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BBS AO K01&K02: Osteology Terms; MSS K01: Osteology; BBS E K01: Istilah dalam Osteologi

Osteology Terms (BBS AO) , Osteology (MSS), dan Istilah dalam osteologi (BBS E)

Introduction

The framework of the body is built upon a series of bones, supplemented in certain regions by cartilage; the bony part of the framework constitutes the skeleton.

The skeletal system serves several functions, among them are:
1. Protection and support:
The ribs protect the organs of the thorax and the skull protects the brain. The legs support the weight of the entire body. The vertebrae also support the upper body.

2. Movement:
Most skeletal muscles attach to the bones of the skeletal system and use them as leverage points for movement of the body.

3. Production of blood cells:
The bone marrow produces blood cells in a process known as hematopoiesis.

4. Storage:
"Yellow bone marrow" or adipose tissue stores fat in the medullary cavity of long bones. Bones can also be broken down to release inorganic calcium and phosphorus stored in the non cellular matrix of the bone.



















In the skeleton of the adult there are generally 206 distinct bones:
a. Axial Skeleton:
- Vertebral column: 26
- Skull: 22
- Hyoid bone: 1
- Ribs and sternum: 25
- Auditory ossicles: 6
Total: 80

b. Appendicular Skeleton:
- Upper extremities: 64
- Lower extremities: 62
Total: 126

Total: 206


Parts of the human body:























































1. Head
2. Neck
3. Trunk:
- Chest (Thorax)
- Stomach (Abdomen)
- Hip (Pelvis)
4. Upper Extremities:
- Arm and Forearm
- Wrist
5. Lower Extremities:
- Thigh
- Leg
- Foot


Types of Bones

Bones are divisible into four classes: Long, Short, Flat, and Irregular.




























1. Long Bones are found in the limbs and function as levers, they are longer than they are wide.

2. Short Bones transfer forces of movement and are cube shaped as in the carpus and tarsus.

3. Flat Bones are used for either extensive protection or the provision of broad surfaces for muscular attachment. The bones expand into broad, flat plates, as in the skull and the scapula.

4. Irregular Bones have peculiar forms, cannot be grouped under the preceding heads, and are used for muscle attachement and articulation. Some irregular bones include the vertebræ, sacrum and coccyx.

LONG BONE


Long bones consists of a body or shaft and two extremities. The body, or diaphysis is cylindrical, with a central cavity termed the medullary cavity. The wall consists of dense, compact tissue of considerable thickness in the middle part of the body, but becoming thinner toward the extremities. Within the medullary cavity is adipose tissue or "yellow bone marrow".

The extremities are refered to as the epiphysis. Within the epiphysis is the "spongy bone" also known as "red bone marrow". It is within this marrow that red blood cells are produced at an average rate of 2.5 million per second. Running horizontally across the spongy bone of this region is the Epiphyseal line which is a region of cell growth responsible for lateral bone growth during youth, when growth is complete this line calcifies and becomes known as the epiphyseal plate.

Nutrient foramen run through the compact bone and allow the passage of nutrients in and out of the bone. There is a thin outer layer of connective tissue called the PERIOSTEUM which is highly vascular and allows for muscle and tendon attachment, it is bound to the bone itself by PERFORATING FIBERS which are composed of collagen.

This layer does not cover the articulating regions of the bone. The bones belonging to this class include: the clavicle, humerus, radius, ulna, femur, tibia, fibula, metacarpals, metatarsals, and phalanges.

SHORT BONE


Short bones are generally equal in length, width, and thickness. They are found in the wrists and ankles. Aside from points of insertion and vascular areas, short bones are almost completely covered by articular surfaces.

FLAT BONE
These bones are composed of two thin layers of compact tissue enclosing between them a variable quantity of spongy bone. They generally offer protection, as is the case with the bones of the cranium and with the ribs and sternum. The flat bones are: the occipital, parietal, frontal, nasal, lacrimal, vomer, scapula, os coxæ (hip bone), sternum, ribs, and, according to some, the patella.

IRREGULAR BONE
The irregular bones are such as, from their peculiar form, cannot be grouped under the preceding heads. They consist of cancellous tissue enclosed within a thin layer of compact bone. The irregular bones are: the vertebræ, sacrum, coccyx, temporal, sphenoid, ethmoid, zygomatic, maxilla, mandible, palatine, inferior nasal concha, and hyoid.


Surfaces of Bones

If the surface of a bone be examined, certain eminences and depressions are seen. These eminences and depressions are of two kinds: articular and non-articular.

Well-marked examples of articular eminences are found in the heads of the humerus and femur; and of articular depressions in the glenoid cavity of the scapula, and the acetabulum of the hip bone.

Non-articular eminences are designated according to their form. Thus, a broad, rough, uneven elevation is called a tuberosity, protuberance, or process, a small, rough prominence, a tubercle; a sharp, slender pointed eminence, a spine; a narrow, rough elevation, running some way along the surface, a ridge, crest, or line. Non-articular depressions are also of variable form, and are described as fossæ, pits, depressions, grooves, furrows, fissures, notches, etc. These non-articular eminences and depressions serve to increase the extent of surface for the attachment of ligaments and muscles, and are usually well-marked in proportion to the muscularity of the subject. A short perforation is called a foramen, a longer passage a canal.


Structural classification of Joints
(according to how the bones are connected to each other)

There are three structural classifications of joints:
1. Fibrous joint - joined by fibrous connective tissue
2. Cartilaginous joint - joined by cartilage
3. Synovial joint - not directly joined

FIBROUS JOINT

























- Fibrous joints are connected by dense connective tissue, consisting mainly of collagen.
- Types of Fibrous joints: Sutures, Syndesmosis, and Gomphosis.
These joints are also called "fixed" or "immoveable" joints, because they do not move. These joints have no joint cavity and are connected via fibrous connective tissue. The skull bones are connected by fibrous joints.

a. Sutures are found between bones of the skull. In fetal skulls the sutures are wide to allow slight movement during birth. They later become rigid (synarthrodial).

b. Syndesmosis are found between long bones of the body, such as the radius and ulna in forearm and the fibula and tibia in leg. Unlike other fibrous joints, syndesmoses are moveable (amphiarthrodial), albeit not to such degree as synovial joints.

c.Gomphosis is a joint between the root of a tooth and the sockets in the maxilla or mandible.

CARTILAGINOUS JOINT


- Cartilaginous joints are connected entirely by cartilage (fibrocartilage or hyaline). Cartilaginous joints allow more movement between bones than a fibrous joint but less than the highly mobile synovial joint.
- An example would be the joint between the manubrium and the sternum. Cartilaginous joints also forms the growth regions of immature long bones and the intervertebral discs of the spinal column.
- Cartilaginous joints can be divided into 2 types: Primary cartilaginous joints and Secondary cartilaginous joints.

a. Primary cartilaginous joints
Known as "synchondroses". Bones are connected by hyaline cartilage or fibrocartilage, sometimes occurring between ossification centers. This cartilage may ossify with age.
Examples in humans are the "growth plates" between ossification centers in long bones. These joints here allow for only a little movement, such as in the spine or ribs.

b. Secondary cartilaginous joints
Known as "symphyses". Fibrocartilaginous joints, usually occurring in the midline.
Examples in human anatomy would be the manubriosternal joint (between the manubrium and the sternum), intervertebral discs, and the pubic symphysis.
Articulating bones at a symphysis are covered with hyaline cartilage and have a thick, fairly compressible pad of fibrocartilage between them.

SYNOVIAL JOINT




















- A Synovial joint, also known as a diarthrosis, is the most common and most movable type of joint in the body of a mammal. As with most other joints, synovial joints achieve movement at the point of contact of the articulating bones.
- Structural and functional differences distinguish synovial joints from cartilaginous joints (synchondroses and symphyses) and fibrous joints (sutures, gomphoses, and syndesmoses). The main structural differences between synovial and fibrous joints is the existence of capsules surrounding the articulating surfaces of a synovial joint and the presence of lubricating synovial fluid within that capsule (synovial cavity).
- There are seven types of synovial joints. Some are relatively immobile, but are more stable. Others have multiple degrees of freedom, but at the expense of greater risk of injury. In ascending order of mobility, they are:


a. Gliding joints (or planar joints): These joints allow only gliding or sliding movements. Example: The carpals of the wrist, acromioclavicular joint

b. Hinge joints: These joints act like a door hinge, allowing flexion and extension in just one plane. Example: The elbow (between the humerus and the ulna)

c. Pivot joints: One bone rotates about another. Example: Atlanto-axial joint, proximal radioulnar joint, and distal radioulnar joint

d. Condyloid joints (or ellipsoidal joints): A condyloid joint is where two bones fit together with an odd shape (e.g. an ellipse), and one bone is concave, the other convex. Some classifications make a distinction between condyloid and ellipsoid joints. Example: The wrist joint (radiocarpal joint)

e. Saddle joints: Saddle joints, which resemble a saddle, permit the same movements as the condyloid joints. Example: Carpometacarpal or Trapeziometacarpal Joint of thumb (between the metacarpal and carpal - the trapezium ) , sternoclavicular joint

f. Ball and socket joints: These allow a wide range of movement. Example: The shoulder(glenohumeral), and hip joints

g. Compound joints: Condylar joint(condyles of femur join with condyles of tibia) and Saddle joint(lower end of femur joins with patela). Example: The knee joint

FM K01: Prinsip-prinsip Kedokteran Keluarga

PRINSIP-PRINSIP KEDOKTERAN KELUARGA
Oleh: dr. Isti Ilmiati Fujiati, MSc. (CM-FM), MPd.Ked.

Area Kompetensi (Area of competence) - 4
Keterampilan pengelolaan masalah kesehatan pada individu, keluarga, ataupun masyarakat dengan cara yang komprehensif, holistik, bersinambung, koordinatif, dan kolaboratif dalam konteks pelayanan kesehatan tingkat primer

Lulusan dokter mampu:
Mengelola penyakit, keadaan sakit dan masalah pasien sebagai individu yang utuh, bagian dari keluarga dan masyarakat:

1.1 Menerapkan prinsip-prinsip pelayanan dokter keluarga secara holistik, komprehensif, koordinatif, kolaboratif, dan berkesinambungan dalam mengelola penyakit dan masalah pasien

Pelayanan Dokter Keluarga
Pelayanan kedokteran yang menyeluruh yang memusatkan pelayanannya kepada keluarga sebagai suatu unit, dimana tanggungjawab dokter terhadap pelayanan kesehatan tidak dibatasi oleh golongan umur, jenis kelamin, juga tidak oleh organ tubuh atau jenis penyakit tertentu saja. (The American Academy of Family Physician)

Pelayanan Kesehatan Tempo Doeloe
… the traditional symbol of medical care the kindly old family doctor with big heart and little bag, part healer, part priest, part family counselor. (Somers and Somer)

PRINSIP KEDOKTERAN KELUARGA

1. CONTINUITY OF CARE (PELAYANAN YANG BERKESINAMBUNGAN)
2. COMPREHENSIVE OF CARE (PELAYANAN YANG MENYELURUH)
3. COORDINATION OF CARE (PELAYANAN YANG TERKOORDINASI)
4. COMMUNITY (MASYARAKAT)
5. PREVENTION (PENCEGAHAN)
6. FAMILY (KELUARGA)

1. PRINSIP PELAYANAN BERKESINAMBUNGAN

Adalah pelayanan kesehatan dimana satu dokter bertemu pasiennya dalam keadaan sakit maupun keadaan sehat, dan mengikuti perjalanan penyakit dari pasiennya hingga ia sembuh.
Dengan pelayanan yang berkesinambungan akan terbentuk hubungan yang didasari kepercayaan terhadap dokternya, dan perjalanan waktu akan membentuk kepercayaan ini.

PENTING DIINGAT
Apakah kita mengetahui riwayat pasien sebelum kita membuat sebuah keputusan?
Apakah kita sudah menjelaskan kepada pasien betapa pentingnya tindak lanjut (follow-up) dalam perawatan penyakitnya?

Apakah pasien percaya kepada dokternya?
Bila kita melihat rekam medik pasien tersebut, apakah dia selalu dirawat oleh dokter yang sama? Hal ini penting khususnya untuk kasus-kasus penyakit khronik.

DISKUSI KASUS
Marni, perempuan 45 tahun masuk IGD sebuah RS dengan keluhan sesak nafas. Ini bukan yang pertama kali Marni masuk IGD. Karena Marni tinggal 40 km dari RS, maka perawatannya terpisah-pisah. Tidak ada tercantum dalam rekam medisnya nama dokter umum yang merawatnya.

Setiap kali dia pulang dari RS, dokter umumnya selalu berganti. Para dokter spesialis yang merawatnya juga selalu berbeda-beda dari waktu ke waktu. Juga, bila kita tanyakan apakah ada kesepakatan untuk rencana kesehatan jangka panjang, kita tidak akan menemukan di dalam rekam medisnya.

2. PRINSIP PELAYANAN YANG MENYELURUH

Artinya kita memandang pasien tidak hanya dari sisi biologis saja tetapi juga dari sisi sosial dan psikologisnya.
Oleh sebab itu, seorang dokter keluarga memandang pasiennya secara keseluruhan, dalam konteks memperhatikan keseluruhan kebutuhan mereka.

PENTING DIINGAT
Lihat rekam medisnya, apakah tertulis daftar masalah (problem list) dan daftar pengobatan (medication list) yang sedang dilakukan.
Lihat rekam medisnya apakah cukup informatif untuk dapat digunakan.
Apakah ada petunjuk yang menunjukkan bahwa dokternya mengerti arti keluhan pasien terhadap pasien tersebut? (patient centered care)

Apakah dokternya tahu kemampuan pasiennya dalam membayar obat maupun pemeriksaan yang dianjurkan?
Waspadai apakah pasien dalam keadaan depresi, atau keluhannya hanya psikosomatik saja. Seringkali pasien yang datang dengan keluhan nyeri dada, lebih sering didiagnosa karena kepanikan bukan karena coronary artery disease.

Bila kita melihat kembali pada kasus Marni, dia mendapat perawatan yang baik untuk masalah biologisnya. Dilakukannya pemeriksaan fungsi paru, pemeriksaan darah, dsb. Tidak ada tertulis mengenai tanda-tanda depresi ataupun kecemasan (anxiety). Bahkan seorang dokter mengatakan, “kita harus menangani penyakitnya dulu baru kita memikirkan masalah psikososialnya”.

Sangat penting bagi dokter untuk berani membuat double diagnosis. Seorang pasien bisa saja depresi dan sekaligus menderita kanker. Adalah penting bagi dokter untuk mengenali keduanya dan mengobati keduanya.

3. PRINSIP PELAYANAN YANG TERKOORDINASI

Dokter keluarga itu seperti orkestrator pelayanan kesehatan bagi pasiennya, yang mengkoordinasi-kan semua pelayanan kesehatan yg dibutuhkan pasien seperti para dokter spesialis, dan pelayanan kesehatan lain diluar praktek dokter keluarga.
Dokter keluarga bertanggung jawab dan menjadi guide bagi pasiennya.

PENTING DIINGAT
Apakah kita mendiskusikan pasien yang kita rujuk dengan konsultan, baik melalui telephone ataupun secara langsung?
Apakah kita pernah bersama-sama dengan pasien bertemu dengan konsultan?

Apakah kita mengajarkan staf atau perawat kita hal-hal yang dapat dilakukannya untuk membantu kita dalam mengkoordinasikan pelayanan kesehatan pasien?
Bila perawatan pasien melibatkan banyak dokter, siapa yang menjelaskan kepada pasien mengenai diagnosa penyakitnya?

Mari kita lihat apakah dalam kasus Marni diterapkan koordinasi. Dari rekam medisnya baik rawat jalan maupun rawat inap ditemukan bahwa sedikit sekali komunikasi antara dokter yang merawatnya.Dokter yang merawat jalan tidak memperhatikan berapa kali sudah Marni keluar masuk RS atau hal-hal yang terjadi di rumah sakit.

Yang menarik, beberapa pemeriksaan sudah dilakukan di dokter yang satu, tetapi diulang kembali di dokter lainnya karena tidak adanya koordinasi antar dokter. Kurangnya komunikasi dan koordinasi ini tentu saja akan memberatkan pasien dan keluarganya dalam hal pembiayaan.

4. PRINSIP PELAYANAN MASYARAKAT

Pekerjaan, budaya, dan lingkungan adalah aspek-aspek dalam komunitas (masyarakat) yang dapat mempengaruhi penatalaksanaan seorang pasien.
Berbagai pihak dalam masyarakat dapat digunakan oleh dokter keluarga dalam rangka memberikan pelayanan kesehatan yang optimal.

PENTING DIINGAT
Apakah sebagai dokter kita tahu apa pekerjaan pasien kita, dan tahu jenis pekerjaan atau tempatnya bekerja, yang mungkin dapat memberikan informasi tentang penyakitnya?

Apakah kita menggunakan sumber-sumber yang tersedia di masyarakat, seperti support group untuk penderita Asthma, adanya Senam Asthma yang dilakukan secara rutin oleh Medan Asthma Center, klub Osteoporosis, dsb.

Apakah kita tahu frekuensi kejadian penyakit yang sama di lingkungan tempat tinggal pasien? Misalnya seperti pasien yang menderita Demam Berdarah, apakah juga didapati orang lain yang terkena DHF di daerah tersebut?

Dalam kasus Marni, jelas sekali orang yang mempunyai masalah pernafasan, lingkungan rumah dan pekerjaannya bisa saja mempunyai hubungan yang erat dengan penyakitnya. Sayangnya, dalam kasus Marni tidak ditemukan di rekam medisnya keterangan apakah dia bekerja atau tidak, atau kondisi dari rumahnya.

5. PRINSIP PENCEGAHAN

Prinsip pencegahan memiliki multi aspek, termasuk mencegah penyakit menjadi lebih berat, mencegah orang lain tertular, pengenalan faktor resiko dari penyakit, dan promosi kesehatan (gaya hidup sehat).
Pencegahan juga termasuk mengantisipasi masalah-masalah yang mungkin mempunyai efek terhadap kesehatan emosional pasien dan keluarganya.

PENTING DIINGAT
Apakah faktor-faktor resiko pasien terhadap penyakit tertentu, tertulis di dalam rekam medisnya?
Apakah faktor-faktor resiko tersebut didiskusikan dengan pasien?
Apakah ada kesepakatan dengan pasien untuk mengurangi faktor resiko?

Apakah kita sudah melakukan antisipasi terhadap masalah-masalah yang secara normal memang terjadi dalam siklus kehidupan sebuah keluarga? Contohnya masalah yang bisa terjadi pada pasangan suami istri yang menikah dan baru memiliki anak (the emptiness syndrome).

Selain pencegahan untuk asthma Marni , tidak ada program pencegahan lainnya yang ditemukan dalam rekam medisnya. Pap’s smear tidak dilakukan dalam 5 tahun terakhir. Pemeriksaan payudara sendiri juga tidak diajarkan. Tidak ada pencegahan terhadap osteoporosis atau anjuran diet untuk mencegah penyakit jantung. Kesimpulannya, perawatan terhadap kasus Mariam adalah contoh yang baik untuk perawatan penyakit dan bukan perawatan pasien.
 
6. PRINSIP PELAYANAN KELUARGA

Seorang dokter keluarga memandang pasiennya sebagai bagian dari keluarganya dan memahami pengaruh penyakit terhadap keluarga dan pengaruh keluarga terhadap penyakit.
Dokter keluarga juga mengenali keluarga yang berfungsi baik dan keluarga yang disfungsi.

PENTING DIINGAT
Apakah di dalam rekam medisnya tercantum genogram, family circle, family Apgar, dan memuat informasi mengenai Siklus Kehidupan Keluarga?
Family circle dan family Apgar biasanya digunakan untuk kasus-kasus tertentu, tetapi genogram dan Siklus Kehidupan Keluarga harus ada di dalam catatan setiap pasien.

Apakah support system dalam keluarga dicatat?
Apakah kita mengevaluasi pengaruh penyakit terhadap keluarga dan pengaruh keluarga terhadap penyakit pasien?

Hypotension

What Is Hypotension?

Hypotension (HI-po-TEN-shun) is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.

Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.

You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

Normal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure that’s lower than 90/60 mmHg.

Overview

Blood pressure changes during the day. It lowers as you sleep and rises when you wake up. It also can rise when you’re excited, nervous, or active.

Your body is very sensitive to changes in blood pressure. Special cells in the arteries can sense if your blood pressure begins to rise or fall. When this happens, the cells trigger your body to try to bring blood pressure back to normal.

For example, if you stand up quickly, your blood pressure may drop. The cells will sense the drop and will quickly take action to make sure that blood continues to flow to your brain, kidneys, and other important organs.

Most forms of hypotension happen because your body can’t bring blood pressure back to normal or can’t do it fast enough.

Some people have low blood pressure all of the time. They have no signs or symptoms, and their low blood pressure is normal for them. In other people, certain conditions or factors cause blood pressure to drop below normal.

Hypotension is a medical concern only if it causes signs or symptoms, such as dizziness, fainting, or, in extreme cases, shock.

Outlook

In a healthy person, low blood pressure without signs or symptoms usually isn’t a problem and needs no treatment. If low blood pressure causes signs or symptoms, your doctor will try to find and treat the underlying condition that’s causing it.

Hypotension can be dangerous. It can make a person fall because of dizziness or fainting. Shock, a severe form of hypotension, is a condition that’s often fatal if not treated right away. With prompt and proper treatment, shock can be successfully treated.




Types of Hypotension

There are several types of hypotension. People who always have low blood pressure have chronic asymptomatic hypotension. They have no signs or symptoms and need no treatment. Their low blood pressure is normal for them.

Other types of hypotension occur only sometimes, when blood pressure suddenly drops too low. The symptoms and effects on the body range from mild to severe.

The three main types of this kind of hypotension are orthostatic (OR-tho-STAT-ik) hypotension, neurally mediated hypotension (NMH), and severe hypotension linked to shock.

Orthostatic Hypotension

This type of low blood pressure occurs when standing up from a sitting or lying down position. It can make you feel dizzy or lightheaded, or even make you faint.

Orthostatic hypotension occurs if your body isn't able to adjust blood pressure and blood flow fast enough for the change in position. This type of low blood pressure usually lasts for only a few seconds or minutes after you stand up. You may need to sit or lie down for a short time while your blood pressure returns to normal.

Orthostatic hypotension can occur in all age groups. However, it's more common in older adults, especially those who are frail or in poor health. It can be a symptom of other medical conditions, and treatment often focuses on treating the underlying condition(s).

Some people have orthostatic hypotension, but also have high blood pressure when lying down.

A form of orthostatic hypotension called postprandial hypotension is a sudden drop in blood pressure after a meal. This type of low blood pressure mostly affects older adults. It’s also more likely to affect people who have high blood pressure or a central nervous system disorder, such as Parkinson’s disease.

Neurally Mediated Hypotension

With NMH, blood pressure drops after you’ve been standing for a long time. You may feel dizzy, faint, or sick to the stomach as a result. This type of low blood pressure also can occur if you have an unpleasant, upsetting, or scary experience.

NMH affects children and young adults more often than people in other age groups. Children often outgrow NMH.

Severe Hypotension Linked to Shock

People may say a person has “gone into shock” as a result of an upsetting event. But to doctors, the word “shock” has a different meaning.

Shock is a life-threatening condition in which blood pressure drops so low that the brain, kidneys, and other vital organs can't get enough blood to work properly. Blood pressure drops much lower in shock than in other types of hypotension.

Many factors can cause shock, such as major blood loss, certain severe infections, severe burns and allergic reactions, and poisoning. Shock can be fatal if it’s not treated right away.




Other Names for Hypotension

- Low blood pressure
- Neurally mediated hypotension
- Neurogenic orthostatic hypotension
- Orthostatic hypotension
- Postprandial hypotension
- Postural hypotension
- Shock



What Causes Hypotension?

Factors or conditions that disrupt the body’s ability to control blood pressure cause hypotension. The different types of hypotension have different causes.

Orthostatic Hypotension

Orthostatic hypotension has many causes. Sometimes two or more factors combine to cause this type of low blood pressure.

Dehydration (de-hi-DRA-shun) is the most common cause of orthostatic hypotension. Dehydration occurs when the body loses more water than it takes in. You may become dehydrated if you don’t drink enough fluids or if you sweat a lot during physical activity. Fever, vomiting, and severe diarrhea also can lead to dehydration.

Orthostatic hypotension may occur during pregnancy, but it generally goes away after the birth.

Because an older body doesn’t manage changes in blood pressure as well as a younger body, getting older also can lead to this type of hypotension.

Postprandial hypotension (a type of orthostatic hypotension) mostly affects older adults. Postprandial hypotension is a sudden drop in blood pressure after a meal.

Certain medical conditions can raise your risk for orthostatic hypotension, including:

- Heart conditions, such as heart attack, heart valve disease, bradycardia (a very low heart rate), and heart failure. These conditions prevent the heart from pumping enough blood to the body.
- Anemia (uh-NEE-me-eh).
- Severe infections.
- Endocrine conditions, such as thyroid disorders, Addison’s disease, low blood sugar, and diabetes.
- Disorders of the central nervous system, such as Parkinson’s disease.
- Pulmonary embolism.

Some medicines used to treat high blood pressure and heart disease can raise your risk for orthostatic hypotension. These medicines include:

- Diuretics, or “water pills”
- Calcium channel blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers
- Nitrates
- Beta blockers

Medicines used to treat conditions such as anxiety, depression, erectile dysfunction, and central nervous system disorders (like Parkinson’s disease) also can increase your risk for orthostatic hypotension.

Other substances, when taken with high blood pressure medicines, also can lead to orthostatic hypotension. These substances include alcohol, barbiturates, and some prescription and over-the-counter medicines.

Finally, other factors or conditions that can trigger orthostatic hypotension include being out in the heat or being immobile (not being able to move around very much) for a long time.

Neurally Mediated Hypotension

Neurally mediated hypotension (NMH) occurs when the brain and heart don’t communicate with each other properly.

For example, when you stand for a long time, blood begins to pool in your legs. This causes your blood pressure to drop. In NHM, the body mistakenly tells the brain that blood pressure is high. In response, the brain slows the heart rate. This makes blood pressure drop even more, causing dizziness and other symptoms.

Severe Hypotension Linked to Shock

Many factors and conditions can cause severe hypotension linked to shock. Some of these factors also can cause orthostatic hypotension. In shock, though, blood pressure drops very low and doesn’t return to normal on its own.

Shock is an emergency and must be treated right away. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

Certain severe infections can cause shock. This is known as septic shock. It can occur when bacteria enter the bloodstream. The bacteria release a toxin (a poison) that leads to a dangerous drop in blood pressure.

A severe loss of blood or fluids from the body also can cause shock. This is known as hypovolemic (HI-po-vo-LE-mik) shock. Hypovolemic shock can happen as a result of:

- Major external bleeding (for example, from a severe cut or injury)
- Major internal bleeding (for example, from a ruptured blood vessel or injury that causes bleeding inside the body)
- Major loss of body fluids from severe burns
- Severe swelling of the pancreas (an organ that produces enzymes and hormones, such as insulin)
- Severe diarrhea
- Severe kidney disease
- Overuse of diuretics

A major decrease in the heart’s ability to pump blood also can cause shock. This is known as cardiogenic (KAR-de-o-JEN-ik) shock. Heart attack, pulmonary embolism, or arrhythmia (an irregular heartbeat) can cause this type of shock.

A sudden and extreme widening of the arteries and drop in blood pressure also can cause shock. This is known as vasodilatory (VA-so-DI-la-tory) shock. It can occur due to:

- A severe head injury
- A reaction to certain medicines
- Liver failure
- Poisoning
- A severe allergic reaction (called anaphylactic (AN-a-fi-LAK-tik) shock)



Who Is At Risk for Hypotension?

Hypotension can affect people of all ages. However, people in certain age groups are more likely to have certain types of low blood pressure.

Older adults are more likely to have orthostatic and postprandial hypotension. Children and young adults are more likely to have neurally mediated hypotension.

People who take certain medicines, such as high blood pressure medicines, are at higher risk for low blood pressure. People who have central nervous system disorders (such as Parkinson’s disease) or some heart conditions also are at higher risk for low blood pressure.

Other risk factors for hypotension include being immobile (not being able to move around very much) for long periods and pregnancy. Hypotension during pregnancy is normal and goes away after birth.



What Are the Signs and Symptoms of Hypotension?

Orthostatic Hypotension

The signs and symptoms of orthostatic hypotension may happen within a few seconds or minutes of standing up after you’ve been sitting or lying down. You may feel that you’re going to faint, or you may actually faint. Signs and symptoms include:

- Dizziness or feeling lightheaded
- Blurry vision
- Confusion
- Weakness
- Nausea (feeling sick to your stomach)
- These signs and symptoms go away if you sit or lie down for a few minutes until your blood pressure adjusts to normal.

Neurally Mediated Hypotension

The signs and symptoms of neurally mediated hypotension (NMH) are similar to those of orthostatic hypotension. They occur after standing for a long time or in response to an unpleasant, upsetting, or scary experience.

The drop in blood pressure with NMH doesn’t last long and often goes away after sitting down.

Severe Hypotension Linked to Shock

In shock, not enough blood flows to the major organs, including the brain.

The early signs and symptoms of reduced blood flow to the brain include lightheadedness, sleepiness, and confusion. In the earliest stages of shock, it may be hard to detect any signs or symptoms. In older people, the first symptom may only be confusion.

Over time, as shock worsens, a person won’t be able to sit up without passing out. If the shock continues, the person will lose consciousness. Shock is often fatal if not treated right away.

Other signs and symptoms of shock vary, depending on what’s causing the shock. When low blood volume (from major blood loss, for example) or poor pumping action in the heart (from heart failure, for example) causes shock:

- The skin becomes cold and sweaty. It often looks blue or pale. If pressed, the color returns to normal more slowly than usual. A bluish network of lines appears- under the skin.
- The pulse becomes weak and rapid.
- The person begins to breathe very quickly.
- When extreme widening or stretching of blood vessels (such as in septic shock) causes shock, a person feels warm and flushed at first. Later, the skin becomes cold and clammy, and the person feels very sleepy.

Shock is an emergency and must be treated right away. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.




How Is Hypotension Diagnosed?

Hypotension is diagnosed based on your medical history, a physical exam, and results from tests. Your doctor will want to know:

The type of low blood pressure you have and how severe it is
Whether an underlying condition is causing the low blood pressure
Specialists Involved
A primary care doctor or specialist may diagnose and treat hypotension. The type of specialist most commonly involved is a cardiologist (heart specialist).

Other specialists also may be involved, such as surgeons, nephrologists (kidney specialists), neurologists (brain and nerve specialists), or others.

Diagnostic Tests

When a person is in shock, someone should call 9–1–1 right away because emergency treatment is needed.

For other types of hypotension, your doctor may order tests to find out how your blood pressure responds in certain situations. The results will help your doctor understand why you’re fainting or having other symptoms.

Blood Tests

During a blood test, a small amount of blood is taken from your body. It’s usually drawn from a vein in your arm using a thin needle. The procedure is quick and easy, although it may cause some short-term discomfort.

Blood tests can show whether anemia or low blood sugar is causing your hypotension.

EKG (Electrocardiogram)

An EKG is a simple test that detects and records the heart’s electrical activity. It shows how fast the heart is beating and the heart’s rhythm (steady or irregular). An EKG also shows the strength and timing of electrical signals as they pass through each part of the heart.

Holter and Event Monitors

Holter and event monitors are medical devices that record the heart's electrical activity. These monitors are similar to an EKG. However, a standard EKG only records the heartbeat for a few seconds. It won't detect heart rhythm problems that don't occur during the test.

Holter and event monitors are small, portable devices. You can wear one while you do your normal daily activities. This allows the monitor to record your heart longer than an EKG can.

Echocardiography

Echocardiography is a test that uses sound waves to create a moving picture of your heart. The picture shows how well your heart is working and its size and shape.

There are several different types of echocardiography, including a stress echocardiogram, or “stress echo.” This test is done as part of a stress test (see below). A stress echo usually is done to find out whether you have decreased blood flow to your heart, a sign of coronary artery disease.

Stress Test

Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (or are given medicine if you’re unable to exercise) to make your heart work hard and beat fast while heart tests are done.

These tests may include nuclear heart scanning, echocardiography, and magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning of the heart.

Valsalva Maneuver

This is a simple test of the part of your nervous system that controls functions such as your heartbeat and the narrowing and widening of your blood vessels. If something goes wrong with this part of the nervous system, blood pressure problems may occur.

During this test you take a deep breath and then force the air out through your lips. You will do this several times. Your heart rate and blood pressure will be checked during the test.

Tilt Table Test

This test is used if you have fainting spells for no known reason. For the test, you lie on a table that moves from a lying down to an upright position. Your doctor checks your reaction to the change in position.

Doctors use a tilt table test to diagnose orthostatic hypotension and neurally mediated hypotension (NMH). People who have NMH usually faint during this test. The test can help your doctor find any underlying brain or nerve condition.



How Is Hypotension Treated?

Treatment depends on the type of hypotension you have and how severe your signs and symptoms are. The goals of treatment are to relieve signs and symptoms and manage any underlying condition(s) causing the hypotension.

Your response to treatment depends on your age, overall health, and strength. It also depends on how easily you can stop, start, or change medicines.

In a healthy person, low blood pressure without signs or symptoms usually needs no treatment.

If you have signs or symptoms of low blood pressure, you should sit or lie down right away. Put your feet above the level of your heart. If your symptoms don’t go away quickly, you should seek medical care right away.

Orthostatic Hypotension

There are a number of treatments for orthostatic hypotension. If you have this type of low blood pressure, your doctor may advise making lifestyle changes such as:

- Drinking plenty of fluids, like water
- Drinking little or no alcohol
- Standing up slowly
- Not crossing your legs while sitting
- Gradually sitting up for longer periods if you’ve been immobile (not able to move around much) for a long time due to a medical condition
- Eating small, low-carbohydrate meals if you have postprandial hypotension (a form of orthostatic hypotension)

Talk to your doctor about using compression stockings. These stockings apply pressure to your lower legs. They help move blood throughout your body.

If medicine is causing your low blood pressure, your doctor may change the medicine or adjust the dose you take.

Several medicines also are used to treat orthostatic hypotension. These medicines, which raise blood pressure, include fludrocortisone and midodrine.

Neurally Mediated Hypotension

If you have neurally mediated hypotension (NMH), you may need to make lifestyle changes. These may include:

Avoiding situations that trigger symptoms. For example, don’t stand for long periods. Try to avoid unpleasant, upsetting, or scary situations.

Drinking plenty of fluids, like water.

Increasing your salt intake (as your doctor advises).

Learning to recognize symptoms that occur before fainting and taking action to raise blood pressure. For example, sitting down and putting your head between your knees can help raise blood pressure.

If medicine is causing your low blood pressure, your doctor may change the medicine or adjust the dose you take. He or she also may prescribe a medicine to treat NMH.

Children who have NHM often outgrow it.

Treating Severe Hypotension Linked to Shock

Shock is a life-threatening emergency. People who have shock usually need to be treated in a hospital or by emergency medical personnel. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

The goals of treating shock are to:

Restore blood flow to the organs as quickly as possible to prevent organ damage
Find and reverse the cause of shock
Special fluid or blood injected into the bloodstream is often used to restore blood flow to the organs. Medicines can be used to raise blood pressure or make the heartbeat stronger. Depending on the cause of the shock, other treatments, such as antibiotics or surgery, may be needed.




Living With Hypotension

Doctors often can successfully treat hypotension. Many people who have the disorder live normal, healthy lives.

If you have low blood pressure, you can take steps to prevent or limit symptoms, such as dizzy spells and fainting.

If you have orthostatic hypotension, get up slowly after sitting or lying down. Eat small, low-carbohydrate meals if you have postprandial hypotension (a form of orthostatic hypotension).

If you have neurally mediated hypotension, don’t stand for long periods. Also, drink plenty of fluids and try to avoid unpleasant or scary situations. Learn to recognize symptoms and take action to raise your blood pressure. Children who have NMH often outgrow it.

Other lifestyle changes also can help you control low blood pressure. For more information, talk to your doctor and see “How Is Hypotension Treated?”

Ask your doctor about learning how to measure your own blood pressure. This will help you find out what a normal blood pressure reading is for you. Keeping a record of blood pressure readings done by health professionals also can help you learn more about your blood pressure.

Severe hypotension linked to shock is an emergency. Shock can cause death if it’s not treated right away. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.




Key Points

Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.

Normal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure that’s lower than 90/60 mmHg.

Some people have low blood pressure all the time. They have no signs or symptoms and their low readings are normal for them. In other people, certain conditions or factors cause blood pressure to drop below normal.

In a healthy person, low blood pressure without signs or symptoms usually isn’t a problem and needs no treatment.

The three main types of hypotension that causes signs and symptoms are orthostatic hypotension, neurally mediated hypotension (NMH), and severe hypotension linked to shock.

Orthostatic hypotension is low blood pressure that occurs after standing up from a sitting or lying down position. With NMH, blood pressure drops after you’ve been standing for a long time or due to severe emotional stress. Shock is a life-threatening condition in which blood pressure drops so low that the brain, kidneys, and other vital organs can’t get enough blood to work properly. Many factors can cause shock, such as major blood loss, certain severe infections, severe burns and allergic reactions, and poisoning. Shock can be fatal if not treated right away.

Factors or conditions that disrupt the body’s ability to control blood pressure cause hypotension. The different types of hypotension have different causes.

Hypotension can affect people of all ages. Older adults are more likely to have orthostatic and postprandial hypotension. Children and young adults are more likely to have NMH.

The signs and symptoms of orthostatic hypotension and NMH include dizziness or feeling lightheaded, blurry vision, confusion, weakness, and nausea (feeling sick to your stomach). You may feel as though you’re going to faint, or you may actually faint. Both of these types of hypotension can be dangerous if a person falls because of the dizziness or fainting.

Signs and symptoms of shock include lightheadedness, sleepiness, and confusion. Over time, if shock worsens, a person won’t be able to sit up without passing out. If the shock continues, the person can lose consciousness. Other signs and symptoms of shock include cold and sweaty skin, a weak and rapid pulse, and rapid breathing. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

Hypotension is diagnosed based on your medical history, a physical exam, and results from tests.

Treatment depends on the type of hypotension you have and how severe your signs and symptoms are. The goals of treatment are to relieve signs and symptoms and manage any underlying condition causing the hypotension. Treatments may include lifestyle changes, compression stockings, procedures, and medicines.
Doctors often can successfully treat hypotension. Many people who have the disorder live normal, healthy lives.



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Tib An Nabawi - Prophet Muhammad (S.A.W.) attached great importance to dental care

From: http://www.harunyahya.com/

The mouth is the easiest place in the body for germs to reach. This means that oral hygiene is no less important than bodily hygiene.

Our Prophet attached great importance to dental care.

Toothbrush

He was the first person in history to use a stick of wood with suitable fibers, known as a miswak, as a toothbrush.

In describing our beloved Prophet the companions report that his teeth were spotlessly clean, immaculately white, and bright like pearls.

Dental cleanliness

Our Prophet served as a role model for a pre-Islamic society that knew nothing about cleanliness and educated them in the best possible way by giving them information inspired by Almighty God.

Circular brushing

Jabir relates: “The Prophet (saas) said, ‘Performing “khilal” on the teeth cleans them, makes them white, strengthens their roots and makes the mouth smell sweet.” (Onder CAGIRAN, Tibbi Nebevi [Al-Tib Al-Nabawi], 1st edition, Bogazici Publications, Istanbul, 1996)

Information about how the teeth should be brushed is also provided in this hadith.

The method described as “khilal” is the brushing of the teeth in a circular manner, in the form of a crescent moon.

This technique is different to side-to-side brushing, which damages the enamel and can lead to abrasion of the teeth.

Circular brushing is also recommended in current-day dental practice and is described as the best way of preventing food particles accumulating between the teeth.

Frequent brushing

We all know that the teeth should be brushed after every meal.

Our Prophet also recommended frequent brushing (Click here for more detail).

*In addition, check-ups every six months are essential for healthy teeth.

Basics Biomedical Sciences (Physiology)

Senarai Daftar Kuliah Blok Basics Biomedical Sciences: Physiology (FK USU-Batch 2010)

Penghantar Fisiologi

(1) Homeostasis dan mekanisme regulasi homeostasis:
- Konsep homeostasis dan arti pentingnya untuk organisme (BBS FL K01-Physiology)
- Aspek-aspek yang dipertahankan dalam homeostasis (BBS FL K01-Physiology)
- Feedback positif dan negatif, feedforward dan refleks berperanan untuk meregulasi homeostasis, beserta contohnya (BBS FL K01-Physiology)

(2) Proses khusus yang berkaitan dengan homeostasis:
- Erti dan efek aklimatisasi terhadap proses homeostasis (BBS FL K02-Physiology)
- Pengaruh irama biologis terhadap respon homeostasis (BBS FL K02-Physiology)
- Peranan apoptosis dalam homeostasis (BBS FL K02-Physiology)
- Efek aging terhadap kemampuan sistem kontrol homeostasis (BBS FL K02-Physiology)


Sistem Kontrol

(1) Sistem kontrol saraf dan endokrin:
- Level Organisasi dalam organisme (BBS FL K03-Physiology)
- Sistem organ dalam tubuh manusia dan komponen utama setiap sistem (BBS FL K03-Physiology)
- Sistem kontrol oleh saraf dan endokrin, dan karakteristiknya masing-masing (BBS FL K03-Physiology)


Sistem saraf

(1) Gambaran umum sistem saraf:
- Organisasi sistem saraf (BBS FL K04-Physiology)
- Peranan neuron sebagai unit fungsional (BBS FL K04-Physiology)
- Bahagian sensorik dan motorik pada sistem saraf (BBS FL K04-Physiology)
- Pengertian sensasi dan persepsi (BBS FL K04-Physiology)
- Peranan integratif sistem saraf (BBS FL K04-Physiology)

(2) Fungsi sistem saraf terhadap berbagai sistem organ:
- Peranan kontrol sistem saraf terhadap sistem lainnya dalam tubuh manusia (BBS FL K05-Physiology)

(3) Komunkasi antara sel & Mekanisme transduksi signal:
- Mekanisme komunikasi antara sel, secara gap junction, paracrine, autocrine, signal elektrik, hormon, neurohormon, dan cytokine (BBS FL K06-Physiology)
- Jenis reseptor pada membran dan mekanisme transduksi signal (BBS FL K06-Physiology)
- Respon sel yang terjadi (BBS FL K06-Physiology)

(4) Bioelektrik:
- Prinsip dasar keelektrikan sel dan potensial membran istirehat (BBS FL K07-Physiology)
- Efek stimulus terhadap potensial membran (BBS FL K07-Physiology)
- Pembentukan graded potential dan action potential pada excitable cell (BBS FL K07-Physiology)
- Faktor-faktor yang mempengaruhi eksitasi neuron (BBS FL K07-Physiology)
- Struktur neuron dan organisasi fungsionalnya (BBS FL K08-Physiology)
- Mekanisme konduksi di neuron (BBS FL K08-Physiology)
- Jenis dan fungsi serat saraf (BBS FL K08-Physiology)

(5) Sinaps:
- Struktur dan fungsi sinaps (BBS FL K09-Physiology)
- Mekanisme aktivasi neuron post sinaps, pembentukan eksitatoriatau inhibitori post sinaps (BBS FL K09-Physiology)
- Prinsip neurotransmitter dan neuromodulator (BBS FL K10-Physiology)
- Lokasi neurotransmitter asetilkolin, amin, serta jenis dan lokasi neurotransmitter yang bersifat inhibitor dan eksitator (BBS FL K10-Physiology)
- Mekanisme transmisi neurovaskular (BBS FL K10-Physiology)

(6) Fisiologi reseptor:
- Jenis-jenis reseptor (BBS FL K11-Physiology)
- Pembentukan potensial reseptor (BBS FL K11-Physiology)
- Mekanisme adaptasi reseptor (BBS FL K11-Physiology)
- Mekanisme penentuan jenis, lokasi, dan intensiti stimulus (BBS FL K11-Physiology)

(7) Struktur fugsional korteks serebri:
- Hemisfer korteks serebri dan penghubung antara kedua hemisfer (BBS FL K12-Physiology)
- Area korteks serebri menurut Brodmann dan berdasarkan lobus (BBS FL K12-Physiology)
- Area-area somatosensorik dan motorik (BBS FL K12-Physiology)
- Area-area asosiasi (BBS FL K12-Physiology)

(8) Struktur fungsional ganglia basalis, talamus, dan hipotalamus:
- Struktur daerah-daerah subkorteks yaitu basal nuclei (ganglia basalis), talamus, dan hipotalamus (BBS FL K13-Physiology)
- Peranan ganglia basalis dalam kontrol motorik (BBS FL K13-Physiology)
- Peranan talamus untuk sensorik dan motorik (BBS FL K13-Physiology)
- Struktur dan fungsi umum sistem limbik (BBS FL K13-Physiology)
- Peranan hipotalamus dalam mengatur banyak fungsi homeostatik (BBS FL K13-Physiology)

(9) Struktur fungsional batang otak dan serebellum:
- Struktur dan fungsi serebellum (BBS FL K14-Physiology)
- Struktur dan fungsi nuklei-nuklei yang berada di medulla oblongata dan pons (BBS FL K14-Physiology)

(10) Struktur fungsional medulla spinalis:
- Struktur medulla spinalis secara vertikal dan potongan melintang (BBS FL K15-Physiology)
- Penyambungan antara serat saraf perifer dengan neuron yang berada di medulla spinalis (BBS FL K15-Physiology)
- Letak dan fungsi 3 tract asenden/ sensorik (BBS FL K15-Physiology)
- Letak dan fungsi 2 tract desenden/ motorik (BBS FL K15-Physiology)

(11) Mekanisme sensasi somatik:
- Pengertian sensasi, sensasi umum, dan persepsi (BBS FL K16-Physiology)
- Jenis-jenis reseptor untuk sensasi umum (BBS FL K16-Physiology)
- Organisasi jalur sensorik dan fungsi setiap jalur (BBS FL K16-Physiology)
- Pemetaan somatosensorik pada korteks serebri (BBS FL K16-Physiology)
- Mekanisme dan fungsi indra posisi (BBS FL K16-Physiology)
- Patofisiologi terjadinya pain (BBS FL K17-Physiology)
- Mekanisme sensasi dan persepsi pain (BBS FL K17-Physiology)
- Teori gate control, referred pain, dan visceral pain (BBS FL K17-Physiology)
- Sistem analgesic saraf (BBS FL K17-Physiology)

(12) Mekanisme kontrol motorik somatik dan refleks:
- Prinsip umum kontrol gerakan motorik volunter, involunter, dan refleks (BBS FL K18-Physiology)
- Struktur korteks serebri dan jalur untuk kontrol motorik (BBS FL K18-Physiology)
- Peranan ganglia basalis, batang otak, serebellum, dan medulla spinalis dalam kontrol motorik (BBS FL K18-Physiology)
- Mekanisme pengaturan postur (BBS FL K19-Physiology)
- Peristiwa refleks dan jenis refleks (BBS FL K19-Physiology)
- Refleks-refleks medulla spinalis (BBS FL K19-Physiology)

(13) Fisiologi cranial nerve:
- Pembahagian dan fungsi sistem saraf perifer (BBS FL K20-Physiology)
- Struktur dan fungsi 12 pasaf saraf kranial (BBS FL K20-Physiology)

(14) Fisiologi sistem saraf autonom:
- Fungsi dan pembahagian saraf autonom (BBS FL K21-Physiology)
- Karakteristik persarafan simpatis dan parasimpatis (BBS FL K21-Physiology)
- Mekanisme kontrol saraf autonom (BBS FL K21-Physiology)
- Refleks autonom (BBS FL K21-Physiology)


Sistem endokrin

(1) Prinsip regulasi endokrin:
- Karakteristik dan fungsi hormon (BBS FL K22-Physiology)
- Reseptor hormon (BBS FL K22-Physiology)
- Regulasi sekresi hormon (BBS FL K22-Physiology)
- Pola interaksi hormon pada stress, pertumbuhan, dan aging (BBS FL K22-Physiology)

(2) Fungsi berbagai hormon:
- Fungsi hormon-hormon yang dihasilkan hipotalamus, hipofise, dan pineal (BBS FL K23-Physiology)
- Fungsi hormon yang dihasilkan kelenjar tiroid dan paratiroid (BBS FL K23-Physiology)
- Menjelaskan fungsi hormon dari kelenjar adrenal (BBS FL K23-Physiology)
- Fungsi hormon dari jaringan endokrin pada usus, ginjal, jantung, timus, pankreas, dan gonad (BBS FL K23-Physiology)


Cairan tubuh

(1) Keseimbangan Cairan, Elektrolit, dan Acid-Base:
- Fungsi cairan tubuh (BBS FL K24-Physiology)
- Input dan Output cairan (BBS FL K24-Physiology)
- Kompartemen cairan intrasel dan ekstrasel (BBS FL K24-Physiology)
- Komposisi elektrolit dan zat terlarut lain dalam kompartemen (BBS FL K24-Physiology)
- Osmolariti dan tekanan osmotik cairan tubuh (BBS FL K24-Physiology)
- Peranan elektrolit dalam mempertahankan homeostasis pH cairan tubuh (BBS FL K24-Physiology)


Sistem kardiovaskular

(1) Fisiologi kardiovaskular:
- Fungsi jantung dan pembuluh darah (BBS FL K25-Physiology)
- Struktur, fungsi, dan karakteristik sirkulasi sistemik dan pulmonal (BBS FL K25-Physiology)
- Fungsi kapilari darah dan sinusoid (BBS FL K25-Physiology)
- Karakteristik dan fungsi sirkulasi portal (BBS FL K25-Physiology)
- Sirkulasi cairan tubuh (BBS FL K25-Physiology)
- Struktur dan fungsi pembuluh limfatik (BBS FL K25-Physiology)


Sistem respirasi

(1) Fisiologi respirasi:
- Peranan sistem pernafasan dalam mempertahankan homeostasis (BBS FL K26-Physiology)
- Makna respirasi internal dan eksternal (BBS FL K26-Physiology)
- Fungsi nonrespirasi sistem pernafasan (BBS FL K26-Physiology)
- Struktur fungsional saluran pernafasan (BBS FL K26-Physiology)


Sistem Pencernaan

(1) Fisiologi pencernaan:
- Struktur fungsional saluran cerna (BBS FL K27-Physiology)
- 4 proses pencernaan dasar: Motilitas, Sekresi, Digesti, dan Absorpsi (BBS FL K27-Physiology)

Keutamaan sebahagian surah-surah dan ayat-ayat Al-Quran

By Toto Sugianto (http://totosugianto.blogspot.com)

Sebelumnya saya ingin berterima kasih kepada Toto Sugianto karena telah menulis sebuah post di dalam blog nya. Saya re-post salah satu isi blog anda yang bertajuk "Keutamaan surah-surah dan ayat-ayat tertentu" di dalam blog ini karena saya ingin post anda sentiasa ada dalam simpanan saya, agar saya dapat mengamalkannya. Semoga kita sentiasa dirahmati dan diredhai oleh Allah. Amin...

Isi post:
1. Dari Abi Said Rafi´´ bin Al Mu´alla ra. ia berkata, "Rasulullah SAW. bersabda kepadaku, ´Maukah saya ajarkan kepadamu surah yang paling agung dalam Al Qur´an, sebelum kamu keluar dari mesjid? ´Lalu beliau memegang tanganku, dan ketika kami hendak keluar, saya bertanya : ´Ya Rasulullah! Engkau berkata bahwa engkau akan mengajarkan surah yang paling agung dalam Al Qur ´an kepadaku´

Beliau menjawab : ´Alhamdu lillahi rabbil ´alamiin (Al Faatihah), adalah tujuh ayat yang dibaca pada setiap salat dan Al Qur´an yang agung yang diberikan kepadaku´. (Bukhari)

2. Dari Ibnu Abbas ra., ia berkata, "Ketika Jibril a.s. sedang duduk di sisi Rasulullah SAW., beliau mendengar suara dari atas, lalu beliau mendongakkan kepala dan bersabda, ´Ini adalah pintu langit yang dibuka pada hari ini, dan tidak pernah dibuka kecuali hari ini´ Lalu seorang malaikat turun dari pintu tersebut. Kemudian beliau bersabda, ´Ini adalah malaikat yang turun ke bumi dan dia tidak pernah turun kecuali hari ini´. Lalu dia (malaikat) memberi salam seraya berkata, ´Aku membawa berita gembira dengan dua cahaya yang diturunkan kepada engkau dan tidak pernah diberikan kepada nabi sebelummu, yaitu : Surah Al Faatihah dan beberapa ayat terakhir Surah Al Baqarah. Tidaklah kamu membaca satu huruf daripadanya kecuali kamu mendapat karunia ´". (Muslim)

3. Dari Abu Hurairah ra., bahwa Rasulullah SAW. bersabda, "Janganlah kau jadikan rumah-rumahmu seperti kuburan, sesungguhnya setan akan lari dari rumah yang di dalamnya dibaca surah Al Baqarah." (Muslim)

4. Dari Ubai bin Kaab ra., ia berkata, "Rasulullah SAW. bersabda, "Wahai Abu Munzir! Tahukah engkau ayat mana dalam Kitab Allah yang paling agung?" Saya menjawab, ´Allahu laailaaha illa huwal hayyul qoyyuum (ayat kursi)´, Lalu beliau menepuk dadaku dan bersabda, ´Semoga Allah memudahkan ilmu bagimu, wahai Abu Munzir´. (Muslim)

5. Dari Abi Mas´ud Al Badri ra., dari Rasulullah SAW. beliau bersabda, "Barangsiapa membaca dua ayat terakhir surah Al Baqarah pada waktu malam, niscaya ia akan mencukupinya." (Disepakati oleh Bukhari dan Muslim)

6. Dari Abu Umamah Al Bahili, ia berkata, "Saya mendengar Rasulullah SAW. bersabda, ´Bacalah Al Qur´an, karena di hari kiamat kelak ia akan memberikan syafaat bagi pembacanya, bacalah zahrawaen, yaitu : surah Al Baqarah dan surah Ali ´Imran. Sesungguhnya pada hari kiamat nanti keduanya akan datang bagaikan dua awan atau dua kawanan burung yang berbaris yang siap membantu orang-orang yang pernah membacanya. Dan bacalah surah Al Baqarah karena membacanya adalah suatu berkat dan meninggalkannya adalah suatu kerugian. Tukang sihir tak akan sanggup menghasutnya." (Muslim)

7. Dari Abu Darda ´ ra., bahwa Rasulullah SAW. bersabda, "Barang siapa menghafal sepuluh ayat pertama dari surah Al Kahfi, maka ia akan terjaga dari dajal." Dalam riwayat lain, "...sepuluh ayat terakhir dari surah Al-Kahf..." (Muslim)

8. Dari Abu Said Al Khudri ra., bahwa Rasulullah SAW. bersabda, "Barangsiapa membaca surah Al Kahfi pada hari Jumat, maka dia akan diterangi cahaya antara dua Jum ´at." (Hakim dan Baihaqi. Hadis ini adalah hadis sahih)

9. Dari Ibnu Masud ra., ia berkata, "Rasulullah SAW. bersabda, "Surah Tabarak (Al Mulk) adalah penjaga dari azab kubur.". (Hakim dan Abu Naim, Hadis di atas adalah hadis sahih)

10. Dari Ibnu Umar ra., dia berkata, "Rasulullah SAW. bersabda, "Siapa yang suka melihat saya di hari kiamat dengan sebenar-benar penglihatan, maka hendaklah ia membaca surah At Takwiir, Al Infithaar dan Al Insyiqaq." (Ahmad, Tirmizi dan Hakim)

11. Dari Abu Said Al Khudri ra. bahwa Rasulullah SAW. bersabda tentang Qul Huwallahu Ahad, "Demi Allah ~Yang diriku berada di dalam genggamanNya~, sesungguhnya ia (Al Ikhlash) menyamai sepertiga Al Qur´an. "Pada riwayat lain, Rasulullah SAW. bersabda kepada para sahabatnya, "Adakah di antara kamu yang tidak sanggup membaca sepertiga Al Qur´an dalam satu malam?" Hal ini memang berat bagi mereka, lalu mereka bertanya, "Siapakah di antara kami yang mampu, wahai Rasulullah?" Beliau bersabda, "Qul Huwallahu Ahad Allahush-Shamad, adalah sepertiga Al Qur´an." (Bukhari)

12. Dari Muaz bin Anas ra., bahwa Rasulullah SAW. bersabda, "Siapa yang membaca Qul Huwallahu Ahad sebanyak sepuluh kali, niscaya Allah akan membangun rumah baginya di surga." (Ahmad)

13. Dari ´Uqbah bin ´Amir ra., bahwa Rasulullah SAW. bersabda, "Adakah kau lihat ayat-ayat yang diturunkan pada malam ini dan selainnya tidak dapat dilihat sepertinya?, dialah, ´Qul a´udzu birabbil falaq´ dan ´Qul a´udzu birabbin-naas´. (Muslim)

14. Dari Aisyah ra., bahwa Rasulullah SAW. apabila akan berangkat tidur setiap malam, beliau mengumpulkan kedua telapak tangannya, kemudian meniupkannya seraya membaca surah Al Ikhlash, Al Falaq dan An-Naas. Kemudian beliau mengusapkannya ke seluruh tubuhnya, sebatas yang bisa dicapai. Dimulai dari kepala, lalu wajah, kemudian bagian depan dari badan. Beliau melakukannya sebanyak tiga kali. (Disepakati oleh Bukhari dan Muslim)

15. Kami diceritai oleh Abdullah bin Yusuf : Kami diberitahu oleh Malik dari Ibnu Syihab, dari Urwah, dari ´Aisyah ra., bahwa Rasulullah SAW. bila merasa sakit beliau membaca sendiri Al Mu´awwizaat ´ (Al Ikhlash, Al Falaq dan An-Naas) kemudian meniupkannya. Apabila rasa sakitnya bertambah saya yang membacanya kemudian saya usapkan ke tangannya mengharap keberkatan darinya." (Bukhari)


SUMBER PENULISAN:

1. Hadits Riwayat Bukhari Muslim.

2. Hadits Riwayat Ahmad, Tirmizi dan Hakim.

3. Beberapa catatan forum kajian Al Qur´an dan Hadits

Ayat 1000 Dinar diturunkan bukan untuk digantung/ ditampal di dinding tetapi untuk dikaji, dihayati & diamalkan

Dipetik dari http://isuhangat.blogspot.com



Ayat 1000 dinar ini adalah sebahagian dari ayat kedua dan dari ayat ketiga Surah At-Talaq. Ramai orang menganjurkan supaya mengamalkan ayat ini untuk memperolehi kejayaan atau keuntungan. Ramai peniaga menampalkan pelekat ayat 1000 dinar ini di premis perniagaan mereka, dengan harapan supaya perniagaan bertambah maju. Ramai pula yang menghafal ayat ini untuk dibaca dimasa-masa yang sesuai, seperti selepas solat.

Memang kita tidak boleh menafikan kelebihan ayat 1000 dinar. Malangnya, pendekatan sebahagian orang mengenai ayat ini, adalah sesat dan tidak betul. Jika kita lihat terjemahan ayat ini, ia mengandungi dua pengajaran iaitu supaya kita bertaqwa dan bertawakkal. Oleh itu, pendekatan yang betul untuk mengamalkan ayat 1000 dinar ini ialah dengan bertaqwa dan bertawakkal. Kenalah kita pelajari bab bertaqwa dan bertawakkal. Kalau menampalkan pelekat ayat 1000 dinar ini di premis perniagaan, tapi solat tidak dikerjakan, amalan tidak jujur dalam perniagaan terus dibuat atau sebagainya, ini tidak bermakna kita mengamalkan ayat 1000 dinar. Tujuan menampalkan pelekat itu hanyalah sebagai cara supaya kita selalu beringat untuk bertaqwa dan bertawakkal. Begitu juga kalau kita baca ayat ini beribu-ribu kali dalam sehari, sedangkan kita tidak bertaqwa dan bertawakkal, itu juga bukan cara yang betul mengamalkan ayat 1000 dinar.

Penulis pernah menguji seorang peniaga yang menampal banyak pelekat ayat 1000 dinar di sekitar meja juruwang di kedainya, apa yang dia faham mengenai ayat itu. Peniaga itu menjawab, dia tidak tahu apa maksud ayat 1000 dinar itu, tetapi dia menampal pelekat ayat itu dengan harapan akan beroleh keuntungan besar. Pada hari Jumaat, peniaga itu tidak sembahyang Jumaat kerana sibuk melayan pelanggan dikedainya. Adakah itu cara yang betul mengamalkan ayat 1000 dinar?

Bagi penulis, mengamalkan ayat 1000 dinar ini adalah dengan mengikuti dan menta'ati ajaran yang terkandung di dalam nya, iaitu bertaqwa dan bertawakkal. Maka jika kita berhajat untuk mengamalkan ayat 1000 dinar, maka kita hendaklah mempelajari dengan lebih mendalam apakah yang dimaksudkan taqwa dan tawakkal, kemudian kita mengamalkan taqwa dan tawakkal pada setiap masa dalam hidup kita. Tak perlu nak tampal pelekat atau mengulang-ulang menyebutnya, sedangkan pengajaran yang dianjurkan dalam ayat 1000 dinar itu tidak diikuti.

High Blood Pressure

Warning: The informations contained in this blog are not medical advices. Please consult your medical doctor before making decision or taking any action on your health or the health of your family.

What Is High Blood Pressure?

High blood pressure (HBP) is a serious condition that can lead to coronary heart disease, heart failure, stroke, kidney failure, and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps out blood. If this pressure rises and stays high over time, it can damage the body in many ways.

Overview

About 1 in 3 adults in the United States has HBP. HBP itself usually has no symptoms. You can have it for years without knowing it. During this time, though, it can damage the heart, blood vessels, kidneys, and other parts of your body.

This is why knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, you need treatment to prevent damage to your body's organs.

Blood Pressure Numbers

Blood pressure numbers include systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.

You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

Below shows normal numbers for adults. It also shows which numbers put you at greater risk for health problems. Blood pressure tends to goes up and down, even in people who have normal blood pressure. If your numbers stay above normal most of the time, you're at risk.

Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of mercury)

Category
Normal: Less than 120 (Systolic) And Less than 80 (Diastolic)
Prehypertension: 120–139 (Systolic) Or 80–89 (Diastolic)
High blood pressure:
Stage 1: 140–159 (Systolic) Or 90–99 (Diastolic)
Stage 2: 160 or higher (Systolic) Or 100 or higher (Diastolic)

The ranges in the table apply to most adults (aged 18 and older) who don't have short-term serious illnesses.

All levels above 120/80 mmHg raise your risk, and the risk grows as blood pressure levels rise. "Prehypertension" means you're likely to end up with HBP, unless you take steps to prevent it.

If you're being treated for HBP and have repeat readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and stay on treatment to keep you blood pressure under control.

Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you're in. For example, if your systolic number is 160 and your diastolic number is 80, you have stage 2 HBP. If your systolic number is 120 and your diastolic number is 95, you have stage 1 HBP.

If you have diabetes or chronic kidney disease, HBP is defined as 130/80 mmHg or higher. HBP numbers also differ for children and teens.

Outlook

Blood pressure tends to rise with age. Following a healthy lifestyle helps some people delay or prevent this rise in blood pressure.

People who have HBP can take steps to control it and reduce their risks for related health problems. Key steps include following a healthy lifestyle, having ongoing medical care, and following the treatment plan that your doctor prescribes.

Other Names for High Blood Pressure

High blood pressure (HBP) also is called hypertension.

When HBP has no known cause, it may be called essential hypertension, primary hypertension, or idiopathic hypertension.

When another condition causes HBP, it's sometimes called secondary high blood pressure or secondary hypertension.

In some cases of HBP, only the systolic blood pressure number is high. This condition is called isolated systolic hypertension (ISH). Many older adults have this condition. ISH can cause as much harm as HBP in which both numbers are too high.

What Causes High Blood Pressure?

Blood pressure tends to rise with age, unless you take steps to prevent or control it.

Certain medical problems, such as chronic kidney disease, thyroid disease, and sleep apnea, may cause blood pressure to rise. Certain medicines, such as asthma medicines (for example, corticosteroids) and cold-relief products, also may raise blood pressure.

In some women, blood pressure can go up if they use birth control pills, become pregnant, or take hormone replacement therapy.

Women taking birth control pills usually have a small rise in both systolic and diastolic blood pressures. If you already have high blood pressure (HBP) and want to use birth control pills, make sure your doctor knows about your HBP. Talk to him or her about how often you should have your blood pressure checked and how to control it while taking the pill.

Taking hormones to reduce the symptoms of menopause can cause a small rise in systolic blood pressure. If you already have HBP and want to start using hormones, talk to your doctor about the risks and benefits. If you decide to take hormones, find out how to control your blood pressure and how often you should have it checked.

Children younger than 10 years who have HBP often have another condition that's causing it (such as kidney disease). Treating the underlying condition may resolve the HBP.

The older a child is when HBP is diagnosed, the more likely he or she is to have essential hypertension. This means that doctors don't know what's causing the HBP.

Who Is At Risk for High Blood Pressure?

In the United States, about 72 million people have high blood pressure (HBP). This is about 1 in 3 adults.

Certain traits, conditions, or habits are known to raise the risk for HBP. These conditions are called risk factors. This section describes the major risk factors for HBP.

Older Age

Blood pressure tends to rise with age. If you're a male older than 45 or a female older than 55, your risk for HBP is higher. Over half of all Americans aged 60 and older have HBP.

Isolated systolic hypertension (ISH) is the most common form of HBP in older adults. ISH occurs when only systolic blood pressure (the top number) is high. About 2 out of 3 people over age 60 who have HBP have ISH.

HBP doesn't have to be a routine part of aging. You can take steps to keep your blood pressure at a normal level. (For more information, see "How Is High Blood Pressure Treated?")

Race/Ethnicity

HBP can affect anyone. However, it occurs more often in African American adults than in Caucasian or Hispanic American adults. In relation to these groups, African Americans:

- Tend to get HBP earlier in life
- Often have more severe HBP
- Are more likely to be aware that they have HBP and to get treatment
- Are less likely than Caucasians and about as likely as Hispanic Americans to achieve target control levels with HBP treatment
- Have higher rates than Caucasians of premature death from HBP-related complications, such as coronary heart disease, stroke, and kidney failure
- HBP risks vary among different groups of Hispanic American adults. For instance, Puerto Rican American adults have higher rates of HBP-related death than all other Hispanic groups and Caucasians. But, Cuban Americans have lower rates than Caucasians.

Overweight or Obesity

You're more likely to develop prehypertension or HBP if you're overweight or obese. Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat.

Gender

Fewer adult women than men have HBP. But, younger women (aged 18–59) are more likely than men to be aware of and get treatment for HBP.

Women aged 60 and older are as likely as men to be aware of and treated for HBP. However, among treated women aged 60 and older, blood pressure control is lower than it is in men in the same age group.

Unhealthy Lifestyle Habits

A number of lifestyle habits can raise your risk for HBP, including:

- Eating too much sodium (salt)
- Drinking too much alcohol
- Not getting enough potassium in your diet
- Not doing enough physical activity
- Smoking

Other Risk Factors

A family history of HBP raises your risk for the condition. Long-lasting stress also can put you at risk for HBP.

You're also more likely to develop HBP if you have prehypertension. Prehypertension means that your blood pressure is in the 120–139/80–89 mmHg range.

Risk Factors for Children and Teens

Overweight is on the rise in youth younger than 18 years. As a result, prehypertension and HBP also are becoming more common in this age group.

African American and Mexican American youth are more likely to have HBP and prehypertension than Caucasian youth. Also, boys are at higher risk for HBP than girls.

Like adults, children and teens need to have routine blood pressure checks. This is even more important if a young person is overweight.

What Are the Signs and Symptoms of High Blood Pressure?

High blood pressure (HBP) itself usually has no symptoms. Rarely, headaches may occur.

You can have HBP for years without knowing it. During this time, HBP can damage the heart, blood vessels, kidneys, and other parts of the body.

Some people only learn that they have HBP after the damage has caused problems, such as coronary heart disease, stroke, or kidney failure.

Knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your numbers are too high, you can take steps to lower them and control your blood pressure. This helps reduce your risk for complications.

Complications of High Blood Pressure

When blood pressure stays high over time, it can damage the body. HBP can cause:

The heart to get larger or weaker, which may lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood throughout the body.

Aneurysms (AN-u-risms) to form in blood vessels. An aneurysm is an abnormal bulge or "ballooning" in the wall of an artery. Common spots for aneurysms are the main artery that carries blood from the heart to the body; the arteries in the brain, legs, and intestines; and the artery leading to the spleen.

Blood vessels in the kidney to narrow. This may cause kidney failure.
arteries throughout the body to narrow in some places, which limits blood flow (especially to the heart, brain, kidneys, and legs). This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.

Blood vessels in the eyes to burst or bleed. This may lead to vision changes or blindness.

How Is High Blood Pressure Diagnosed?

Your doctor will diagnose high blood pressure (HBP) using the results of blood pressure tests. These tests will be done several times to make sure the results are correct. If your numbers are high, your doctor may have you return for more tests to check your blood pressure over time.

If your blood pressure is 140/90 mmHg or higher over time, your doctor will likely diagnose you with HBP. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.

The HBP ranges in children are different. (For more information, see below.)

How Is Blood Pressure Tested?

A blood pressure test is easy and painless. This test is done at a doctor's office or clinic.

To prepare for the test:

- Don't drink coffee or smoke cigarettes for 30 minutes prior to the test. These actions may cause a short-term rise in your blood pressure.
- Go to the bathroom before the test. Having a full bladder can change your blood pressure reading.
- Sit for 5 minutes before the test. Movement can cause short-term rises in blood pressure.
- To measure your blood pressure, your doctor or nurse will use some type of a gauge, a stethoscope (or electronic sensor), and a blood pressure cuff.

Most often, you will sit or lie down with the cuff around your arm as your doctor or nurse checks your blood pressure. If he or she doesn't tell you what your blood pressure numbers are, you should ask.

Diagnosing High Blood Pressure in Children and Teens

Doctors measure blood pressure in children and teens the same way they do in adults. Your child should have routine blood pressure checks starting at 3 years of age.

Blood pressure normally rises with age and body size. Newborn babies often have very low blood pressure numbers, while older teens have numbers similar to adults.

The ranges for normal blood pressure and HBP are generally lower for youth than for adults. These ranges are based on the average blood pressure numbers for age, gender, and height.

To find out whether a child has HBP, a doctor will compare the child's blood pressure numbers to average numbers for his or her age, height, and gender.

For more information, see the National Heart, Lung, and Blood Institute's "A Pocket Guide to Blood Pressure Measurement in Children."

What Does a Diagnosis of High Blood Pressure Mean?

If you're diagnosed with HBP, you will need treatment. You also will need to have your blood pressure tested again see how treatment affects it.

Once your blood pressure is under control, you will need to stay on treatment. "Under control" means that your blood pressure numbers are normal. You also will need regular blood pressure tests. Your doctor can tell you how often you should be tested.

The sooner you find out about HBP and treat it, the better your chances to avoid problems like heart attack, stroke, and kidney failure.

How Is High Blood Pressure Treated?

High blood pressure (HBP) is treated with lifestyle changes and medicines.

Most people who have HBP will need lifelong treatment. Sticking to your treatment plan is important. It can prevent or delay the problems linked to HBP and help you live and stay active longer.

For more tips on controlling your blood pressure, see the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to Lowering Blood Pressure."

Goals of Treatment

The treatment goal for most adults is to get and keep blood pressure below
140/90 mmHg. For adults who have diabetes or chronic kidney disease, the goal is to get and keep blood pressure below 130/80 mmHg.

Lifestyle Changes

Healthy habits can help you control HBP. Healthy habits include:

- Following a healthy eating plan
- Doing enough physical activity
- Maintaining a healthy weight
- Quitting smoking
- Managing your stress and learning to cope with stress
- If you combine these measures, you can achieve even better results than taking single steps. Making lifestyle changes can be hard. Start by making one healthy lifestyle change and then adopt others.

Some people can control their blood pressures with lifestyle changes alone, but many people can't. Keep in mind that the main goal is blood pressure control. If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy habits. This will help you better control your blood pressure.

Follow a Healthy Eating Plan

Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have HBP. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in sodium (salt).

This eating plan is low in fat and cholesterol. It also features fat-free or low-fat milk and dairy products, fish, poultry, and nuts. The DASH eating plan suggests less red meat (even lean red meat), sweets, added sugars, and sugar-containing beverages. The plan is rich in nutrients, protein, and fiber.

To help control HBP, you should limit the amount of salt that you eat. This means choosing low-salt and "no added salt" foods and seasonings at the table or when cooking. The Nutrition Facts label on food packaging shows the amount of sodium in the item. You should eat no more than about 1 teaspoon of salt a day.

You also should try to limit alcoholic drinks. Too much alcohol will raise your blood pressure. Men should have no more than two alcoholic drinks a day. Women should have no more than one alcoholic drink a day.

For more information on limiting salt and alcohol in your diet, see the Your Guide to Lowering High Blood Pressure Web site.

Do Enough Physical Activity

Regular physical activity can lower HBP and also reduce your risk for other health problems.

Check with your doctor about how much and what kinds of activity are safe for you. Unless your doctor tells you otherwise, try to get at least 30 minutes of moderate-intensity activity on most or all days of the week. You can do it all at once or break it up into shorter periods of at least 10 minutes each.

Moderate-intensity activities include brisk walking, dancing, bowling, riding a bike, working in a garden, and cleaning the house.

If your doctor agrees, you also may want to do more intense activities, such as jogging, swimming, and playing sports. For more information, see the NHLBI's "Your Guide to Physical Activity and Your Heart."

Maintain a Healthy Weight

Staying at a healthy weight can help control blood pressure and also reduce your risk for other health problems.

If you're overweight or obese, aim to reduce your weight by 7 to 10 percent during your first year of treatment. This amount of weight loss can lower your risk for health problems related to HBP.

After the first year, you may have to continue to lose weight so you can lower your body mass index (BMI) to less than 25.

BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for keeping blood pressure under control.

You can measure your BMI using the NHLBI's online calculator, or your health care provider can help.

For more information on losing weight and keeping it off, see the Diseases and Conditions Index Overweight and Obesity article.

Quit Smoking

Smoking can damage your blood vessels and raise your risk for HBP. It also can worsen health problems related to HBP. Smoking is bad for everyone, especially those who have HBP.

If you smoke or use tobacco, quit. Talk to your doctor about programs and products that can help you quit. The U.S. Department of Health and Human Services has information on how to quit smoking. Also, take steps to protect yourself from secondhand smoke.

Managing Stress

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

Physical activity helps some people cope with stress. Other people listen to music or focus on something calm or peaceful to reduce stress. Some people learn yoga, tai chi, or how to meditate.

Medicines

Today's blood pressure medicines can safely help most people control their blood pressures. These medicines are easy to take. The side effects, if any, tend to be minor.

If you have side effects from your medicines, talk to your doctor. He or she may be able to adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.

Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body to lower blood pressure. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one.

Diuretics

Diuretics are sometimes called water pills. They help your kidneys flush excess water and salt from your body. This lessens the amount of fluid in your blood, and your blood pressure goes down.

Diuretics often are used with other HBP medicines and sometimes combined into one pill.

Beta Blockers

Beta blockers help your heart beat slower and with less force. Your heart pumps less blood through your blood vessels, and your blood pressure goes down.

ACE Inhibitors

ACE inhibitors keep your body from making a hormone called angiotensin II. This hormone normally causes blood vessels to narrow. ACE inhibitors prevent this, so your blood pressure goes down.

Angiotensin II Receptor Blockers

Angiotensin II receptor blockers (ARBs) are newer blood pressure medicines that protect your blood vessels from angiotensin II. As a result, blood vessels relax and widen, and your blood pressure goes down.

Calcium Channel Blockers

Calcium channel blockers (CCBs) keep calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, and your blood pressure goes down.

Alpha Blockers

Alpha blockers reduce nerve impulses that tighten blood vessels. This allows blood to flow more freely, causing blood pressure to go down.

Alpha-Beta Blockers

Alpha-beta blockers reduce nerve impulses the same way alpha blockers do. However, they also slow the heartbeat like beta blockers. As a result, blood pressure goes down.

Nervous System Inhibitors

Nervous system inhibitors increase nerve impulses from the brain to relax and widen blood vessels. This causes blood pressure to go down.

Vasodilators

Vasodilators relax the muscles in blood vessel walls. This causes blood pressure to go down.

Treatment for Children and Teens

If another condition is causing your child's HBP, treating it often resolves the HBP. When the cause of a child or teen's HBP isn't known, the first line of treatment is lifestyle changes (as it is for adults).

If lifestyle changes don't control blood pressure, children and teens also may need to take medicines. Most of the medicines listed above for adults have unique doses for children.

How Can High Blood Pressure Be Prevented?

If You Have Normal Blood Pressure

- If you don't have high blood pressure (HBP), you can take steps to prevent it. Lifestyle measures can help you maintain normal blood pressure.
- Follow a healthy eating plan. This includes limiting the amount of sodium (salt) and alcohol that you consume. An example of a healthy eating plan is the National Heart, Lung, and Blood Institute's Dietary Approaches to Stop Hypertension (DASH).
- Lose weight if you're overweight or obese.
- Do enough physical activity.
- Quit smoking.
- Manage your stress and learn to cope with stress

Many people who take one or more of these steps are able to prevent or delay HBP. The more steps you take, the more likely you are to lower your blood pressure and avoid related health problems.

If You Have High Blood Pressure

If you have HBP, you can still take steps to prevent the long-term problems it can cause. Lifestyle measures (listed above) and medicines can help you live a longer, more active life.

Follow the treatment plan your doctor prescribes to control your blood pressure. It can help you prevent or delay coronary heart disease, stroke, kidney disease, and other health problems.

Children and Teens

A healthy lifestyle also can help prevent HBP in children and teens. Key steps include having a child:

- Follow a healthy eating plan that focuses on plenty of fruits, vegetables, and, for children older than 4 years, low-fat dairy products. The plan also should be low in saturated and trans fats and salt.
- Be active for at least 1 to 2 hours per day. Limit screen time in front of the TV or the computer to 2 hours per day at most.
- Maintain a healthy weight. If your child is overweight, ask his or her doctor about how your child can safely lose weight.
- Make these habits part of a family health plan to help your child adopt and maintain a healthy lifestyle.

Living With High Blood Pressure

If you have high blood pressure (HBP), you will need to treat and control it for life. This means making lifestyle changes, taking prescribed medicines, and getting ongoing medical care.

Treatment can help control blood pressure, but it will not cure HBP. If you stop treatment, your blood pressure and risk for related health problems will rise. For a healthy future, follow your treatment plan closely. Work with your health care team for lifelong blood pressure control.

Lifestyle Changes

Following a healthy lifestyle is an important step for controlling HBP. A healthy lifestyle includes following a healthy eating plan, losing weight (if you're overweight or obese), doing regular physical activity, and not smoking. (For more information, see "How Is High Blood Pressure Treated?")

Medicines

You should take all blood pressure medicines that your doctor prescribes. Be sure you know the names and doses of your medicines and how to take them. If you have questions about your medicines, talk to your doctor or pharmacist.

Make sure you refill your medicines before they run out. Take your medicines exactly as your doctor directs—don't skip days or cut pills in half.

If you're having side effects from your medicines, talk to your doctor. He or she may need to adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.

Ongoing Care

Go for medical checkups or tests as your doctor advises. Your doctor may need to change or add medicines to your treatment plan over time. Regular checkups allow your doctor to change your treatment right away if your blood pressure goes up again.

Keeping track of your blood pressure is vital. Have your blood pressure checked on the schedule your doctor advises. You may want to learn how to check your blood pressure at home. Your doctor can help you with this. Each time you check your own blood pressure, you should write down your numbers and the date.

The National Heart, Lung, and Blood Institute's (NHLBI's) "My Blood Pressure Wallet Card" can help you track your blood pressure. You also can write down the names and doses of your medicines and keep track of your lifestyle changes with this handy card.

During checkups, you can ask your doctor or health care team any questions you have about your lifestyle or medicine treatments.

High Blood Pressure and Pregnancy

Many pregnant women who have HBP have healthy babies. However, HBP can cause problems for both the mother and the fetus. It can harm the mother's kidneys and other organs. It also can cause the baby to be born early and with a low birth weight.

If you're thinking about having a baby and you have HBP, talk to your health care team. You can take steps to control your blood pressure before and while you're pregnant.

Some women get HBP for the first time while they're pregnant. In the most serious cases, the mother has a condition called preeclampsia (pre-e-KLAMP-se-ah).

This condition can threaten the lives of both the mother and the unborn child. You will need special care to reduce your risks. With such care, most women and babies have good outcomes.

See the NHLBI's Your Guide to Lowering High Blood Pressure Web site for more information about HBP and pregnancy.

Key Points

High blood pressure (HBP) is a serious condition that can lead to coronary heart disease, heart failure, stroke, kidney failure, and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps out blood. When this pressure rises and stays high over time, it can damage the body in many ways.

Blood pressure numbers include systolic and diastolic pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.

All blood pressure levels above 120/80 mmHg increase your risk for the health problems related to HBP. A blood pressure level of 140/90 mmHg or higher is considered HBP for most adults. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.

Blood pressure tends to rise with age. Certain medical problems and medicines may cause blood pressure to rise. In some women, blood pressure can go up if they use birth control pills, become pregnant, or take hormone replacement therapy.

Children younger than 10 years who have HBP often have another condition that's causing it (such as kidney disease). Treating the underlying condition may resolve HBP.

In the United States, about 72 million people have HBP. This is about 1 in 3 adults.

Certain traits, conditions, or habits may raise your risk for HBP. These include older age, race/ethnicity, overweight or obesity, gender, unhealthy lifestyle habits, a family history of HBP, long-lasting stress, and having prehypertension (blood pressure levels between 120–139/80–89).

HBP itself usually has no symptoms. Rarely, headaches may occur. Some people only learn that they have HBP after it causes health problems, such as coronary heart disease, stroke, or kidney failure.

Your doctor will diagnose HBP using the results of a blood pressure test. This test is easy and painless. It may be done several times to make sure the results are correct.

Doctors measure blood pressure in children and teens the same way they do in adults. However, the ranges for normal blood pressure and HBP are different for youth than for adults. These ranges are based on the average blood pressure levels for a child or teen's age, gender, and height.

HBP in adults and children is treated with lifestyle changes and medicines.

Lifestyle changes include following a healthy eating plan, doing enough physical activity, maintaining a healthy weight, quitting smoking, and managing and coping with stress.

If you have normal blood pressure, you can take steps to prevent or delay HBP.

Healthy lifestyle habits can help you maintain normal blood pressure.

If you have HBP, you can take steps to prevent the long-term problems it can cause.

Adopt healthy lifestyle habits and follow the treatment plan your doctor prescribes.

Children and teens can prevent HBP and its related problems in the same ways.