EFFECTIVENESS OF AMLODIPINE WITH CONCOMITANT HERBAL THERAPY (BAY LEAVES, CELERY, CUCUMBER) IN HYPERTENSIVE PATIENTS IN SURAKARTA
Abstrak
Hypertension is a chronic disease that requires long-term management. The use of medicinal plants as complementary therapy is increasingly recognized, although scientific evidence remains limited. This study aimed to evaluate the effectiveness of amlodipine with concomitant herbal therapy (bay leaves, celery, and/or cucumber) compared with amlodipine monotherapy in hypertensive patients. A retrospective cohort design was employed using medical record data and patient questionnaires from three community health centers in Surakarta. Treatment effectiveness was measured by the achievement of the target blood pressure over three months. Data were analyzed using bivariate tests and multivariate logistic regression. The results showed that clinical effectiveness was higher in the amlodipine group with concomitant herbal therapy (bay leaves, celery, and/or cucumber) at 78.4% compared to amlodipine monotherapy at 68.8%, although the difference was not statistically significant (p=0.160). Factors significantly associated with treatment effectiveness were medication adherence (p<0.001), baseline systolic blood pressure (p<0,001), and educational level (p=0,047). Concomitant herbal therapy with amlodipine showed potential blood pressure–lowering effects, though not statistically significant. Prospective studies or clinical trials are warranted to further assess the benefits and safety of this therapeutic approach.
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Referensi
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29. Ismail A, Wan Ahmad WN. Autonomic receptors and nitric-oxide involvements in mediating vasorelaxation effect induced by Syzygium polyanthum leaves extract. Pharmacognosy Res. 2017;9(5):9. doi:10.4103/pr.pr_69_17
30. Ismail A, Ahmad WANW. Syzygium polyanthum (Wight) Walp: A Potential Phytomedicine. Pharmacognosy Journal. 2019;11(2):429-438. doi:10.5530/pj.2019.11.67
31. Ismail A, Syahida Ramli N, Mohamed M, Wan Ahmad WAN. Acute and Sub-Acute Antihypertensive Effects of Syzygium polyanthum Leaf Extracts with Determination of Gallic Acid using HPLC Analysis. Pharmacognosy Journal. 2018;10(4):663-671. doi:10.5530/pj.2018.4.109
32. Chittenden K. Patient Non-Compliance: A Barrier to Successful Outcomes in Medicine and Healthcare Service. Journal of Clinical Case Studies Reviews & Reports. Published online December 31, 2022:1-4. doi:10.47363/JCCSR/2022(4)236
33. Campo C, Segura J, Ruilope LM. Factors Influencing the Systolic Blood Pressure Response to Drug Therapy. The Journal of Clinical Hypertension. 2002;4(1):35-40. doi:10.1111/j.1524-6175.2002.00487.x
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2. Kemenkes RI. Hasil Utama RISKESDAS 2018. 2018. Accessed February 14, 2024. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
3. Setyowati, Yuliansyah A, Sulistyaningsih T, Subagyo E, Utami E. Profil Kesehatan Kota Surakarta 2023.; 2024. Accessed January 24, 2025. https://solodata.surakarta.go.id/uploads/publikasi/Profil_Kesehatan_2023-2.pdf
4. Carey RM, Wright JT, Taler SJ, Whelton PK. Guideline-Driven Management of Hypertension. Circ Res. 2021;128(7):827-846. doi:10.1161/CIRCRESAHA.121.318083
5. Bulsara KG, Patel P, Cassagnol M. Amlodipine. StatPearls Publishing. Published online January 2024. Accessed May 17, 2024. https://www.ncbi.nlm.nih.gov/books/NBK519508/
6. Wang J, Palmer BF, Vogel Anderson K, Sever P. Amlodipine in the current management of hypertension. The Journal of Clinical Hypertension. 2023;25(9):801-807. doi:10.1111/jch.14709
7. Shaito A, Thuan DTB, Phu HT, et al. Herbal Medicine for Cardiovascular Diseases: Efficacy, Mechanisms, and Safety. Front Pharmacol. 2020;11. doi:10.3389/fphar.2020.00422
8. Aloufi BH, Atwan MA, Alshammari AM. Treatment of Hypertension by Using Natural Herbs and their Mechanism of Action. J Biochem Technol. 2022;13(2):19-28. doi:10.51847/wx7mN3flrC
9. Joachimdass RJ, Hai TC, Subramaniam K, Loganathan A. The Practice of Herbs Integration Among Patients With Hypertension Attending Primary Care Facilities: A Systematic Review. Malaysian Journal of Medicine and Health Sciences. 2023;19(Supplement 9):269-279. doi:10.47836/MJMHS.19.S9.37
10. Azizah N, Halimah E, Puspitasari IM, Hasanah AN. Simultaneous use of herbal medicines and antihypertensive drugs among hypertensive patients in the community: A review. J Multidiscip Healthc. 2021;14:259-270. doi:10.2147/JMDH.S289156
11. Ekici M, Tuncay HO, Akalın E, Yaman Bucak A, Üresin AY. Evaluation of the Efficacy, Safety, and Mechanism of Action of Plants Traditionally Used in the Treatment of Hypertension in Turkey. J Herb Med. 2024;43:100835. doi:10.1016/j.hermed.2023.100835
12. Jadid N, Kurniawan E, Himayani CES, et al. An ethnobotanical study of medicinal plants used by the Tengger tribe in Ngadisari village, Indonesia. PLoS One. 2020;15(7 July). doi:10.1371/journal.pone.0235886
13. Hendrayana T, Yoana K, Adnyana IK, Sukandar EY. Cucumber (Cucumis sativus L.) Fruit and Combination with Losartan Attenuate the Elevation of Blood Pressure in Hypertensive Rats Induced by Angiotensin II. J Pharmacopuncture. 2023;26(4):298-306. doi:10.3831/KPI.2023.26.4.298
14. Ismail A, Rahim ENAA, Omar MN, Ahmad WANW. Antihypertensive assay-guided fractionation of syzygium polyanthum leaves and phenolics profile analysis using lc-qtof/ms. Pharmacognosy Journal. 2020;12(6):1670-1692. doi:10.5530/pj.2020.12.227
15. Kemenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 6 Tahun 2016 Tentang Formularium Obat Herbal Asli Indonesia.; 2016. Accessed June 7, 2024. https://www.regulasip.id/themes/default/resources/js/pdfjs/web/viewer.html?file=/eBooks/2018/November/5be135ca4690b/Permenkes_6_2016.pdf
16. Francis NS, Lim YM, Mat S, Loganathan A. Effectiveness of herbs taken concurrently with antihypertensive drugs in managing hypertension and lipid outcomes. A systematic review and meta-analysis. Complement Ther Med. 2024;83:103058. doi:10.1016/j.ctim.2024.103058
17. Nyulas KI, Simon-Szabó Z, Pál S, et al. Cardiovascular Effects of Herbal Products and Their Interaction with Antihypertensive Drugs-Comprehensive Review. Int J Mol Sci. 2024;25(12). doi:10.3390/ijms25126388
18. Alobaidi S, Saleh E. Antihypertensive Property of Celery: A Narrative Review on Current Knowledge. Int J Food Sci. 2024;2024:9792556. doi:10.1155/2024/9792556
19. Asih SW. Pengaruh Rebusan Daun Salam terhadap Penurunan Tekanan Darah pada Lansia Penderita Hipertensi di Wisma Seruni UPT PSLU Jember. The Indonesian Journal of Health Science. Published online October 14, 2018:169. doi:10.32528/ijhs.v0i0.1543
20. Ma’rifah A, Puji Suryantini N. Apium Graveolans L Extract: Alternative Complementary Therapies to Decrease Hypertension. Jombang Nursing and Midwifery Journal. 2022;1(1):15-21. doi:10.57101/jnmj.v1i1.4
21. Amadi CN, Mgbahurike AA. Selected Food/Herb-Drug Interactions: Mechanisms and Clinical Relevance. Am J Ther. 2018;25(4):e423-e433. doi:10.1097/MJT.0000000000000705
22. Ueng KC, Lin LC, Voon WC, et al. An eight-week, multicenter, randomized, double-blind study to evaluate the efficacy and tolerability of fixed-dose amlodipine/benazepril combination in comparison with amlodipine as first-line therapy in chinese patients with mild to moderate hypertension. Blood Press Suppl. 2008;1:24-31.
23. Nagawa CS, Palakshappa JA, Sadasivam RS, Houston TK. Herbal or dietary supplement use and hypertensive medications: Does the combination relate to medication adherence and blood pressure control? Journal of Alternative and Complementary Medicine. 2021;27(2):168-175. doi:10.1089/acm.2020.0254
24. Lukito AA, Harmeiwaty E, Situmorang TD, et al. Konsensus Penatalaksanaan Hipertensi 2021: Update Konsensus PERHI 2019.; 2021. Accessed December 19, 2024. https://pkmbaruilir.balikpapan.go.id/files/20240902162459917181_6__konsensus-hipertensi-2021.pdf
25. Fauziah F. Validitas dan Reliabilitas Hill-Bone Versi Bahasa Indonesia pada Pasien Hipertensi. Universitas Jember; 2019.
26. Kim MT, Hill MN, Bone LR, Levine DM. Development and testing of the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Prog Cardiovasc Nurs. 2000;15(3):90-96. doi:10.1111/j.1751-7117.2000.tb00211.x
27. Xiong X, Li X, Zhang Y, Wang J. Chinese herbal medicine for resistant hypertension: a systematic review. BMJ Open. 2015;5(1):e005355. doi:10.1136/bmjopen-2014-005355
28. Fares H, DiNicolantonio JJ, O’Keefe JH, Lavie CJ. Amlodipine in hypertension: a first-line agent with efficacy for improving blood pressure and patient outcomes. Open Heart. 2016;3(2):e000473. doi:10.1136/openhrt-2016-000473
29. Ismail A, Wan Ahmad WN. Autonomic receptors and nitric-oxide involvements in mediating vasorelaxation effect induced by Syzygium polyanthum leaves extract. Pharmacognosy Res. 2017;9(5):9. doi:10.4103/pr.pr_69_17
30. Ismail A, Ahmad WANW. Syzygium polyanthum (Wight) Walp: A Potential Phytomedicine. Pharmacognosy Journal. 2019;11(2):429-438. doi:10.5530/pj.2019.11.67
31. Ismail A, Syahida Ramli N, Mohamed M, Wan Ahmad WAN. Acute and Sub-Acute Antihypertensive Effects of Syzygium polyanthum Leaf Extracts with Determination of Gallic Acid using HPLC Analysis. Pharmacognosy Journal. 2018;10(4):663-671. doi:10.5530/pj.2018.4.109
32. Chittenden K. Patient Non-Compliance: A Barrier to Successful Outcomes in Medicine and Healthcare Service. Journal of Clinical Case Studies Reviews & Reports. Published online December 31, 2022:1-4. doi:10.47363/JCCSR/2022(4)236
33. Campo C, Segura J, Ruilope LM. Factors Influencing the Systolic Blood Pressure Response to Drug Therapy. The Journal of Clinical Hypertension. 2002;4(1):35-40. doi:10.1111/j.1524-6175.2002.00487.x
34. Woolf D. Why Educational Attainment Is Crucial to Improving Population Health. In: Exploring Opportunities for Collaboration Between Health and Education to Improve Population Health: Workshop Summary. National Academies Press; 2015. Accessed June 27, 2025. https://www.ncbi.nlm.nih.gov/books/NBK316096/
Penulis
Mahmuda, N. A., Andrajati, R. ., & Elya, B. (2025). EFFECTIVENESS OF AMLODIPINE WITH CONCOMITANT HERBAL THERAPY (BAY LEAVES, CELERY, CUCUMBER) IN HYPERTENSIVE PATIENTS IN SURAKARTA. JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, Online ISSN 2579-8103, 17(2), 601–612. https://doi.org/10.34011/juriskesbdg.v17i2.2939
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