertensive (adjusted OR= 0.87; 95% CI= 0.87-4.17; P= 0.109). In addition, those who discontinued antihypertensive drugs had almost 14-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR= 14.16; 95% CI= 7.14- 28.05). In general, the results of this study is similar with our last year study which used different subjects. This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs; andwhom had light daily working load to prevent hypertension.

Age, body posture, daity working load, past antihypertensive drugs and risk of hypertension: A rural Indonesian study.

Indonesia has about 210 million inhabitans and most of them live in rural areas, therefore in rural community it is estimated that a big number of hypertensive people can be found. However, few rural community-based studies have been conducted to identify hypertensive risk factors. This study aims to identfy some risk factors related to hypertension in rural areas. The data for this study came from the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta. The study was conducted on July 12, 2000 at 10:00 AM to 1:00 PM in a rural area, the Cijeruk subdistrict in Bogor regency. The subjects were selected randomly using neighborhood cluster. Interviews and blood pressure were taken at the houses of the subjects. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 17-39 year old group, and the risk was most prominent among the 55-59 year group (adjusted odds ratio = 21.62; 95% confidence intervals (CI) = 4.10-113.97). Compared to the subjects with normal body posture, those who were obese had more than 6.3-folds increase in the risk to be hypertensive (adjusted OR = 6.33: 95% CI = 2.62-15.29). In addition, those who discontinued antihypertensive drugs had almost 12-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR = 11.92; 95% CI = 4.61 -30.80). This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs, and whom had light daily working load to prevent hypertension.