Published date: Oct 04 2024

Journal Title: KnE Life Sciences

Issue title: 4th International Conference in Social Science (4th ICONISS): Healthcare

Pages: 52–62

DOI: 10.18502/kls.v8i2.17358

Endry Septiadiendry.septiadi@lecture.unjani.ac.idDepartment of Nutrition, Faculty of Medicine, University of Jenderal Achmad Yani, Cimahi

Yudith Y KusmalaDepartment of Internal medicine, Faculty of Medicine, University of Jenderal Achmad Yani, Cimahi

Iis Inayati RakhmatDepartment of Biochemistry, Faculty of Medicine, University of Jenderal Achmad Yani, Cimahi

Muhammad Haekal AfdhalahGeneral Medicine Study Program, Faculty of Medicine, University of Jenderal Achmad Yani, Cimahi

Muhammad Naufal RamadhanGeneral Medicine Study Program, Faculty of Medicine, University of Jenderal Achmad Yani, Cimahi

Fadli Nurul HanifGeneral Medicine Study Program, Faculty of Medicine, University of Jenderal Achmad Yani, Cimahi

According to the 2018 Basic Health Research Data (RISKESDAS), the prevalence of hypertension in West Java was 39.6%, while in Cimahi City it was 41.83%. The composition of the Mediterranean diet contains a high proportion of MUFA and PUFA which act as anti-inflammatory, antioxidant, and cardioprotective with a potential to lower blood pressure. The aim of this study is to determine the impact of Mediterranean diet components on blood pressure in patients with hypertension. The study uses observational analytic methods as the design and also employs a prospective cohort sample of 36 patients with hypertension for three months, using a systematic random sampling technique. The research subjects were checked for blood pressure in the first month (T1) and the last month of the study (T2). The relative Mediterranean Diet (rMED) was used as a source of data on component intakes by administering the Food Frequency Questionnaire (FFQ) 12 times within three months. The differences in Mediterranean diet composition and blood pressure in all Mediterranean diet adherence groups were examined using the ANOVA test and Tuckey’s post-hoc test, as well as to test comparisons of proportions between rMED adherence groups. The impact of each component of the Mediterranean Diet on blood pressure was evaluated using a linear regression analysis test. The results showed that the average age of hypertensive patients who underwent the Mediterranean diet was 57.94 years and 69.44% were female. The components of fruit and nuts, vegetables, and fish have a significant effect on systolic blood pressure. Fish components have a significant effect on diastolic blood pressure. The components of vegetables and fish have a significant effect on the mean arterial pressure (MAP). Fruit and nut components have a significant effect on pulse pressure. The limitations of this study are the short research time, the absence of salt consumption restrictions on the Mediterranean diet, and the presence of smoking and physical activity as confounding activities.

Keywords: blood pressure, composition, Mediterranean diet, mean arterial pressure, pulse pressure

[1] Kesehatan K. Tekanan darah tinggi (Hipertensi) [Internet]. 2016. Available from: https://p2ptm.kemkes.go.id/uploads/2016/10/Tekanan-Darah-Tinggi-Hipertensi

[2] Melgarejo JD, Yang WY, Thijs L, Li Y, Asayama K, Hansen TW, et al.; International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators*. Association of fatal and nonfatal cardiovascular outcomes with 24- hour mean arterial pressure. Hypertension. 2021 Jan;77(1):39–48.

[3] Bell K, Twiggs J, Olin BR. Hypertension : The Silent Killer : Updated JNC-8 Guideline Recommendations [Internet]. 2018. Available from: https://cdn.ymaws.com/www. aparx.org/resource/resmgr/CEs/CE_Test_Hypertension_The_Sil.pdf

[4] World Orfanization Health. www.who.int. 2021. Hypertension. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension

[5] Rokom. Sehat Negeriku Sehatlah Bangsaku. 2019 [cited 2022 May 16]. Hipertensi Penyakit Paling Banyak Diidap Masyarakat. Available from: https://sehatnegeriku.kemkes.go.id/baca/umum/20190517/5130282/hipertensipenyakit-paling-banyak-diidap-masyarakat/

[6] Carlos S, De La Fuente-Arrillaga C, Bes-Rastrollo M, Razquin C, Rico-Campà A, Martínez-González MA, et al. Mediterranean diet and health outcomes in the SUN cohort. Nutrients. 2018 Mar;10(4):439.

[7] Lăcătușu CM, Grigorescu ED, Floria M, Onofriescu A, Mihai BM. The Mediterranean diet: from an environment-driven food culture to an emerging medical prescription. Int J Environ Res Public Health. 2019 Mar;16(6):942.

[8] De Pergola G, D’Alessandro A. Influence of Mediterranean diet on blood pressure. Nutrients. 2018 Nov;10(11):1700.

[9] Park YM, Steck SE, Fung TT, Zhang J, Hazlett LJ, Han K, et al. Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) style diet, and metabolic health in U.S. adults. Clin Nutr. 2017 Oct;36(5):1301–9.

[10] Gurven M, Blackwell AD, Rodríguez DE, Stieglitz J, Kaplan H. Does blood pressure inevitably rise with age?: longitudinal evidence among forager-horticulturalists. Hypertension. 2012 Jul;60(1):25–33.

[11] National Institutes of Health. National Institutes of Health. 2022 [cited 2023 Jan 9]. High Blood Pressure and Older Adults. Available from: https://www.nia.nih.gov/health/high-blood-pressure/high-blood-pressure-and-olderadults

[12] Singh JN, Nguyen T, Kerndt CC, Dhamoon AS. Physiology, blood pressure age related changes. 2019;

[13] Li Y, Jiang B, Keehn L, Gu H, Boguslavskyi A, Cecelja M, et al. Hemodynamic mechanism of the age-related increase in pulse pressure in women: insights from twins UK. Hypertension. 2019 May;73(5):1018–24.

[14] Sun Z. Aging, arterial stiffness, and hypertension. Hypertension. 2015 Feb;65(2):252–6.

[15] Gillis EE, Sullivan JC. Sex differences in hypertension: recent advances. Hypertension. 2016 Dec;68(6):1322–7.

[16] Reckelhoff JF. Gender differences in the regulation of blood pressure. Hypertension. 2001 May;37(5):1199–208.

[17] Schwingshackl L, Hoffmann G. Mediterranean diet and health status : Active ingredients and pharmacological mechanisms. 2020;(April 2019):1241–57.

[18] E T. The role of B-glucan, plant stanols, and oxy(phyto)sterols in managing cardiovascular risk Citation. Maastricht University; 2024.

[19] Genova Diagnostics. Fatty Acids Support Guide. 2018;

[20] Pantsi WG, Bester DJ, Esterhuyse AJ, Aboua G. Dietary Antioxidant Properties of Vegetable Oils and Nuts – The Race Against Cardiovascular Disease Progression. Antioxidant-Antidiabetic Agents and Human Health; 2014. pp. 209–38.

[21] Tibaoui S, Smeti S, Essid I, Bertolín JR, Joy M, Atti N. Physicochemical Characteristics, Fatty Acid Profile, Alpha-Tocopherol Content, and Lipid Oxidation of Meat from Ewes Fed Different Levels of Distilled Myrtle Residues. Molecules. 2020 Oct;25(21):1–13.

[22] Jennings A, Berendsen AM, de Groot LC, Feskens EJ, Brzozowska A, Sicinska E, et al. Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults. Hypertension. 2019 Mar;73(3):578–86.

[23] Triliana R, Soeatmadji DW, Kalim H. Pengaruh Terapi Suplementasi Fitosterol pada Profil Lemak Plasma, Kadar Apolipoprotein (Apo) B-48, dan Penghitungan Sel Busa Aorta Tikus Pascadiet Pengaruh Terapi Suplementasi Fitosterol pada Profil Lemak Plasma, Kadar Apolipoprotein (Apo) B-48, d. J Exp Life Sci. 2012;2(2):70–81.

[24] Swaminathan S, Dehghan M, Raj JM, Thomas T, Rangarajan S, Jenkins D, et al. Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study. BMJ. 2021 Feb;372:m4948.

[25] González-Rámila S, Sarriá B, Seguido MÁ, García-Cordero J, Bravo-Clemente L, Mateos R. Effect of Olive Pomace Oil on Cardiovascular Health and Associated Pathologies. Nutrients. 2022 Sep;14(19):3927.

[26] Roy S, Baker B, LaPierre S, Geary W, Delfausse L, Pasha E, et al. Effects of Whole Milk and Full-Fat Dairy Products on Blood Pressure in Patients with Elevated Blood Pressure. FASEB J. 2017;31 S1:1035–1.

[27] McGrane MM, Essery E, Obbagy J, Lyon J, Macneil P, Spahn J, et al. Dairy Consumption, Blood Pressure, and Risk of Hypertension: An Evidence-Based Review of Recent Literature. Curr Cardiovasc Risk Rep. 2011 Aug;5(4):287–98.

[28] Schmidt KA, Cromer G, Burhans MS, Kuzma JN, Hagman DK, Fernando I, et al. Impact of low-fat and full-fat dairy foods on fasting lipid profile and blood pressure: exploratory endpoints of a randomized controlled trial [Internet]. Am J Clin Nutr. 2021 Sep;114(3):882–92.