Pengaruh Kombinasi Jus Alpukat (Persea americana Mill.) dan Melon Honeydew (Cucumis melo L.) terhadap Tekanan Darah Normal Perempuan Dewasa.

iv

ABSTRAK

PENGARUH KOMBINASI JUS ALPUKAT

(Persea americana Mill.) DAN

MELON HONEYDEW (Cucumis melo L.)

TERHADAP TEKANAN DARAH NORMAL

PEREMPUAN DEWASA

Inneke Frieska F, 2015.

Pembimbing I : Julia Windi Gunadi, dr., M. Kes Pembimbing II : Rizna Tyrani R., dr., M. Kes

Pola hidup sehat semakin banyak dipraktikkan oleh masyarakat luas dan telah terbukti dapat mengurangi risiko penyakit, salah satunya yaitu hipertensi. Pencegahan hipertensi dapat dilakukan dengan menambahkan konsumsi jus buah-buahan, seperti kombinasi jus alpukat (Persea americana Mill.) dan melon honeydew (Cucumis melo L.).

Tujuan penelitian ini adalah untuk mengetahui pengaruh kombinasi jus alpukat dan melon honeydew dalam menurunkan tekanan darah normal perempuan dewasa. Penelitian ini merupakan eksperimental semu dengan desain pre test dan post test. Subjek penelitian terdiri atas 30 orang berjenis kelamin perempuan berusia 18-25 tahun. Data yang diukur adalah tekanan darah sebelum dan sesudah minum jus kombinasi alpukat dan melon honeydew. Analisis data menggunakan uji “t” berpasangan dengan α=0,05. Pengukuran tekanan darah dengan menggunakan metode gabungan palpasi-auskultasi.

Hasil penelitian menunjukkan terdapat perbedaan yang sangat signifikan diantara rerata tekanan darah sistolik sesudah diberi minum jus kombinasi alpukat dan melon honeydew (96,4 mmHg) dan sebelum diberi minum jus kombinasi alpukat dan melon honeydew (107,67 mmHg) dengan p=0,000, sedangkan rerata tekanan darah diastolik sesudah diberi minum jus kombinasi alpukat dan melon honeydew (65 mmHg) berbeda sangat signifikan dari sebelum diberi minum jus kombinasi alpukat dan melon honeydew (69 mmHg) dengan p=0,000.

Simpulan penelitian ini adalah kombinasi jus alpukat dan melon honeydew menurunkan tekanan darah normal perempuan dewasa.

Kata kunci : alpukat, melon, tekanan darah

ABSTRACT

THE EFFECT OF AVOCADO (Persea americana Mill.) AND

HONEYDEW MELON (Cucumis melo L.) JUICE COMBINATION

ON NORMAL BLOOD PRESSURE IN ADULT WOMEN

Inneke Frieska F, 2015.

1st Supervisor : Julia Windi Gunadi, dr., M. Kes 2nd Supervisor : Rizna Tyrani R., dr., M. Kes

Healthy lifestyle has been practiced by people nowadays and has been proven could reduce the risk of diseases, one of them is hypertension. Prevention of hypertension can be done by consuming fruit juices, such as avocado (Persea americana Mill.) and honeydew melon (Cucumis melo L.) juice combination.

The objective of this research was to determine the effect of avocado and honeydew melon juice combination on decreasing normal blood pressure in adult women.

This research was a quasi experimental with pre test and post test design. The subject consisted of thirty adult women aged 18-25 years old. The data measured was blood pressure, before and after given avocado and honeydew melon juice combination. The data was analysed using paired t test with α=0.05. The blood pressure was measured using palpatory-auscultatory method.

The result showed that there were highly significant differences between the average systolic blood pressure after given avocado and honeydew melon juice combination (96.4 mmHg) and before given avocado and honeydew melon juice combination (107.67 mm Hg) with p=0.000; for the average diastolic blood pressure after given avocado and honeydew melon juice combination (65 mmHg) was also highly significant different than before given avocado and honeydew melon juice combination (69 mmHg) with p=0.000.

The conclusion is avocado and honeydew melon juice combination decreases normal blood pressure in adult women.

viii

DAFTAR ISI

Halaman

LEMBAR JUDUL ... i

LEMBAR PERSETUJUAN ... ii

SURAT PERNYATAAN ... iii

ABSTRAK ... iv

ABSTRACT ... v

KATA PENGANTAR ... vi

DAFTAR ISI ...viii

DAFTAR TABEL ... xi

DAFTAR GAMBAR ... xii

DAFTAR LAMPIRAN ...xiii

BAB I PENDAHULUAN 1.1 Latar Belakang ... 1

1.2 Identifikasi Masalah ... 2

1.3 Maksud dan Tujuan Penelitian ... 3

1.3.1 Maksud ... 3

1.3.2 Tujuan ... 3

1.4 Manfaat Penelitian ... 3

1.4.1 Manfaat Akademis ... 3

1.4.2 Manfaat Praktis ... 3

1.5 Kerangka Pemikiran dan Hipotesis Penelitian ... 3

1.5.1 Kerangka Pemikiran ... 3

1.5.2 Hipotesis ... 5

BAB II TINJAUAN PUSTAKA

2.1 Pembuluh Darah dan Tekanan Darah ... 6

2.2 Faktor-faktor yang Memengaruhi Tekanan Darah ... 7

2.2.1 Faktor-faktor Utama yang Memengaruhi Tekanan Darah ... 7

2.2.2 Faktor -faktor Tambahan yang Memengaruhi Tekanan Darah ... 9

2.3 Sistem Renin Angiotensin ... 14

2.4 Pengukuran Tekanan Darah ... 16

2.5 Alpukat (Persea americana Mill.) ... 19

2.5.1 Taksonomi ... 19

2.5.2 Sejarah dan Perjalanan Melintasi Benua ... 20

2.5.3 Kandungan Alpukat ... 20

2.5.4 Manfaat Alpukat ... 21

2.5.5 Efek Alpukat terhadap Tekanan Darah ... 23

2.6 Melon Honeydew (Cucumis melo L.)... 24

2.6.1 Taksonomi ... 24

2.6.2 Sejarah dan Perjalanan Melintasi Benua ... 24

2.6.3 Kandungan Melon ... 25

2.6.4 Manfaat Melon ... 26

2.6.5 Efek Melon terhadap Tekanan Darah ... 27

BAB III BAHAN DAN METODE PENELITIAN 3.1 Alat, Bahan dan Subjek Penelitian ... 28

3.1.1 Alat dan Bahan Penelitian ... 28

3.1.2 Subjek Penelitian ... 28

3.1.3 Ukuran Sampel ... 29

3.2 Lokasi dan Waktu Penelitian ... 30

x

3.3.1 Desain Penelitian ... 30

3.3.2 Data yang Diukur ... 30

3.3.3 Variabel Penelitian ... 30

3.4 Prosedur Kerja ... 31

3.4.1 Persiapan Sebelum Tes ... 31

3.4.2 Persiapan Bahan Uji ... 31

3.4.3 Cara Pemeriksaan ... 31

3.4.3.1 Prosedur Pengukuran Tekanan Darah ... 31

3.4.3.2 Prosedur Penelitian ... 32

3.4.4 Uji Pendahuluan ... 32

3.5 Analisis Data ... 33

3.6 Aspek Etik ... 34

BAB IV HASIL DAN PEMBAHASAN 4.1 Hasil Penelitian ... 35

4.2 Pembahasan ... 36

4.3 Pengujian Hipotesis Penelitian ... 37

BAB V SIMPULAN DAN SARAN 5.1 Simpulan ... 39

5.2 Saran ... 39

DAFTAR PUSTAKA ... 40

LAMPIRAN ... 46

RIWAYAT HIDUP ... 52

DAFTAR TABEL

Tabel 2.1 Kandungan Alpukat ... 21 Tabel 2.2 Kandungan Melon ... 25 Tabel 4.1 Hasil Uji t Berpasangan Tekanan Darah Sistolik Sesudah Meminum

Kombinasi Jus Alpukat dan Melon Honeydew ... 35 Tabel 4.2 Hasil Uji t Berpasangan Tekanan Darah Diastolik Sesudah Meminum

xii

DAFTAR GAMBAR

Gambar 1.1 Efek Alpukat dan Melon terhadap Tekanan Darah ... 4

Gambar 2.1 Faktor Utama yang Memengaruhi Tekanan Darah ... 9

Gambar 2.2 Sistem Renin Angiotensin ... 15

Gambar 2.3 Pengukuran Tekanan Darah dengan Cara Palpasi... 16

Gambar 2.4 Pengukuran Tekanan Darah dengan Cara Auskultasi ... 17

Gambar 2.5 Oscilometer ... 19

Gambar 2.6 Alpukat ... 20

Gambar 2.7 Melon Honeydew ... 24

DAFTAR LAMPIRAN

Lampiran 1 Tekanan Darah Sistolik Sebelum dan Sesudah Meminum Kombinasi Jus Alpukat dan Melon Honeydew ... 46 Lampiran 2 Tekanan Darah Diastolik Sebelum dan Sesudah Meminum Kombinasi

Jus Alpukat dan Melon Honeydew ... 47 Lampiran 3 Hasil Uji “t” Berpasangan Tekanan Darah Sistolik dan Diastolik 48 Lampiran 4 Surat Pernyataan untuk Ikut Serta dalam Penelitian

(Informed Consent) ... 49 Lampiran 5 Surat Keputusan Komisi Etik Penelitian ... 50 Lampiran 6 Dokumentasi ... 51

1 BAB I PENDAHULUAN

1.1Latar Belakang

Pola hidup sehat semakin banyak dipraktikkan oleh masyarakat luas seiring dengan meningkatnya kesadaran tentang manfaat pola hidup sehat. Beberapa hal yang termasuk dalam pola hidup sehat yaitu tidak merokok, mengonsumsi alkohol dalam jumlah sedikit, melakukan olahraga sedikitnya tiga kali dalam seminggu, mengonsumsi sayur dan buah-buahan kaya serat setiap hari, dan memiliki body mass index (BMI) kurang dari 25 (Phillip, 2012).

Dari beberapa penelitian yang telah dilakukan, pola hidup sehat terbukti dapat mengurangi risiko terkena berbagai macam penyakit, salah satunya adalah hipertensi (Chow, 2008). Hipertensi meningkatkan tingginya risiko terkena beberapa penyakit yang membahayakan jiwa, yaitu serangan jantung, stroke, gagal jantung kronis, dan penyakit ginjal (CDC, 2015).

Di seluruh dunia, hipertensi diperkirakan menyebabkan 12,8% dari total kematian di dunia (WHO, 2015). Kriteria hipertensi yang digunakan pada penetapan kasus merujuk pada kriteria diagnosis JNC VII 2003, yaitu hasil pengukuran tekanan darah sistolik ≥140 mmHg atau tekanan darah diastolik ≥ 90 mmHg (NHLBI, 2003).

Menurut laporan hasil Riset Kesehatan Dasar (Riskesdas) sebagian besar penderita hipertensi di Indonesia belum terdiagnosis. Pada tahun 2013, prevalensi hipertensi berdasarkan jenis kelamin lebih banyak pada perempuan dibandingkan dengan laki-laki (Riskesdas, 2013).

Penderita hipertensi seharusnya meminum obat setiap hari, tetapi rutinitas ini sering tidak disukai penderita karena membuat bosan dan konsumsi obat dalam jangka panjang membuat penderita takut pada efek sampingnya (Nurrahmani, 2012). Oleh karena itu, dilakukan beberapa upaya untuk mencegah hipertensi. Salah satu cara mencegah hipertensi dapat dilakukan melalui program nutrisi dari The DASH (Dietary Approaches to Stop Hypertension), yang merupakan diet

rendah lemak, tinggi buah-buahan dan sayuran (McKinley Illinois, 2008). Buah-buahan yang dianjurkan adalah buah-buahan yang berefek menurunkan tekanan darah, misalnya alpukat dan melon honeydew (Hammond, 2013). Masyarakat umumnya hanya mengonsumsi satu buah saja, sedangkan yang disarankan oleh The DASH adalah mengonsumsi lebih dari 8 buah dan sayuran tiap harinya (Hammond, 2013), untuk memenuhi hal ini masyarakat dapat mengombinasikan antara 2 buah yang berbeda, misalnya kombinasi buah alpukat dan melon honeydew.

Buah alpukat merupakan sumber kalium dan asam folat yang berfungsi dalam menjaga kesehatan jantung (Megan, 2015). Buah melon mengandung kalium dan choline sehingga dapat digunakan untuk terapi dalam mencegah hipertensi (Murray, 2014).

Fransiskus Balpon pada tahun 2010 melakukan penelitian tentang efek buah alpukat (Persea americana Mill.) terhadap tekanan darah wanita dewasa muda, menggunakan 146 gr buah alpukat yang setara dengan 200 ml jus alpukat. Hasil penelitian tersebut menunjukkan bahwa jus alpukat menurunkan tekanan darah normal. Demikian pula telah dilakukan penelitian terhadap buah melon honeydew (Cucumis melo L.) pada tahun 2010 oleh Eufracia Ratna dengan menggunakan 265 gr buah melon honeydew yang setara dengan 250 ml jus melon. Hasil penelitian tersebut menunjukkan bahwa jus melon dapat menurunkan tekanan darah normal perempuan dewasa.

Kombinasi kedua buah ini diharapkan memberikan hasil yang sinergis dalam menurunkan tekanan darah. Oleh karena itu, penelitian ini bertujuan untuk membuktikan pengaruh kombinasi jus alpukat dan melon honeydew terhadap penurunan tekanan darah.

1.2Identifikasi Masalah

Apakah kombinasi jus alpukat dan melon honeydew menurunkan tekanan darah normal perempuan dewasa.

3 1.3Maksud dan Tujuan Penelitian

1.3.1 Maksud Penelitian

Memperoleh terapi untuk mencegah hipertensi dengan menggunakan kombinasi jus alpukat dan melon honeydew.

1.3.2 Tujuan Penelitian

Mengetahui penurunan tekanan darah setelah pemberian kombinasi jus alpukat dan melon honeydew pada perempuan dewasa.

1.4Manfaat Penelitian

1.4.1 Manfaat Akademis

Memperluas pengetahuan tentang pengaruh buah alpukat dan melon honeydew dalam menurunkan tekanan darah.

1.4.2 Manfaat Praktis

Masyarakat dapat menggunakan kombinasi jus alpukat dan melon honeydew sebagai terapi untuk mencegah hipertensi.

1.5Kerangka Pemikiran dan Hipotesis Penelitian

1.5.1 Kerangka Pemikiran

Alpukat (Persea americana Mill.) mengandung beberapa zat yang diduga memengaruhi tekanan darah, yaitu kalium dan asam folat.

Kalium dapat menurunkan tekanan darah dengan cara menghambat kontraksi otot jantung, menekan sekresi renin, menyebabkan vasodilatasi pembuluh darah, dan meningkatkan ekskresi ion natrium (Oates & Brown, 2001).

Asam folat berperan dalam penurunan kadar homosistein dalam darah sehingga vasokonstriksi terhambat, elastisitas pembuluh darah meningkat, serta konsentrasi NO meningkat. Hal ini menyebabkan TPR menurun sehingga tekanan darah menurun (Qipshidze et al, 2010).

Melon honeydew (Cucumis melo L.) memiliki kandungan kalium dan choline sehingga dapat membantu menurunkan tekanan darah, dan juga mengurangi dampak dari makanan yang bernatrium tinggi di mana makanan tersebut akan memperburuk kesehatan jantung.

Choline berperan dalam menurunkan kadar homosistein yang menyebabkan terjadinya vasodilatasi sehingga Total Peripheral Resistance (TPR) berkurang kemudian tekanan darah menurun (Volek, 2015).

Efek kandungan alpukat dan melon terhadap penurunan tekanan darah secara ringkas dapat dilihat pada bagan di bawah ini:

5 1.5.2 Hipotesis

Kombinasi jus alpukat dan melon honeydew menurunkan tekanan darah normal perempuan dewasa.

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