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BIOMOLECULAR AND HEALTH SCIENCE JOURNAL 2020 OCTOBER VOL 03 (02)

ORIGINAL ARTICLE

Prevalence Proportion of Patient with Coronary Heart

Disease in Inpatient Room of RSUD Dr. Soetomo
Surabaya in 2017
Faradila Budi Saputri1, Dyah Fauziah2, Esti Hindariati3*
1
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
2
Department of Pathology Anatomy, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Hospital ,
Surabaya, Indonesia
3
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General
Hospital , Surabaya, Indonesia

ARTICLE INFO ABSTRACT

Article history: Introduction: Coronary heart disease (CHD) is the most common type of heart disease that causes
Received 18 September 2020 death. It occurs as a result of hardening of the coronary arteries which supply oxigen-rich blood
Received in revised form 26 to the entire heart muscle so that the heart can contract properly. However, many patients neglect
October 2020 the symptoms. Moreover, the risk factor and the comorbides disease worsen the condition. This
Accepted 29 October 2020 research aims to study the profile of coronary heart disease patients in the inpatient rooms at Dr.
Available online 31 October 2020 Soetomo General Hospital Surabaya in 2017.
Methods: This study was a cross-sectional and retrospective study by assessing patients’ medical
Keywords: record and analyzed descriptively.
Hypertension, Results: From total 587, 263 patiens met inclusion criteria, aged between 51-60 years (42.6%)
Coronary Heart Disease, with domination of male (82,13%). %). Risk Factors are into one of the Comorbidities of CHD
Dyslipidemia, Patient. There are Risk Factor can be aggravate of CHD Patients. Most of subjects had risk factor
Diabetes Mellitus. hipertension (50,79%), and hypertension with DM (38,7%). Hypertension based on systolic
pressure and diastolic pressure obtained that systolic pressure <120 mmhg was 39.6% and diastolic
*) Corresponding author: pressure <80 was 37.4%.
ehindariati@yahoo.com Conclusion: Most of CHD patients in this study were in age group 51 – 60 years old, male, had risk
factor hypertension and DM.

and has became the first leading mortality in global for

Introduction
last 15 years.3 Risk factors for CHD have been identified
Coronary heart disease (CHD) is caused by the by various studies outside, but research on risk factors
abnormality on the arteries of the coronary experienced for CHD has not been identified in Dr.Soetomo General
thickening on the wall blood vessels and interrupt the Hospital. Even though these risk factors can be used to
flow blood heading to the muscles of the heart impairs prevent prevention, diagnosis, and therapy. In addition,
its functions blood to the entire body.1 Cardiovascular profiles regarding risk factors can also be used as materials
disease is a non-communicable disease contributing for further implementation.
to a high mortality rate in the world. Mortality number Therefore, this research on coronary heart disease
of cardiovascular disease in the world in 2008 were 17 profile is made for clinical purposes for diagnosis and
millions. This numbers are predicted that will increase other therapies as well as for material in further research
year by year until it will reach 25 millions of mortality in at inpatient room in cardiovascular unit of Dr. Soetomo
2030. The death rate due to cardiovascular in Indonesia General Hospital, Surabaya in 2017
is still high.2 According to mortality numbers, there were
56.9 millions mortality in the world in 2016, it was more Methods
than half of 54% mortality caused by ischemic heart
disease and stroke as the biggest leading mortality in This research was a cross sectional study to describe
the world which caused 15.2 millions mortality in 2016 the profile of CHD patients in the inpatient room in the

Biomolecular and Health Science Journal.

Available at https://e-journal.unair.ac.id/BHSJ ; DOI: 10.20473/bhsj.v3i2.22094
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
 BIOMOLECULAR AND HEALTH SCIENCE JOURNAL 2020 OCTOBER VOL 03 (02) 93

cardiovascular unit of Dr. Soetomo General Hospital, many patients had normal blood pressure. This can happen
Surabaya. The study Design and protocol were approved because when taking data on the medical record, the patient
by the Ethics Committee of Dr.Soetomo General Hospital, has taken anti-hypertension drugs so that the coronary heart
Surabaya (Sertificate Number 0056/KEPK/II/2018). patient data has normal blood pressure.
The study population was all patients with CHD that Table 1. Profile of patients with CHD
hospitalized at Dr. Soetomo General Hospital, Surabaya
from January - December 2017. The inclusion criteria was Variable n Percentage(%)
patient with CHD in inpatient room in the cardiovascular Age n=263
unit of Dr. Soetomo General Hospital. In assessment ≤ 30 years 1 0,4
part on medical record at least 1 time, over the period 31 – 40 years 10 3,8
given, by the doctor on duty. The exclusion criteria were
incomplete medical record, missings medical record. 41 – 50 years 53 20,2
This study used secondary data from medical records. 51 – 60 years 112 42,6
All Subjects were collected who had some variable 61 – 70 years 66 25,1
with seen From Demography Patients seen Sex and Age 71 – 80 years 19 7,2
patients. History of comorbid disease such as patients with
comorbidities such as hypertension comorbidity, Diabetes > 80 years 2 0,8
mellitus (DM) comorbidity, patients with dyslipidemia Gender n=263
that can shown from laboratory result found high LDL Male 216 82,13
and combined from those comorbidities.Another variable Female 47 17,87
in this research are found from hypertension level. This
hypertension level seen from blood pressure levels systol Hypertension n=191
and dyastol. The analyzed data were then analyzed using Hypertension 97 50,79
IBM SPSS ver.16 for normality and then processed No Hypertension 94 49,21
using Microsoft Excel 2010. Quantitative variables Diabetes mellitus n=192
were presented as percentages or number of samples for
categorical variables. DM 76 39,58
No DM 116 60,42
Results Dyslipidemia n=165
Numbers of patients with coroner heart who were stayed
Dyslipidemia 56 33,94
at inpatient rooms in cardiovascular unit of Dr. Soetomo
General Hospital, Surabaya in 2017 were 587 patients. No Dyslipidemia 109 66,06
263 patients were included in this research, while 324 Risk factors n=151
patients were exclude, in details: 233 patients admitted not DM+HT 48 38,7
under diagnose of atherosclerosis but others such as: Old HT+Dislipid 26 9,3
myocardial infarction, aneurysm, and other causes. There
were 66 patients with CHD who stayed in inpatients room DM+Dislipid 47 37,3
other than cardiovascular unit. There were 25 data of medical HT+DM+Dislipid 30 14,7
record were lost and it had not been found yet. Systolic pressure n=263
Of 263 patients, 216 (82.1%) were male and 47 Normal 93 39,6
(17.9%) were female with most in age range of 51-60 years
(42.6%). The average of age of patients was 57.11 years Pre-Hypertension 59 21,4
(SD ± 9,472). the youngest patient in this research was 27 HT Stage 1 61 22,5
years, where as the oldest patient in this research was 83 HT Stage 2 50 16,5
years. The results showed that the age of 51-60 years is Diastolic pressure n=263
most at risk of CHD.
Risk factors are into one of the comorbidities of CHD Normal 89 37,4
Patient. From the comorbidity data, the domination patients Pre-Hypertension 102 45,1
who had hypertension were 97(50.8%), patients with no HT Stage 1 50 16,5
comorbidity of DM of 109 patients (66.6%) and patients HT Stage 2 22 1.1
with normal lipid who laboratorium result were normal
LDL of 116 (60.42%). Patients of CHD with more than 1
comorbidities as seen in table were with DM and HT 29
Discussion
patients (38.7%).
From the physical examination from blood pressure Our data shows the ratio of male and female reached 4.5
result of 263 patients, a number of 72 (39,6%) patients with :1. The similar result was obtained in the research done by
normal blood pressure had normal systolic blood pressure Irina F Prof. Kandou General Hospital, Manado in 2011
under 120 mmhg and as most patients had normal systolic with 54 males with percentage of 67.5% and total of female
pressure, while diastol level shown that most patients with were 26 with percentage of 32.5%.3 Gender was a factor
level diastol 82mmHg. Most patients with CHD were that can affect heart function and caused heart attack. Male
men who have had history of disease with HT and DM. had more tendency with CHD risk factors such as alcohol,
However, from the results of the hypertension staging, smoking, obesity and modern lifestyle that caused heart
 BIOMOLECULAR AND HEALTH SCIENCE JOURNAL 2020 OCTOBER VOL 03 (02) 94

damage. Women suffered CHD in older age, over 60 years was referred to as the “Lipid Triad”. Atherosclerosis was a
old, about 5-10 years slower than men. It was considered form of ateriosclerosis that mainly affected the intima layer
because of estrogen hormone gave protection to heart and and generally occurred in large and medium muscular
blood vessels through increasing levels of High-Density arteries and it was an underlying disorder of ischemic heart
Lipoprotein (HDL) or good cholesterol.3 disease.13
Age is indeed one of the non-modified factors DM is very influential in early atherosclerosis which
inherent in humans. It would also lead to a decrease in the can lead to CHD. In addition, the role of insulin is very
functioning of organs including the weakening of the heart influential in lipid metabolism.10 Uncontrolled DM will
muscle contraction and heart rate.4 This could also lead to increase cholesterol and triglycerides.9
a decrease in the elasticity of blood vessels when draining Study result done in 2017 Allauddin Makassar was
blood, which would cause easy buildup of blood vessel obtained as a result of normal systolic blood pressure of
plaque. If this occurrs continuously, it would resulting in less than 120 mmh of 29 people with a percentage of 32.6%
atherosclerosis and narrowing the blood vessel lumen. Thus, and it was the highest number. It was the result with the
blood to the heart will be hampered and CHD occurs.5 At highest number compared to other hypertension stagging
the time, the condition of someone in the older age group values based on diastolic pressure.10 It was also studied the
will experience increased susceptibility to cardiovascular stage of hypertension based on JNC VII obtained results
disease, including CHD.6 Degenerative processes appear in that more risk factors associated with CHD were affected
blood vessels so that atherosclerosis occurred and resulted by hypertension 41 of 78 respondents (60%).14 Different
in CHD that had an impact on myocardial infarction which results were also shown in Kautzar Rizky’s study of 611
increases up to 5 times.7 respondents 60 (9.8%) who were affected by hypertension.
Hypertension comorbid was one of the causes of The differences in result from this study was due to
CHD. Research conducted in the inpatient department differences in sampling and the time of research. Many
of cardiology at Dr. Kariadi General Hospital, Semarang aspects still out of discussion from this study, like lifestyle
in the period of April - June 2011 the results of history from patients. This aspect is important to know if
hypertension sufferers were more than 89 people with a CHD condition may come from bad lifestyle, regarding
percentage 69.50.8 High blood pressure and sedentary the domination of lifestyle cause of CP from this study.
would cause direct trauma to the walls of the coronary Data about CHD patients in Indonesia is still minimal, thus
arteries. Therefore, it facilitated coronary atherosclerosis many references coming from other country may have
(coronary factors). This caused angina pectoris, coronary different sociodemographic background.
insufficiency and myocardial infarction which were
symptoms of CHD more frequently found in hypertension Conclusion
patients compared to normal people.9 High blood pressure The most age range was 51-60 years, dominated by male
in the arteries continuously together with the presence of patients. Risk factors of patients with coroner heart were
plaque accumulation of fat or blood flow so that the lumen hypertension, DM and dyslipidemia. The highest result
of the blood vessels would become narrower.8 shows comorbid hypertension and also accompanied by
Based on this study, 39.6% subjects suffered CHD with DM suffered CHD the most. Based on the criteria of JNC
DM comorbid. From these results, it was also in line with VII it is concluded that the blood pressure values in most
several studies those carried out in Makassar’s conducted patients were normal systolic pressure less than 120 mmHg
that showed that 95.5% of the samples did not suffer DM. and pre-hypertension diastolic pressure 80-89mmHg.
High number of differences from the results of this study
because in the research conducted at Makassar, it used Acknowledgement
primary data on residents in the Makassar area in 2017.10 The researcher says thank you to all those involved in this
The research conducted by Supriyono 2008 resulted in writing. They cannot be mentioned one by one and thank
25 people suffering from DM who were also affected by you to the medical record staff of Dr. Soetomo General
CHD.3 Coronary and peripheral atherosclerosis were the Hospital who helped in collecting data for this study.
main causes of morbidity and mortality in diabetics. In Funding: No funding sources.
order to reduce cardiovascular risk in diabetes, it should
carefully control blood glucose, correct obesity by diet and Conflict of Interest
exercise, stop smoking,11 correction of abnormal plasma
The author stated there is no conflict of interest
lipids, and control of blood pressure was important.12
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