Relationship of Hypertension Control Factors with Blood Pressure in Hypertension Patients at Pandanwangi Primary Health Care Malang

CORRESPONDING AUTHOR Erna Dwi Wahyuni erna-d-w@fkp.unair.ac.id Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia ABSTRACT Introduction: Hypertension is a common cause of the increase of mortality rate and morbidiety in the community. Complications of hypertension cause approximately 9.4 deaths around the world each year. The purpose of this study is to analyze the relationship of factors controlling hypertension with blood pressure. Methods: This study used a descriptive correlational design with the cross sectional approach. The study population was patients with hypertension in Puskesmas Pandanwangi Malang City. The sample used as many as 96 people based on purposive sampling technique. The instruments used were questionnaire sheets, spyghmomanometer and stethoscope. Analysis using the test Spearman rho test with a significance level of p <0.005. Result: The results showed there are a relationship between knowledge (p = 0.000 and r = 0.778), attitude (p = 0.000 and r = 0.626), diet (p = 0.000 and r = 0.609), physical activity (p = 0.000 and r = 0.449), family support (p = 0.000 and r = 0.607), and medication adherence (p = 0.000 and r = 0.726) with blood pressure . Conclusion: There is a significant relationship and the direction between the knowledge, attitude, diet, physical activity, family support, and medication adherence with blood pressure.

every year, it is estimated that by 2025 there will be 1.5 billion people affected by hypertension, and it is estimated that each year 9.4 million people die from hypertension and its complications. Rikesdas (2018) data shows the prevalence of hypertension in

Meanwhile, based on International Health Metrics
Monitoring and Evaluation (IHME) data in 2017 in Indonesia, the cause of death in the first rank is caused by stroke, followed by ischemic heart disease which is a complication of hypertension (Ministry of Health, 2019).About 40% of deaths at a young age are due to uncontrolled hypertension (Artiyaningrum, 2016). Data from the AHA (American Heart Association) in 2011, in America, from 59% of people with hypertension, only 34% whose blood pressure is controlled (Artiyaningrum, 2016).
An increase in blood pressure that lasts for a long time (persistent) can lead to complications or damage to the body's organ systems, such as the kidneys (kidney failure), heart (coronary heart disease), and brain (stroke) if not detected early and get proper treatment. adequate. Hypertension triggers the atherosclerotic plaque in the cerebral arteries and arterioles, which can cause arterial occlusion, ischemic injury and stroke as long-term complications (Yonata, 2016). Hypertension complications cause approximately 9.4 deaths worldwide each year. Hypertension causes at least 45% of deaths due to heart disease and 51% of deaths due to stroke. Deaths caused by cardiovascular disease, especially coronary heart disease and stroke are estimated to continue to increase to 23 (Datin, 2014).
Hypertension sufferers must be able to control their blood pressure in order to remain stable under normal conditions, this is aimed at avoiding complications and DRPs. According to JNC 8, the target stable blood pressure at <60 years of age is <140/90 mmHg, and at> 60 years of age it is <150/90 mmHg. Controlling blood pressure can be started by increasing the knowledge of patients and families about hypertension and its control, increasing attitudes and physical activity, adhering to diet and adhering to taking medication. Efforts to control blood pressure are not only the responsibility of sufferers, but family and health workers also play an important role in efforts to control blood pressure (Maharani & Syafrandi, 2017).
This study was conducted to prove the theory of Lawrence W. Green with the Precede-Proceed Model on health behavior in hypertensive patients in controlling their blood pressure. The aim is to analyze the relationship between hypertension control factors and blood pressure in hypertensive patients, which are grouped into three, namely predisposing factors, supporting factors, and driving factors (Nursalam, 2016).          Table 7 shows that as many as 44 respondents

DISCUSSION
Diabetes Based on the results of research conducted from May to June 2020, it is known that the majority of respondents are female and aged 56-65 years (late elderly). The majority of the respondents' last education was high school level or equivalent (Senior High School / equivalent) and did not have a smoking habit, and the majority of respondents consumed Amlodipine type drugs. Based on the results of this study, it is known that there is a significant and unidirectional relationship between knowledge, attitudes, diet, physical activity, family support and adherence to taking medication with blood pressure.

City
The results showed that the knowledge about controlling hypertension was related to blood pressure, where the higher the level of knowledge, the better the blood pressure of the respondents. This can be seen from the distribution of the frequency of Efforts that can be made by personnel include providing psychoeducation and / or education to hypertension sufferers and their families so that respondents' knowledge increases.

The Relationship Between Attitude and Blood
Pressure in Pandanwangi Health Center, Malang

City
The results showed that the attitude of controlling hypertension was related to blood pressure, where the better the attitude, the more controlled the blood pressure was. hypertension consume more sodium and don't eat fibrous foods and don't avoid fatty foods, it will be difficult to control blood pressure itself.

The Relationship between Physical Activity and
Blood Pressure at Pandanwangi Health Center,

Malang City
The results showed that the physical activity of controlling hypertension was related to blood pressure, where the better the physical activity of the respondents, the more controlled the blood pressure Based on this study, it was found that the majority of respondents had a negative physical activity pattern so that blood pressure was out of control. This is because the majority of respondents are late elderly (56-65 years), so that their ability to move is decreasing. Respondents also said that they tire easily during activities and there are complaints such as rheumatism or stiff pains. With less physical activity, blood pressure is getting out of control.
Efforts that can be made by respondents include getting used to small sports such as walking regularly, because the increased leg muscle strength when walking can increase the supply of oxygen to the heart and brain. Regular exercise will build muscle fitness, make it stronger, and of good quality in the amount of flexibility.

Relationship between Family Support and Blood
Pressure at Pandanwangi Health Center, Malang

City
The results showed that family support in controlling hypertension was related to blood pressure, where the better the support of families with hypertension, the better the respondent's blood pressure. In this study all respondents lived with their families, but when the study was conducted, many respondents conducted regular examinations at the health center. sector is the ability to recognize health problems, the ability to make decisions to overcome health problems, the ability to care for family members who are sick, the ability to modify the environment for the family to stay healthy and optimal, and the ability to take advantage of the health facilities available in their environment (Wahyudi & Arjun, 2020