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PembimbingDr. Oscar Nurhadi , Sp. S
Oleh :Nanda Sulistyaningrum, S.Ked
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Stroke
Tea and coffe for Prevention of stroke BAB I. PENDAHULUAN
I. PENDAHULUAN
1.Truelsen Thomas, Ruth Bonita, and Konrad J. Surveillance of Stroke: A Global Perspective .
International epidemiologi Association. 2001; 30: S11-S162. 2.Ingall Timothy, MD. Stroke-Incidence, Mortality, Morbidity and Risk . Journal of
gangguan neurologis fokal dengan onsetmendadak dan berlangsung lebih dari 24 jam(atau dapat menyebabkan kematian) akibat
gangguan vaskular.
Di Amerika Serikat , 700.000 orang yang
mengalami stroke sekitar 165.000 meninggalsetiap tahunnya.
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Stroke
Tea and coffe for Prevention of stroke BAB I. PENDAHULUAN
I. PENDAHULUAN
Pencegahan Stroke
1.Truelsen Thomas, Ruth Bonita, and Konrad J. Surveillance of Stroke: A Global Perspective .
International epidemiologi Association. 2001; 30: S11-S162.Ingall Timothy, MD. Stroke-Incidence, Mortality, Morbidity and Risk . Journal of Insurance
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
Stroke
faktor-faktor mungkin demografis, sosial, budaya,perilaku, dan persepsi atau mungkin berhubungan
dengan gejala yang muncul pada stroke
6.Lecouturier Jan, Madelaine JM, Richard GT,et al. Response to Symptoms of Stroke in theUK: a Systematic Review. Research Article. 2010; 10-157
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
II.B Gejala Stroke
MidCity. Stroke. Diagnosis and Initial Management of acute stroke and Transient Ischaemic Attack (TIA). National Institute for health and Clinical Excellence.(NHS). 2008.
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
II.B Gejala Stroke
Stroke Teh dan Kopi
MidCity. Stroke. Diagnosis and Initial Management of acute stroke and Transient Ischaemic Attack (TIA). National Institute for health and Clinical Excellence.(NHS). 2008.
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Teh dihasilkan dari tanaman daun Camellia sinensis
teh diklasifikasikan menjadi hitam (fermentasi) teh - terutama diEropa, Amerika Utara dan Afrika Utara dan teh hijau (tanpafermentasi), terutama dikonsumsi di Asia
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
C. Teh
7. Castelnuovo Augusto Di, Romina DG, Kicia lacoviello,et al. Consumption of Cocoa, Tea
and Coffe and Risk of Cardiovaskuler Disease. Review Article. European Journal of InternalMedicine. 2011; 07-011
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PencegahanStroke
KandunganTeh
Flavonoid
polifenol
Catechins
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
D. Kandungan Teh
8. Haqqi Tariq M, Donald DA, Sanjay Gupta,et al. Prevention of Collagen-Indeuced arthritis in Mice by A Polyphenolic Fraction fromGreen Tea. Proc.Natl. Acad Sci.USA. 1999; 96: 4524-4529.
9.Roccaro Sudono Andrea, anna RB, Francesso G, et al. Epigallocatechin-Gallte Enhaces the Activity of Tetracycline in Staphyloccoci by Inhibiting Its Eff;lux From Bacterial Cells. Antimicrobial Agents and Chemotherapy. 2004; 1968-1973.10. Caacko Sabu M, Priya T Thambi, Ramadasan Kuttan, and Ikuo Nishigaki. Beneficial Effects og Green tea: A Literature Review. Chacko
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Catechin yang terkandung dalam teh berperandalam proses peradangan pembuluh darah danaterosklerosis melalui beberapa mekanisme(misalnya anti-hipertensi, antilipidemic, anti-
inflamasi, anti-proliferasi dan anti-thrombogenic).
1. Perry A C, Miller P C, Allison M D, Jackson M L, and Applegate E B. Clinical predictability of the waist-to-hip ratio inassessment ofcardiovascular disease risk factors in overweight, premenopausal women. Am J Clin Nutr 1998;68:10221027.
2. Gupta R, Rastogi P, Sarna M, Gupta V P, Sharma S K, Kothari K. Body-Mass Index, Waist-Size, Waist-Hip Ratio and Cardiovascular Risk Factors in Urban Subejcts . JAPI 2007:55: 621-627.
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
E.Hubungan Kandungan Teh dengan Stroke
11.Velayuthan Pon, Anandh babu, and Dongmin Liu. Green tea Catechins and Cardiovaskuler Health: A Update. Curr Med Chem.2008;15(18): 1840-1850.
12.Moore JR, Kim G, Jackson, and Anne MM. Green Tea (Camellia Sinensis) catechins and Vaskuler Function . British Journal of Nutrition.2009; 1790-1802
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efek biologis dari polifenol teh terutama padaefek EGCG (epigallocatechin-3-gallate),termasuk pencegahan oksidasi LDL, mengurangiagregasi platelet, regulasi lipid, danpenghambatan proliferasi dan migrasi sel ototpolos
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
1. Polyfenol E.1.a. Hubungan Polyfenol dengan Endotel Pembuluh Darah
7. Castelnuovo Augusto Di, Romina DG, Kicia lacoviello,et al. Consumption of Cocoa, Tea
and Coffe and Risk of Cardiovaskuler Disease. Review Article. European Journal of InternalMedicine. 2011; 07-011
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Polifenol memiliki efek antiplatelet, dan efekantiinflamasi
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
1. PolyfenolE.1.b. Hubungan Polyfenol dengan komponen darah
.
7. Castelnuovo Augusto Di, Romina DG, Kicia lacoviello,et al. Consumption of Cocoa, Tea
and Coffe and Risk of Cardiovaskuler Disease. Review Article. European Journal of InternalMedicine. 2011; 07-011
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Menstabilkan tekanan darah .
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
1. PolyfenolE.1.c.. Hubungan Polyfenol dengan Tekanan Darah
13. Vita a Joseph. Polyfenols and Cardiovaskuler Disease: Effects on Endothelial and Platelet-
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Endotelium vaskular memainkan peran kuncidalam regulasi homeostatis vaskulerFlavonoid juga meningkatkan produksi oksida(NO) nitrat dari endothelium
Nitrat oksida juga menghambat proliferasi sel ototpembuluh darah halus dan ekspresi komponennoncellular yang merupakan matriks dindingpembuluh darah, pembentukan lesi, hipertrofidari dinding kapal, dan vaskular
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
2. Flavonoid E.2.a Hubungan Flavonoid dengan Endotel Pembuluh Darah
13. Vita a Joseph. Polyfenols and Cardiovaskuler Disease: Effects on Endothelial and Platelet Function 1-4. Am J Clin Nutr. 2005; 292S-7S.14.Ignaroo LJ. Nitric Oxide. A Novel Signal Transduction Mechanism for Transcelluar Communication. AHA. 1990; 1524-4563
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Agregasi trombosit merupakanmekanisme utama dalam pathogenesissindrom koroner akut, termasuk infarkmiokard dan angina tidak stabil
Flavonoid sebagai antioksidan sehinggadapat mengurangi agregasi platelet danmencegah penumpukan LowLipoprotein Densitas 1
flavonoid dapat mencegah LDL oksidasi, yang merupakan kunci awal dalamperkembangan aterosklerosis 8.
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
1FlavonoidE.2.b.Efek flavonoid terhadap Tekanan Darah
13. Vita a Joseph. Polyfenols and Cardiovaskuler Disease: Effects on Endothelial and Platelet-
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Flavonoid dapat dijadikansebagai pencegahan primerdari penyakit kardiovaskuler.
Mukamal etal meneliti konsumsi teh diMyocardial Infarction Onset Study, sebuahstudi kohort prospektif yang meneliti 1.900pasien yang dirawat di rumah sakitmasyarakat di Amerika Serikat dengan infarkmiokard akut. Selama masa tindak lanjutdari 3,8 peminum teh yang sedang dan beratmemiliki 31% dan pengurangan 39% risikokardiovaskular
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
1FlavonoidE.2.c.Efek Flavonoid terhadap Tekanan darah
15.Mukamal Kj, Malcolm M, James,et al. Tea Concumption and Mortality After Acute
d ff f f k
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
3.Catechin . E.3.a.Efek catechin terhadap pembuluh darah
15.Mukamal Kj, Malcolm M, James,et al. Tea Concumption and Mortality After Acute
Catechin memiliki pengaruhterhadap proses peradanganpembuluh darah melalui beberapamekanisme seperti 5
antihipertensi,antihiperlipidemic,antiinflamasi,antiproliferasi, danantitrombogenik
T d ff f P i f k BAB II TINJAUAN PUSTAKA
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katekin teh hijau, dapatmenghambat ADP-, kolagen-,
epinefrin-, dan agregasi plateletdalam polyfenol 7.
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
3.CatechinE.3.b. Efek catechin terhadap komponen darah
7.Castelnuovo Augusto Di, Romina DG, Kicia lacoviello,et al. Consumption of Cocoa, Tea
T d ff f P i f k BAB II TINJAUAN PUSTAKA
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Secara keseluruhan dapatdisimpulkan bahwa minumhijau teh sehari mengurangirisiko IS dengan 40-65%.
Studi yang dilakukan oleh
berbagai peneliti tidak hanyaberdasarkan jumlah cangkirtetapi pada faktor-faktor lainseperti diet, gaya hidup dll . 18
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
3.CatechinE.3.c.Efek catechin terhadap tekanan darah
16.Mesas Au,et al.The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945
T d ff f P ti f t k BAB II TINJAUAN PUSTAKA
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
F. KOPI
15.Mukamal Kj, Malcolm M, James,et al. Tea Concumption and Mortality After Acute
Kopi merupakan minuman yang dikonsumsi diseluruh dunia yang masih memiliki efek potensialpada penyakit kardiovaskular tetapi masihkontroversialSelain sebagai sumber utama kafein, kopimengandung senyawa beberapa , khususnya fenol, vitamin B3, magnesium, potasium dan serat yangmungkin memiliki efek baik menguntungkan ataumerugikan pada sistem kardiovaskular
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16.Mesas Au,et al.The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945
H.Hubungan kopi dengan Stroke H.1.a. Kafein terhadap endotel pembuluh darah Para penulis menemukan bahwa konsumsi kafein akut (dalam bentuk kapsul yang mengandung 200 mg kafein) dikaitkan dengan peningkatan flow-mediated dilation dan penurunan C-reaktif protein pada subyek dengandengan atau tanpa CAD. 7 H.1.b. Kafein terhadap komponen darah
kafein telah terbukti dapat menghambat trombosit agregasi. 7 Beberapabaris bukti menunjukkan bahwa Kopi yang direbus meningkatkan kadarkolesterol 7.Selain konsumsi kopi, terutama dalam bentuk kopi rebus,
meningkatkan lipid serum dan kadar homosistein17
H.1.c. Kafein terhadap tekanan darah Jee et al (2) melaporkan bahwa mengkonsumsi kopi sehari dapat
menyebabkan sedikit peningkatan dalam BP 16.
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
G. KOPI
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16.Mesas Au,et al.The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945
H.2.b. fenol terhadap komponen darah Oksidasi LDL + VLDL, dua lipoprotein aterogenik.Polifenol utama dalam kopi adalah asam klorogenat(CGA)ester asam caffeic dan asam quinic. CGA adalahantioksidan vitro dengan dua kelompok fenolikberfungsi anti radikal . 17
Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
Fenol
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
Skema Kerangka Berfikir
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Tea and coffe for Prevention of stroke BAB II.TINJAUAN PUSTAKA
Skema Kerangka Berfikir
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16.Mesas Au,et al.The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945
Di seluruh dunia, penyakit serebrovaskular diperkirakan menyebabkan5,4 juta kematian per tahun. Stroke merupakan salah satu daripenyebab kematian. Korban sering mengalami hemiparesis, afasia,hemianopia, gejala depresi, disfagia, inkontinensia, dan kesulitanberjalanTeh dihasilkan dari tanaman daun Camellia sinensis . Menurut tingkatfermentasi, teh diklasifikasikan menjadi hitam (fermentasi) teh -terutama di Eropa, Amerika Utara dan Utara Afrika dan teh hijau(tanpa fermentasi), terutama dikonsumsi di Asia. Karena kandungantinggi catechin (epicatechin, epicatechin gallate, epigallocatechin, danepigallocatechin gallate), juga dikenal sebagai the flavonoid, konsumsiteh tampaknya untuk melindungi terhadap pengembangan CVD.Flavonoid mengurangi agregasi platelet dan mencegah oksidasi lowlipoprotein densitas karena sifat antioksidannya. 7Flavonoid memperbaiki fungsi endotel
Tea and coffe for Prevention of stroke BAB III. PENUTUP
VI.1. Ringkasan
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16.Mesas Au,et al.The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945
Pencegahan stroke berfokus pada pengelolaankardiovaskular termasuk dalam mencegah faktorrisiko terutama mengontrol tekanan darah, komponendarah dan Endotel Pembuluh darah.Teh memiliki efek yang menguntungkan bagi sistemkardiovaskuler seperti menghambat agregasitrombosit,dan menurunkan LDL.Kopi adalah minuman yang cukup banyak dikonsumsioleh masyarakat. Dimana untuk efeknya terhadapsistem vaskuler sampai sekarang masih kontroversi.
Tea and coffe for Prevention of stroke BAB III. PENUTUP
VI.2 Kesimpulan
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16.Mesas Au,et al.The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945
Penulis berharap untuk kedepannya dapat ditelitimengenai hubungannya Kebiasaan minum Teh danKopi dengan jumlah kejadian Stroke untuk setiappasien yang berobat ke RS. Ulin Banjarmasin.
Tea and coffe for Prevention of stroke BAB III. PENUTUP
VI. 3. Saran
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.Truelsen Thomas, Ruth Bonita, and Konrad J. Surveillance of Stroke: A Global Perspective. International epidemiologi Association. 2001; 30: S11-S16Ingall Timothy, MD. Stroke-Incidence, Mortality, Morbidity and Risk . Journal of Insurance medicine.J Insur Med. 2004; 26: 143-152Noordij Marlies, Cuno S.P.M. Uiterwaal, Lidia, et al. Blood Pressure response to hronic Intake of cofe and Caffeine: a Meta-Anlaysis of Randomized Controlled Trials . Journal of Hypertension. 2005; 23: 921-928Hakim Iman A,et al. Tea Concumption and The Prevalence of Coronoary heart Disease in Saudi Adults: results from A Saudi National Study.american Heatlh Foundation andElsevier Scince (USA). 2002; 64-71MidCity. Stroke. Diagnosis and Initial Management of acute stroke and Transient Ischaemic Attack (TIA). National Institute for health and Clinical Excellence.(NHS). 2008.Lecouturier Jan, Madelaine JM, Richard GT,et al. Response to Symptoms of Stroke in the UK: a Systematic Review . Research Article. 2010; 10-157Castelnuovo Augusto Di, Romina DG, Kicia lacoviello,et al. Consumption of Cocoa, Tea and Coffe and Risk of Cardiovaskuler Disease. Review Article. European Journal of Internal Medicine. 2011; 07-011Haqqi Tariq M, Donald DA, Sanjay Gupta,et al. Prevention of Collagen-Indeuced arthritis in Mice by A Polyphenolic Fraction from Green Tea. Proc.Natl. Acad Sci.USA. 1999; 96:4524-4529.Roccaro Sudono Andrea, anna RB, Francesso G, et al. Epigallocatechin-Gallte Enhaces the Activity of Tetracycline in Staphyloccoci by Inhibiting Its Eff;lux From Bacterial Cells.
Antimicrobial Agents and Chemotherapy. 2004; 1968-1973.Caacko Sabu M, Priya T Thambi, Ramadasan Kuttan, and Ikuo Nishigaki. Beneficial Effects og Green tea: A Literature Review. Chacko et al. Chinesse.2010; 5-13
Velayuthan Pon, Anandh babu, and Dongmin Liu. Green tea Catechins and Cardiovaskuler Health: A Update. Curr Med Chem.2008; 15(18): 1840-1850.Moore JR, Kim G, Jackson, and Anne MM. Green Tea (Camellia Sinensis) catechins and Vaskuler Function . British Journal of Nutrition. 2009; 1790-1802.
Vita a Joseph. Polyfenols and Cardiovaskuler Disease: Effects on Endothelial and Platelet Function 1-4. Am J Clin Nutr. 2005; 292S-7S.Ignaroo LJ. Nitric Oxide. A Novel Signal Transduction Mechanism for Transcelluar Communication. AHA. 1990; 1524-4563.Mukamal Kj, Malcolm M, James,et al. Tea Concumption and Mortality After Acute Myocardial Infarction. Circulation. American Heart Association (AHA). 2002; 105: 2476-2481Mesas Au,et al. The Effect of Coffe on Blood Pressure and Cardiovaskuler disease in Hypertensive Individuals: A Systematic Review and Meta-Analysis 1-3. AJCN.2011; 10.3945Bonita Stella Jennifer, Michael Mandarano,Dona S,and Joe V. Coffe and Cardiovaskuler Disease: In Vitro, Celluler, Animal, and human Studies. Pharmacological Research. 2007;187-198.Gupta alka, Bhawna K, and Indira Raheja. Green tea: A Phytopharmaceutical Wonder Extract for Ischemic stroke . Reserch Journal of Pharmaceutical, Biological and Chemical.2011; 2(1).301
Tea and coffe for Prevention of stroke BAB III. PENUTUP
DAFTAR PUSTAKA
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Terimakasih Atas Perhatiannya
Alhamdulillah
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