Penggunaan Irbesartan pada Pasien

Hipertensi dan Sindrom Metabolik

Yoska Yasahardja
Medical Department Kalbe Farma

Curriculum Vitae

Name
Yoska Yasahardja
Place of birth/ date
West Berlin/ 21 November 1975
Graduate
UNIKA Atma Jaya 2003, Jakarta
Attending symposiums:
The 6th ACPH & the 9th ISH, Beijing, China
AICT 2008, Bangkok
PERKENI 2009, Bali, Indonesia
ESC 2009, 2011, 2012, 2013
And others
Activities

As a speaker at several symposiums at several places

in Indonesia (with topic Hypertension and Diabetes)
Penatalaksanaan hipertensi dalam kehidupan sehari-hari,
IDI meeting Ende 2009
Tatalaksana Diabetes Terkini, East Kalimantan 2009
Main speaker Seminar sehari Penatalaksanaan Hipertensi KPPIK
meeting Bandung 2008
Seminar Hipertensi pertemuan IDI Cirebon 2008
Hypertension: Combination Therapy, Jakarta 2010
Dewan Redaksi of Cermin Dunia Kedokteran
As speaker at Suara Surabaya with several topics about metabolic
syndrome 2009
Hypertension: Combination Therapy, Surabaya 2010
Antioxidan and Metabolic Syndrome, MU Caf Jakarta Nov, 2010
TRUVAZ, PERKENI Surabaya, Desember 2010
Tatalaksana GERD dengan PPI 2014
Penulis dan editor majalah kedokteran CDK

Hypertensio
n
Worldwide : 1 billion people
USA : 50 million people
Prevalence in China 13.6%;
Canada 22%; Egypt 26.3%
INDONESIA : ???
Highest: West Java
Lowest : Irian jaya
Prevalence will be higher if there are no
effective preventions
Worldwide in 2025: 1,56 billion people

Hypertension and Diabetes

Co-existence of hypertension and diabetes
mellitus of either type substantially increases
the risk of developing renal and other organ
damage, leading to a much greater
Incidence of stroke, coronary heart disease,
congestive heart failure, peripheral artery
disease and cardiovascular mortality

Mancia G. 2007 Guidelines for the Management of Arterial Hypertension.

Journal of Hypertension 2007; 25 : 1105-87

Natural History of Cardiovascular Disease

Coronary
thrombosis

CV Death
Stroke

Myocardial
Ischemia

Myocardial
infarction

Arrhythmia &
Myocardial damage

Sudden death

Silent
Angina
Hibernation

Remodeling

CHD
Ventricular
dilatation

Atherosclerosis

LVH
Congestive
heart failure

Endothelial
dysfunction
RISK FACTOR
hypercholesterolemia, blood pressure,
Diabetes, smoking, thrombosis,
fibrinogen

HEALTH

End stage
Heart disease

Death

NEW TREATMENT
APPROACH
Hypertension
= disease of blood vessels
Vascular biology altered
Treat vasculature
Therapeutic
options
ACE
Inhibitors

AT1
blockers

CCB

* Minimal evidence of effects on

endothelial function

-Blockers* Diuretics*

Angiotensin II Plays a Central Role in

Organ Damage
Atherosclerosis*
Vasoconstriction
Vascular hypertrophy
Endothelial dysfunction

A II

AT1
receptor

LV hypertrophy
Fibrosis
Remodeling
Apoptosis
GFR
Proteinuria
Aldosterone release
Glomerular sclerosis

Stroke

Hypertension

Heart failure
MI

DEATH

Renal failure

*preclinical data
LV = left ventricular; MI = myocardial infarction; GFR = glomerular filtration rate
Adapted from Willenheimer R et al Eur Heart J 1999; 20(14): 997 1008, Dahlf B J Hum Hypertens 1995; 9(suppl 5):
S37S44, Daugherty A et al J Clin Invest 2000; 105(11): 1605 1612, Fyhrquist F et al J Hum Hypertens 1995; 9(suppl 5):
S19S24, Booz GW, Baker KM Heart Fail Rev 1998; 3: 125 130, Beers MH, Berkow R, eds. The Merck Manual of
Diagnosis and Therapy. 17th ed. Whitehouse Station, NJ: Merck Research Laboratories 1999: 1682 1704, Anderson S
Exp Nephrol 1996; 4(suppl 1): 3440, Fogo AB Am J Kidney Dis 2000; 35(2):179 188

INDIKASI
HIPERTENSI Ringan Berat
Menurunkan mikroalbuminuria dan
makroalbuminuria pada pasien
hipertensi dengan nefropati DM
Pasien yang tidak dapat mentoleransi
efek samping batuk karena ACE Inhibitor
DOSIS & CARA
PEMBERIAN
Dosis awal & dosis pemeliharaan 150 mg OD

Dosis dapat ditingkatkan hingga :

300 mg/hari
Pasien hemodialisis dosis awal: 75 mg
Tidak perlu penyesuaian dosis pada pasien
usia tua, gangguan fungsi hati, insufisiensi
renal.

KONTRAINDIKASI
Hipersensitif
Wanita Hamil &
Menyusui

INTERAKSI OBAT
+ HCT dan obat antihipertensi
lainnya : efek aditif
Tidak berinteraksi dengan
digoxin, warfarin,
nifedipine, simvastatin

Uji BABE IRVASK VS REFERENSI

Uji BABE IRVASK VS REFERENSI

Uji BABE IRVASK VS REFERENSI

Terapi kombinasi hipertensi, Mancia et al

Mancia G. 2007 Guidelines for the Management of

Arterial Hypertension. Journal of Hypertension
2007; 25 : 1105-87

THANK YOU