Penyakit Arteri Perifer Disertai Klaudikasio Intermiten di Daerah Terpencil Kabupaten Sikka, Flores –Studi Potong Lintang dengan Metode Palpasi Nadi dan Faktor Risikonya

Naldo Sofian, Garry Prasetyo, Stephanie Wibisono

Abstract

Pendahuluan. Belum banyak studi di Indonesia yang mengidentifikasi penyakit arteri perifer (PAP) pada orang dewasa dengan klaudikasio intermiten beserta faktor risikonya. Penelitian ini dilakukan untuk mengetahui hubungan dan perbandingan faktor risiko PAP dengan klaudikasio intermitten pada orang dewasa, terutama di daerah terpencil Kabupaten Sikka, Flores, diukur dengan metode palpasi nadi.

Metode. Studi potong lintang di 3 wilayah kerja Puskesmas di Kabupaten Sikka dilakukan dengan consecutive sampling. Identifikasi faktor risiko dilakukan melalui wawancara, pemeriksaan tekanan darah yang dilakukan pada keempat ekstremitas menggunakan sphygmomanometer setelah beristirahat pada posisi supinasi. Ankle brachial index (ABI) didapat dengan membagi tekanan darah per palpasi pada dorsalis pedis atau tibialis posterior dibagi dengan tekanan darah sistolik tertinggi dari kedua ekstremitas atas. PAP ditegakkan bila ada klaudikasio intermiten dengan salah satu ABI <0,9. Glukosa darah, kolesterol, dan asam urat sewaktu dilakukan dengan menggunakan EasytouchTM. Pemeriksaan urin menggunakan tes celup urin.

Hasil. Sebanyak333 subjek dihimpun dengan mayoritas subjek adalah wanita (64,9%), petani (71,2%), bekerja, dan berusia rerata 57,47 tahun, serta baru terdiagnosis hipertensi kurang dari 5 tahun terakhir (30,3%). Ada 135 subjek dengan klaudikasio intermiten pada penelitian ini dengan 39 subjek di antaranya mengalami PAP (28,89%). Sejumlah faktor risiko independen yang berhubungan secara signifikan (p<0,05), antara lain jenis kelamin (laki-laki vs. perempuan; p=0,001; OR 0,167 [0,056–0,497]) dan proteinuria (p= .000; OR 6,612 [2,725–16,045]).

Simpulan. Proteinuria dan jenis kelamin merupakan faktor risiko independen yang berhubungan secara bermakna terhadap kejadian PAP disertai klaudikasio intermiten pada orang dewasa di daerah terpencil Kabupaten Sikka, Flores.

 

Kata Kunci:Ankle Brachial Index, Klaudikasio Intermiten, Penyakit Arteri Perifer


Peripheral Artery Disease Accompanied by Intermittent Claudication in Rural Areas of Sikka Regency – A Cross Sectional Study with Pulse Palpation Methods and Its Risk Factors

Introduction. There are few studies regarding peripheral artery disease (PAD by intermittent claudication) on adults in Indonesia, including its risk factors.This study aims to determine relationship and comparison of PAD accompanied by intermittent intermittent claudication risk factors in adult, especially in rural areas of Sikka regency, Flores, measured by pulse palpation.

Methods. A cross sectional study in 3 primary healthcare working areas in Sikka regency and consecutive sampling had been done. Interview of risk factors was conducted and blood pressure was taken from all four extremities in supine position. Ankle brachial index (ABI) value was defined as systolic blood pressure of foot arteries (dorsalis pedis and posterior tibia) divided by highest systolic blood pressure among brachial artery. PAD was then defined by presence of both intermittent claudication and ABI <0.9. Random blood glucose, total cholesterol, and uric acid had been measured using EasytouchTM while urine examination was done using urine dipsticks.

Results. A total of333 subjects had been participated in which woman (64.9%), farmers (71.2%), working, less-than-5-year-hypertension history (30.3%) and mean age 57.47 years old were our majority subjects’ characteristics. There were 135 subjects had intermittent claudication and 39 (28.89%) of them had PAD. Several independent significant (p<0.05) risk factors include sex (man vs. female; p=0.001; OR 0.167 [0.056–0.497]) and proteinuria (p=.000; OR 6.612 [2.725–16.045]).

Conclusion. Proteinuria and sex are independent risk factors and significantly related on PAD accompanied by intermittent claudication in adult of rural areas in Sikka regency.


Keywords

Ankle Brachial Index, Intermittent Claudication, Peripheral Artery Disease

References

Balitbangkes Kemenkes RI Riskesdas 2013.

Seran SB, Hala KK, Simanjuntak EMF, Hermanus L, Sinaga ME, Ralo T, et al. Profil Kesehatan Provinsi Nusa Tenggara Timur Tahun 2014. Dinas Kesehatan Propinsi NTT. .1 Juni 2015 [Diakses 2 Juli 2017]; Tersedia di: http://www.depkes.go.id/resources/download/profil/PROFIL_KES_PROVINSI_2014/19_NTT_2014.pdf

Thendria T, Toruan IL, Natalia D. Hubungan hipertensi dan penyakit arteri perifer berdasarkan nilai ankle-brachial index. eJKI. April 2014 [Diakses 7 Agustus 2017]; 2(1):281-8.

Kannel WB, Mc Gee DL. Update on some epidemiologic features of intermittent claudication: the Framingham study. J Am Geriatr Soc. 1995; 33:13-8

Sihombing B. Prevalensi penyakit arteri perifer pada populasi penyakit diabetes mellitus di puskesmas kota medan. USU e-repository [Online]. Januari – Juli 2008 [Diakses 3 Agustus 2017].

Begelman SM, Jaff MR. Noninvasive diagnostic strategies for peripheral arterial disease. Cleve Clin J Med. Oktober 2006 [Diakses 8 Agustus 2017]. 73(Suppl 4): S22-9.

Ranasinghe LD, Somasundaram NP, Wickramasinghe SWADA, Ranawake N, Jayasena KRC. Reliability of ankle-brachial pressure index measured by pulse palpation method in diagnosing peripheral artery disease among patients with diabetes mellitus.

Collins TC, Suarez-Almazor M, Peterson NJ. An absent pulse is not sensitive for the early detection of peripheral artery disease. Fam Med [Online]. Januari 2006 [Diakses 4 Agustus 2017]; 38(1): 38-42.

Fatayati I. Hubungan hipertensi dengan penyakit arteri perifer di posyandu lanjut usia kelurahan pucangan – tinjauan terhadap nilai ankle brachial index. 2017 [Diakses 8 Juli 2017].

Verma A, Prasad A, Elkadi GH, Chi YW. Peripheral arterial disease: evaluation, risk factor modification, and medical management. JCOM. Februari 2011 [Diakses 10 Agustus 2017]; 18(2):74-84

Gero SP. Moke (alkohol, suatu zat adiktif). Pos Kupang [Online]. 27 November 2013 [Diakses 11 Agustus 2017]. Tersedia di: http://kupang.tribunnews.com/2013/11/27/moke-alkohol-suatu-zat-adiktif.

Bozkurt AK, Tasci I, Tabak O, Gumus M, Kaplan Y. Peripheral artery disease assessed by ankle brachial index in patients with established cardiovascular disease or at least one risk factor for atherothrombosis – CAREFUL Study: a national, multi-center, cross sectional observational study. BMC Cardiovasular Disorders [online]. 2011 [Diakses 10 Agustus 2017]; 11:4

Riley RS, McPherson RA. Basic examination of urine. Dalam: McPherson RA, Pincus MR. Henry’s Clinical Diagnosis and Management by Laboratory Methods. Edisi ke-23.2017. H 447-9

Verma EV. Proteinuria. 12 Desember 2016 [Diakses 10 Agustus 2017]. Tersedia di: http://emedicine.medscape.com/article/238158-overview#a1

Vonkeman HE. Understanding the NSAID related risk of vascular events. BMJ [Online]. 13 April 2006 [Diakses 10 Agustus 2017]. Tersedia di: http://www.bmj.com/content/332/7546/895

Cui R, Yamagishi K, Imano H, Ohira T, Tanigawa T, Hitsumoto S, et al. J Atheroscler Thromb [Online]. Relationship between ankle brachial index and the risk of coronary heart disease and stroke: the circulatory risk in communities study. 31 Juli 2014 [Diakses 2 Januari 2017]; 21:000-000.

Bhimma R. Renal glucosuria. Medscape [Online]. 17 Oktober 2016 [Diakses 19 Juli 2017]. Tersedia di: http://emedicine.medscape.com/article/983678-overview#a6

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