INFLUENCE OF YOGA ON THE BLOOD PRESSURE OF ELDERLY WITH HYPERTENSION

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1 doi: /mjmr.218.v2i3.4 INFLUENCE OF YOGA ON THE BLOOD PRESSURE OF ELDERLY WITH HYPERTENSION Mariza Elvira Nabila Nursing Academy, Padang Panjang City, West Sumatera, Indonesia Corresponding Author s mariza_elvira@yahoo.com ABSTRACT According to WHO (World Health Organization) about 972 million people in the earth suering rom hypertension that occurs in the elderly over the age o 6 years. The purpose o this study is to determine the eect o yoga exercises on blood pressure in the elderly who experienced hypertension in Social House Trisna Werdha Kasih Sayang Ibu Batusangkar. This research was conducted in April to May 217 with quantitative methods. The instrument used was the observation sheet with elderly respondents who suered rom hypertension as many as people that meet the criteria with Sampling. The statistical test used is Dependent t-test. The results o statistical tests showed a signiicant inluence between elderly blood pressure beore yoga gymnastics and ater yoga exercises with p value =. (<.5). So it can be concluded that there is a relationship o yoga exercises with blood pressure.it is expected to Trisna Werdha Kasih Sayang Ibu at Batusangkar Social House to be able to make this yoga gymnastics as one o the main program or elderly. Keywords: Yoga Gymnastics, Blood INTRODUCTION Elderly are at high risk or degenerative diseases, such as Coronary Heart Disease (CHD), hypertension, diabetes mellitus, gout (rheumatism) and cancer. One o the diseases oten experienced by the elderly is hypertension (Dalimartha, 28). or high blood disease is a disorder o the blood vessels that result in oxygen supply and nutrients, which are carried by the blood obstructed to the tissues o the body in need (Sustrani, 26). The incidence o hypertension increases with age. A person over 6, (5-6) has a blood pressure greater than or equal to 14/9 mmhg. This is a degenerative inluence that occurs in people who are getting older. is a multiactorial disease that arises because o the interaction o various actors. With increasing age, the blood pressure will also increase. Ater the age o 45 years, the arterial wall will experience thickening due to the accumulation o collagen substances in the muscle layer, so that the blood vessels will gradually become narrow and sti. Systolic blood pressure increases as lexibility o the large blood vessels diminishes in age to the seventh decade, whereas diastolic blood pressure increases until the ith and sixth decades then persists or tends to declinen (Dalimartha, 28). World Health Organization (WHO) data show that worldwide, about 972 million people or 26.4 o the world's population suer rom hypertension (26.6) and 26.1 o women. This igure is likely to increase to 29.2 by 23. O 972 million people with hypertension, 333 million are in developed countries and 639 are in developing countries, including Indonesia (WHO, 2).WHO data in 29 showed elderly who had a history o hypertension amounted to (7.49) o the total population, in 211 to (7.69) and in 213 obtained elderly proportion o (8.1) o total population (WHO, 2). Nationally (25.8) o Indonesia's population suer rom hypertension disease. I the current population o Indonesia amounted to inhabitants then there are 65,48,11 people who suer rom hypertension (Ministry o Health, Republic o Indonesia,213). Based on a national health basic research survey (Ministry o Health, Republic o Indonesia, 213) hypertension has a high prevalence o In addition, hypertension control is not yet adequate despite the availability o many eective medicines (Depkes, 213). According to data (Ministry o Health, Republic o Indonesia, 213). Prevalence o hypertension in elderly age years old (45.9), age years old (57.6), and age 75 years old (63.8). The number o hypertension cases in some provinces in Indonesia has Malaysian Journal o Medical Research Vol. 2 (3) JULY 218 3

2 exceeded the national average, rom 33 provinces in Indonesia there are 8 provinces with hypertension cases exceeding the national average: South Sulawesi (27), West Sumaetra (27), West Java ( 26), East Java (25), North Sumatera (24), South Sumatra (24), Riau (23) and East Kalimantan (22) (Ministry o Health, Republic o Indonesia, 213). In accordance with data rom BPS West Sumatra Province, hypertension patients (31.2) while national data reached (31.7) (Proil Kesehatan Provinsi Sumatera Selatan, 214). in elderly can be prevented or treated. There are various ways to treat hypertension, among others, by taking blood pressurelowering drugs, dietary regulation, exercise, reduce stress, avoid alcohol and cigarettes. In addition to lowering blood pressure can also use the concept o holistic nursing (Koizer & Erb, 21). Holistic is one o the underlying concepts o nursing actions that include the physiological, psychological, socio-cultural, and spiritual dimensions. The dimension is a uniied whole, i one dimension is disturbed will aect other dimensions. In holistic nursing there are our great modalities o healing, such as touch therapy (massage, acupressure, oot relexology and reiki), mind-body (exercise) therapy (progressive relaxation, biological eedback, imagination, yoga, meditation, prayer, music therapy, laughter, hypnosis and aroma therapy), transpersonal therapy (non-contact therapeutic touch and intermediate prayer) and alternative treatment therapies (acupuncture and oriental medicine, chiropathic, herbal remedies, homeopathy and naturopathy). Apart rom the above therapy, exercise can also cure hypertension (Koizer & Erb, 21). at harmonious development o body and mind and covers all aspects o human lie that lead to physical well being, mental harmony culminating into positive thinking, happiness and peace (Marchanda & Madan, 215).Yoga combines breathing, relaxation and mediation techniques and stretching exercises. Yoga is recommended in people with hypertension, because yoga has a relaxing eect that can improve blood circulation throughout the body. Smooth blood circulation indicates good heart work (Marchanda & Madan, 215). According to Pangaribuan & Bewari (216) the inluence o gymnastics yoga, heart, elderly gymnastics and aerobics in lowering blood pressure in the elderly research results obtained that regular exercise exercises can reduce the value o blood pressure in the elderly who all into the category o hypertension.while a research Wol et.al.,(213) about Impact o yoga on blood pressure and quality o lie in patients with hypertension a controlled trial in primary care, matched or systolic blood pressure. The result shows that the yoga class group showed no improvement in blood pressure or sel-rated quality o lie, while in the yoga at home group there was a decline in diastolic blood pressure o 4.4 mmhg (p<.5) compared to the control group. Moreover, the yoga at home group showed signiicant improvement in sel-rated quality o lie compared to the control group (p <.5). Kinasih (21) also conducted research on the eect o yoga practice on improving the quality o lie. The results show that yoga exercises have an eect on the physical, psychological and spiritual.dinata (215) in his research on how to lower blood pressure in the elderly through yoga gymnastics concluded that every part o yoga practice has good beneits or the body especially to lower blood pressure, so yoga is highly recommended in people with high blood pressure. Exercise is one o the physical and psychological activities o someone who is useul to maintain and improve the quality o one's health. Exercise, which can lower high blood pressure, is part o the eort to reduce weight and manage stress, two actors that enhance hypertension. By doing the right movement or 3-4 minutes or as much as at least 3 days and a maximum o 4 days per week can lower blood pressure as much as 1 mmhg on systolic and diastolic readings. Sports that can be done by elderly with hypertension one o them is yoga gymnastics. Yoga is a uniying mechanism o the body (body), mind and soul (Marchanda & Madan, 215). According to Hagins et al.,(213), eectiveness o Yoga or hypertension. Results show that all 17 studies included in the review had unclear or high risk o bias. Yoga had a modest but signiicant eect on systolic blood pressure p=.2 and diastolic blood pressure p=.1. The results o the initial survey conducted by researchers obtained the number o elderly as many as 7 people. O 7 elderly people there are elderly people who have a history o hypertension, which consists o 8 men and 4 women. Yoga is an integrated system o sel culture, which aims The results o interviews conducted by researchers with 31 Vol. 2 (3) JULY 218 Malaysian Journal o Medical Research

3 3 oicers that have never applied yoga exercises. Nurses also said that elderly people had blood pressure above 14/11 mmhg with cardiac complications and diabetes mellitus. According to 3 elderly people also argued that the rise in blood pressure is oten caused by stress actors, thoughts, and the inluence o ood purchased outside without permission rom the oicer. Elderly said not knowing about yoga gymnastics, because it has never been done. Based on this, researchers interested in researching about the "Inluence o Yoga Gymnastics Against Blood In The Elderly With In The Tresna Werdha Kasih Sayang Ibu at Batusangkar Social House". METHODOLOGY The research method used in this research is quantitative method. This study to determine the eect o yoga gymnastics on blood pressure elderly who experience hypertension in Trisna Werdha Kasih Sayang Ibu at Batusangkar Social House. The research design used in this research is the type o Preexperimental Design research design using the one group pretest-posttest research design is a study with no control group, but it has been done the irst observation (pretest) that allows research can test the change changes that occur ater an experiment (Sugiyono, 28). agreement to be sampled, then the researchers collect elderly who are willing to be sampled in the Hall o Tresna Werdha Kasih Sayang Ibu at Batusangkar Social House. Then the researchers explain briely about the purpose o research and the beneits o gymnastics yoga. Ater that the researchers measured the respondent's blood pressure to serve as pretest data. The researchers recorded the results o blood pressure in the observation sheet. Ater 1 minutes, researchers started doing yoga exercises against the respondents with the duration o doing yoga exercises or 3-6 minutes. Ater doing gymnastics o yoga, respondents are invited to rest or a while or 3 minutes, then the researchers do the blood pressure o respondents back to be used as data Postest. Then do the recording on the observation sheet. Ater all collected or 3 weeks, the researchers reviewed whether the observation sheet and demographic data o the respondents were completed or not. In doing the analysis, the data irst processed with the aim o converting data into inormation. In statistics, the inormation obtained is used or the decision-making process, especially in hypothesis testing.the data analysis used is T dependent or paired sample test to test mean dierence between two dependent data groups (Hastono, 26). RESULTS Ater the data is collected then processed by computerized and presented in the orm o Diagram and table below. With the design orm as ollows: Table 1: Research Design Q1 X Q2 Pre-Test Yoga Gymnastics Post-Test Table 2: Frequency Distribution o Blood Beore Gymnastic Yoga Based on Systolic Blood The sample is part o the population to be studied or part o the number o characteristics possessed by the population (Hastono, 26). In this study the sample taken by researchers as many as people.this research uses Sampling method where all population is taken as sample (Hidayat, 27). In this study data collection is done by using the implementation o Yoga Gymnastics and observation sheet. This study was conducted or 3 weeks with the implementation o yoga exercises or 3-6 minutes. Researchers visit the elderly who became respondents to each - each guest house. Ater the respondent signed an Systolic Mild hypertension Moderate hypertension Severe hypertension Malignant hypertension beore doing gymnastics yoga there are hal respondents who suer rom hypertension with systolic blood pressure is on the scale o moderate hypertension is 6 people (5). Malaysian Journal o Medical Research Vol. 2 (3) JULY

4 Table 3: Frequency Distribution o Blood Beore Yoga Gymnastics Based on Diastolic Blood Diastolic Mild Moderate Severe Malignant Table 4: Frequency Distribution o Blood Ater Yoga Gymnastics Based on Systolic Blood ater doing gymnastic yoga there are hal respondents who suer rom hypertension with systolic blood pressure is on the scale o mild hypertension is 6 people (5). Table 5: Frequency Distribution o Blood Ater Yoga Gymnastics Based on Diastolic Blood Dastolic Mild Moderate Severe Malignant 5 7 Table 6: Mean o Systolic and Diastolic Blood Variabe l Systolic beore and ater yoga exercises beore doing gymnastics yoga there are more than hal o respondents who suer rom hypertension with diastolic blood pressure is on the scale o mild hypertension is 8 people (66.7). Systolic Mild Moderate Severe Malignant ater doing gymnastic yoga there are more than hal o respondents who suer rom hypertension with diastolic blood pressure is on the scale o mild hypertension is 7 people (58.3) Diastolic beore and ater yoga exercises Mean SD p value Based on the above table it can be seen that the average systolic blood pressure beore and ater doing gymnastic yoga is 5, with standard deviation 2,923. While the mean diastolic blood pressure beore and ater doing gymnastic yoga is 6,5 with standard deviation 2,276. The result o T test on systolic blood pressure beore and ater yoga exercises got p value =. (p value <,5) meaning there is signiicant dierence between systolic blood pressure beore and ater doing yoga gymnastics and T test result on diastolic blood pressure beore and ater yoga exercises p value =, (p value <.5) means that there is a signiicant dierence between diastolic blood pressure beore and ater doing yoga exercises. So it can be concluded that there is inluence o yoga exercises on blood pressure elderly who have hypertension. DISCUSSION The results showed that at the time ater doing gymnastic yoga there are 6 respondents with systolic blood pressure is on the scale o mild hypertension (5). While at the time ater doing yoga exercises there are 7 respondents with diastolic blood pressure is on the scale o mild hypertension (58.3). The mean systolic blood pressure beore and ater yoga exercises was 5. with a standard deviation o While the mean diastolic blood pressure beore and ater doing gymnastic yoga is 6.5 with standard deviation The result o statistical test showed that systolic blood pressure beore and ater yoga exercise got p value =, (p value <,5) meaning that there is signiicant dierence between systolic blood pressure beore and ater doing yoga gymnastics and T test result on diastolic blood pressure beore and ater yoga exercises P value = 33 Vol. 2 (3) JULY 218 Malaysian Journal o Medical Research

5 , (P value <.5) means there is a signiicant dierence between diastolic blood pressure beore and ater doing yoga exercises. So it can be concluded that there is inluence o yoga exercises on blood pressure elderly who have hypertension. The results are supported by Pangaribuan & Bewari's research (216) on the inluence o gymnastics yoga, heart, elderly gymnastics and aerobics in lowering blood pressure in the elderly research results obtained that regular exercise exercises can reduce the value o blood pressure in the elderly who all into the category o hypertension. This is also in line with the study o Wol et.al., (213) on the impact o yoga on blood pressure and quality o lie in people with hypertension. The results showed that the yoga class did not show any increase in blood pressure or quality o lie alone, while in the yoga group at home decreased diastolic blood pressure o 4.4 mmhg (p <.5) compared with the control group In addition, the yoga group at home shows signiicant selimprovement compared to the control group (p <.5). The same study also conducted Kinasih (21) about the inluence o yoga practice on improving the quality o lie. The results show that yoga exercises have an eect on the physical, psychological and spiritual. While Dinata (215) in his research on how to lower blood pressure in the elderly through yoga gymnastics concluded that every part o yoga practice has good beneits or the body especially to lower blood pressure, then yoga is highly recommended in people with high blood pressure. The same is revealed by Hagins et al., (213) in his research on the Eectiveness o Yoga or shows that Yoga has a simple but signiicant eect on systolic blood pressure with p-values=.2 and diastolic blood pressure with p =.1). This study is also supported by the theory o Marchanda & Madan (215) which states that yoga can regularly reduce the 'aldosterone' stress hormone which is a powerul vasoconstrictor that can increase blood pressure. Regular yoga exercises can reduce the 'vasopressin' o other stress hormones secreted by the pituitary gland in the brain that can increase vasopressin through the contraction o blood vessels. Yoga is recommended in people with hypertension, because yoga has a relaxing eect that can improve blood circulation throughout the body. Smooth blood circulation indicates good heart work (Marchanda & Madan, 215). From the results o research and theory above researchers analyze that yoga gymnastics does have a relationship or it can aect a person's blood pressure. This has been proven by researchers and also previous researchers. But there are also some studies that the results are unrelated, perhaps because o respondents' actors, wrong or incorrect time and possibly due to inappropriate techniques. Because to get good results that someone must also do gymnastics yoga regularly, on time implementation, exactly how to do it, then someone also must do gymnastics yoga seriously because in doing yoga gymnastics one must ocus his mind. As we know that blood pressure will be normal i someone's mind is calm, so yoga exercises done with a calm mind and his intentions come rom himsel rather than coercion rom others. CONCLUSION Based on the results o this study it can be concluded that beore doing yoga exercises there are hal respondents with systolic blood pressure is on the scale o moderate hypertension and diastolic blood pressure is on the scale o mild hypertension while ater doing yoga exercises there are hal respondents with systolic blood pressure is on the scale o mild hypertension and diastoliknya are on the scale o mild hypertension. From the statistical test ound there was a signiicant dierence between blood pressure beore and ater doing gymnastics yoga, so it can be concluded that there is inluence o yoga exercises on blood pressure in elderly who have hypertension. For that, yoga gymnastics program can be used as one o the main programs or the elderly at the Trisna Werdha Kasih Sayang Ibu in Batusangkar Social House in and not only elderly who suer rom hypertension, but yoga gymnastics is applicable or all elderly. It is expected that oicers at the Social Institution should be more strict in supervising the elderly who get ood deliveries rom the amily. The likelihood o increased elderly blood pressure is caused by the ood that the amily carries while visiting. ACKNOWLEDGMENT Acknowledgment to the Chairman and Director o Nabila Nursing Foundation who has provided motivation and acilitate the researcher to conduct research and also Malaysian Journal o Medical Research Vol. 2 (3) JULY

6 thank the researcher to the leader o Trisna Werdha Kasih Sayang Ibu at Batusangkar Social House who has given permission to the researcher to conduct research as well as colleagues o sta and lecturers Nabila Nursing who has encouraged researchers in completing this research report. REFERENCES Dalimartha, S., Purnama, B.T., Sutarina, N., Mahendra, B. & Darmawan, R.(28). Care Your Sel. Depok: Penebar Plus. Depkes, R.I. (213), Keputusan Menteri Kesehatan Republik Indonesia Nomor 3/MENKES/SK /IX/213 tentang Datar Obat Esensial Nasional 213, Departemen Kesehatan RI, Jakarta. Dinata, W.W. (215). Menurunkan Tekanan Darah Pada Lansia Melalui Senam Yoga. Jurnal Olahraga Prestasi, 11(2). Koizer, B. & Erb, B. (21). Buku Ajar Fundamental Keperawatan Konsep, Proses dan Praktik. 7, EGC, Indonesia Marchanda, S.C.& Madan,K.(215).Liestyle Changes, Yoga and, 1(1), pp Ministry o Health, Republic o Indonesia. (213). Report o national basic health research. Retrieved rom: Pangaribuan, B, B, P. & Berawi, K. (216). Pengaruh Senam Jantung, Yoga, Senam Lansia Dan Senam Aerobik Dalam Penurunan Tekanan Darah Pada Usia. Majority, 5(4), Pages 6. Proil Kesehatan Provinsi Sumatera Selatan. (214). Dinas KesehatanProvinsi Sumatera Selatan. Retrieved rom: /download/proil/profil_kes_provinsi_214 /6_Sumatera_Selatan_214.pd Sugiyono.(28). Metodologi Penelitian Pendidikan: Pendekatan Kuantitati dan Kualitati dan R & D, Alabeta, Sweden. Hagins, M., States, R.A, Sele, T. & Innes, K.E. (213). Eectiveness o Yoga or : Systemic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, Pages 13. Sustrani, L. (26). Hipertensi. Jakarta: PT Gramedia Pustaka. Hastono, S. P. (26). Analisis Data. Universitas Indonesia. Retrieved rom: edu/ /sutanto_priyo_hastono_analisis_da ta_sutanto_priyo_hastono WHO. (2). New data highlight increases in hypertension, diabetes incidence.retrieved rom: 2/world_health_statistics_2516/en/ Hidayat, A.A.A (27). Metode Penelitian Keperawatan dan Tekhnik Analisa Data, Salemba Medika, Jakarta. Wol, M., Sundquist, K., Larsson, L.S. & Midlov, P. (213). Impact o Yoga on Blood and Quality o Lie in Patients with a Controlled Trial in Primary Care, Matched or Systolic Blood. BMC Cardiovascular Disorder, Pages 9. Kinasih, A. S. (21). Pengaruh Latihan Yoga Terhadap Peningkatan Kualitas Hidup. Buletin Psikology, 18(1), Pages. 35 Vol. 2 (3) JULY 218 Malaysian Journal o Medical Research

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