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Asian Journal of Healthy and Science

p-ISSN: 2980-4302

e-ISSN: 2980-4310

Vol. 2 No. 7 July 2023

EFFECTIVE BIOMASSAGE METHOD LOWERS BLOOD PRESSURE IN

HYPERTENSIVE MENOPAUSAL WOMEN AT PUSKESMAS DENPASAR

BARAT II DENPASAR BALI

I Nyoman Ribek, Ni Putu Dyah Aditya Pradnyani, I Dewa Ayu Ketut Surinati

Ni Nyoman Hartati, V.M.Endang S.P.Rahayu

Politeknik Kesehatan Denpasar, Indonesia

Email: nyomanribek0606@gmail.com

Abstract

The main problem of menopausal women is hypertension because in menopause

the hormone estrogen is decreasing, cholesterol levels increase then arthrosclerosis

occurs and blood vessels are damaged. Hypertension is one of the entrances to heart

disease, kidney failure, diabetes, stroke and the global prevalence of 22% of the

world's population, in Indonesia in 2018 is 34.11%. , in Bali 21% and Denpasar City

26.23%. Overcoming this problem besides conventionally needed another method to

solve the problem of hypertension, namely biomassage massage. The purpose of the

study was to find out whether biomassage massage is effective in lowering blood

pressure in menopausal hypertension. This research method is true experimental

method with pretest-postest control group design; The sample of 66 people with

simple random techniques was divided into two, one experiment and one control.

Analysis before and after treatment was carried out normality test, the results were

all variables normally distributed for systole so that hypothesis testing with t test and

abnormal on diastole so that the analysis used vicoxson and the results there were

significant differences before and after treatment with sig values of 0.00 < 0.05.with

a systole difference rank of 7 mmH and Diastole 4 mmHg. It was concluded that

there was a significant difference before and after the Biomassage procedure. It is

recommended in overcoming hypertension, besides conventionally with drugs need

to be supplemented with biomassage massage education.

Keywords: hypertension; menopause; education; biomassage.

INTRODUCTION

The background of this research is because the number of menopausal women is

increasing and hypertension is easier. Menopause is a natural phase that will be experienced

by every woman that usually occurs over the age of 40 years. Women are said to have

Menopause If you have not menstruated for 12 months since the last menstruation caused by

decreased ovarian function (Suryoprajogo, 2019). Hypertension, is a condition of high blood

pressure when at rest systolic blood pressure is in the position of 140 mmHg and above or

diastolic blood pressure at the position of 90 mmHg and above after repeated measurements

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(Woro Riyadi 2019). According to the occurrence of hypertension it occurs because the

hormone estrogen is decreasing so that cholesterol levels increase which serves as a protector

of the process of arthrosclerosis and loss of the hormone estrogen which functions as a

protector of blood vessels from damage. According to WHO by 2025 the number of women

Menopause in Asia will increase from 107 million people to 373 million people and the

Indonesian Ministry of Health estimates that Indonesia's population in 2030 will reach 262.6

million people with the number of women living in age Menopause About 30.3 million people

with an average age of 49 years experienced Menopause (Wardani, D. A., Sumiati, &;

Waisong 2019). In Bali Province in 2020, the number of women aged 45 - 64 years was

539,700 people, the number of women in Denpasar City is 359,013 people (BPS Prov Bali,

2020) Hypertensive data according to (WHO 2018) It continues to increase, it is estimated

that as many as 1.13 billion people worldwide suffer from hypertension and occur in adults

aged 30-79 years. Based on data from (Riskesdas 2018) in Indonesia, the prevalence of

hypertension based on measurement results in the population aged ≥18 years is 34.11%. This

disease is most prevalent in the elderly aged 75 years and over as much as 69.53% (Research

and Development Agency of the Ministry of Health of the Republic of Indonesia 2018)

Therefore Hypertension become One of the entrances to diseases such as heart, kidney

failure, diabetes, stroke So a solution is needed to overcome this problem of hypertension.

Solutions to solve the problem This is besides conventionally required a method of nursing

action, namely with biomassage massage. The purpose of the study was to find out whether

biomassage massage can effectively lower blood pressure in menopausal hypertensive

patients.

RESEARCH METHODS

This research method uses an approach with a true experimental method with

pretest-postest control group design. Sampling techniques at the time of the study with

simple random techniques with a total sampling of 66 people .The samples obtained were

divided into two groups, one experimental group and one control group totaling 33 people

each. Instrument of data collection with questionnaires for characteristic data and with

digital tension meters for systolic and diastolic blood pressure in hypertensive

menopausal women. The analysis techniques used are the t test and vicoxson test. The t

test is carried out to see the difference in systole before and after biomassage, which has

previously been carried out data normality test with normal data results, as early as

diastole analysis with vilcoxon test because the test does not distribute normal spark

plugs.

RESULT AND DISCUSSION

The subjects of this study are menopausal women who experience hypertension

located in the area of the West Denpasar 2 Denpasar Health Center as described

below:

Table 1. Characteristics of respondents by age

Age in years

Frequency (n)

Percentage (%)

51-53 Years

54-56 Years

57-59 Years

Total

100

Based on table 1. it can be seen that the most respondents experiencing

hypertension are ages 54-56 years with a total of 25 respondents (38%).

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Table 2. Education Level of Respondents

Education

Frequency (n)

Percentage (%)

7,6

JUNIOR

19,7

SMA

68,2

College

4,5

Total

100

Based on table 2. It can be seen that the most respondents who experienced

hypertension were high school education with a total of 45 respondents (68.2%).

Table 3. Job classification Rsponden

Work

Frequency (n)

Percentage (%)

Housewives

45,5

Business hero

28,8

Private

25,8

Total

100

Based on table 3. It can be seen that the most respondents experiencing

hypertension are housework with a total of 30 respondents (45.5%).

Table 4. Measurement results before biomassage treatment

Category

Frequency

Sistole

Percentage

Frequency

Diastole

Percentage

Usual

18%

Normal – High

33%

Stage 1 (mild hypertension)

52%

46%

Stage 2 (Moderate Hypertension)

48%

Total

100

Based on table 4. It can be seen that the most respondents before the biomassage

action were stage 1 hypertension with systole 17 people (52%) and diastole 15 people

(46%).

Table 5. Measurement results after biomassage treatment

Category

Frequency

Sistole

Percentage

Frequency

Diastole

Percentage

Usual

12%

91%

Normal – High

67%

Stage 1 (mild hypertension)

21%

Stage 2 (Moderate Hypertension)

Total

100

Based on table 5. It can be seen that the most respondents after the Biosage

Action were normal-high hypertension with systole 22 people (67%) and diastolic

30 people (91%) normal category.

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Table 6. Measurement results before conventional treatment in the control group

Category

Frequency

Sistole

Percentage

Frequency

Diastole

Percentage

Normal

36%

Normal – High

43%

Stadium 1 (mild hypertension )

52%

21%

Stadium 2 (Moderate Hypertension)

48%

Total

100

Based on table 6. It can be seen that the most respondents before conventional

measures were Stage 1 Hypertension (Mild Hypertension) with 17 people (52%)

systole and 14 people (43%) diastolic, high normal category.

Table 7. Measurement results after conventional treatment in the control group

Category

Frequency

Sistole

Percentage

Frequency

Diastole

Percentage

Normal

48%

94%

Normal – Tinggi

Stadium 1 (Hipertensi Ringan)

52%

Stadium 2 (Hipertensi Sedang)

Total

100

Based on table 7. It can be seen that the respondents after conventional

measures were normal with 16 people (48%) systole and 31 people (94%) diastolic

normal category.

Table 8. Summary of normality test results

Group

Sig

Conclusion

Systole before the biomassage of the experimental group

0.129

Normal

Systole after the biomassage of the experimental group

0.765

Normal

Control group early systole

0.447

Normal

Control group end systole

0.177

Normal

Based on the normality test with the Shapiro Wilk test, the data results were

0.129, 0.765, 0.447, 0.177, which means above 0.05, so it can be concluded that the

data is normally distributed.

Table 9. Recapitulation of data analysis of blood pressure measurement results

Analysis

experimental group

control group

Min

Maks

Mean

Asymp.

Sig.

(2-

tailed)

Min

Maks

Mean

Asymp.

Sig.

(2-

tailed)

Systolic

before action

142

167

154

0.00

140

167

151

0.00

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Systolic after

action

125

147

136

0.00

132

152

140

0.00

Diastolic

before action

0.00

Postoperative

diastolic

0.00

Based on table 9. It can be seen that in the experimental group the systolic value

before the action averaged 154 mmHg and afterward was 136 mmHg and the

diastolic average before the action was 90 mmHg and afterward was 86 mmHg, in

the control group the average systolic value was 151mmHg and after that it was 140

mmHg, the diastolic value before 86 mmHg and after 82 mmHg and Asymp value.

Sig. (2-tailed) is 0.00

Table 10. Results of t Test on Blood Pressure in experimental and control groups

Group

Average

Sig. (2-tailed)

Sistole

-3.61

8.49

-2.43

0.020

Diastole

-9.39

3.20

-1.68

0.153

Based on table 10, the results of the t test obtained a sig value of 0.020 for systolic,

meaning 0.020 <0.05, meaning that there is a significant difference in blood pressure

in systole after biomassage measures, while in diastole, a sig value of 0.153 means

0.153 > 0.05, meaning there is no difference after biomassage.

Characteristics of Respondents

The results of the study stated menopausal women who have hypertension,

with age the most at the age of 54-56 years, the lowest 51 years and the highest 59

years and the level of education is still in elementary and junior high schools as much

as 27%, and the most jobs are housewives as many as 30 samples (45.5%). This data

is in line with research conducted by wardani where average age of 49 years

experienced Menopause (Wardani, D. A., Sumiati, &; Waisong 2019) .Menopause is

a natural phase that every woman will experience which usually occurs over the age of

40 and women do not experience menstruation forever .(Suryoprajogo, 2019) . One of the

consequences of menopause is a decrease in the hormone estrogen and an increase

in the hormone cortisol, so that menopausal women tend to get stressed more easily

which can affect an increase in blood pressure or hypertension. (Lestari et al., 2020)

Prevalence data in Bali Province in 2020, the number of women aged 45 - 64

years was 539,700 people, the number of women in Denpasar City was 359,013

people (BPS Prov Bali, 2020) .Based on education there is still lower education in

elementary and junior high school, this means that although today the majority have

android phones that they can use to access the internet and use it to find information

about diseases, it will be difficult for them to remember the knowledge they learned.

and apply it in their daily lives, because of low education iu. (Pratama, Fathnin and

Budiono, 2020)

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Measurement results before treatment.

The results of the study obtained data on women Menopause who had

hypertension before treatment (pre-test) in the experimental group the number of valid

samples was 33, the mean score of systole was 154 mmHg, the highest systole was

167, and the lowest was 142, the mean diastole was 89 mmHg, the lowest was 73 and

the highest was 95, while in the control group the average score was 158 mmHg,

diastole was 86 mmHg. This hypertension when viewed from the theory classified by

Triyanto is in Stage 1 (Mild Hypertension) Cystole: 140-159 Diastole: 90-99 as much

as 17 0rang or 52% and Stage 2 (Moderate Hypertension) Cystole: 160-179 Diastole:

100-109 as many as 16 people or 48%. For normal diastole values < 85 as many as 6

people or 18%, normal-high 85-89 as many as 11 people or 33%, mild hypertension

diastole 90-99 as many as 15 people or 46% and moderate hypertension diastole 100-

109 as many as 1 person or 3%. The average value of the systole score of 154 is

already stage 1 hypertension, because the definition of hypertension itself is a state of

high blood pressure when at rest systolic blood pressure is in the position of 140

mmHg and above after repeated measurements. (Woro Riyadi, 2014). The

respondents of this study were hypertension during menopause. One of the

consequences of Menopause There is a decrease in the hormone estrogen and there is

an increase in the hormone cortisol, so women Menopause tends to be more easily

stressed which can affect the increase in blood pressure or hypertension. (Lestari et

al., 2020). Various consequences will arise when hypertension includes narrowing

of the arteries that carry blood and oxygen to the brain resulting in damage to the

brain organs resulting in a stroke and complications, namely pain when walking,

damage to the kidneys and damage to the organs of the eye which can lead to

blindness (Agustin & Anggraini, 2022)

The loss of such hormones results in an increase in triglyceride levels, a decrease

High Density Lipopotrein (HDL), LDL and higher salt sensitivity so that it can improve

the work of the heart and increase blood pressure. An increase in LDL will result in

the accumulation of macrophages in vascular smooth muscle cells and increase LDL

oxidation resulting in inflammation. Inflammation that occurs will cause

vasodilation disorders and protorhombic effects so that atherosclerosis plaques

appear which will cause an increase in blood pressure (Suryonegoro et al., 2021).

These respondents in both experimental and control groups all followed the

hypertension treatment program programmed by the puskesmas,

Hydrochlorothiazide (HCT) 12.5 – 25 mg per day single dose in the morning,

Reserpine 0.1 – 0.25 mg, Propranolol, Captopril 12.5 – 25 mg and Nifedipine ranging

from 5mg – 10 mg. Thus it can be concluded that the average blood pressure before

biomassage is 154, the highest is 167 and the lowest is 142 and the average diastole

is 89 mmHg, the lowest is 73 and the highest is 95. While in the control group the

average systole was 158 and diastole 86. Symptoms that arise in menopausal

hypertension include headache (heavy feeling in the back of the neck), palpitations,

fatigue, nausea, vomiting, nervousness, excessive sweating, muscle tremors, chest

pain, epistaxis, blurred or double vision, tinnitus (ringing in the ears), chest pain,

fatigue, palpitations, sleep disturbances and these symptoms really appear before

stopping menstruation (Achmad Ali Fikri, Syamsul Arifin, 2022)

Measurement results after treatment.

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The results of the study obtained data on women Menopause who develop

hypertension after treatment (post-test) in the experimental group the number of valid

samples was 33, the mean score of systole was 136 mmHg, the highest systole was

147, and the lowest was 125, the mean diastole was 81 mmHg, the lowest was 70 and

the highest was 88, while in the control group the average score of systole was 140

mmHg, the highest was 152 and the lowest was 132 while the mean diastole was 82

mmHg, the lowest was 72 and the highest was 85 mmHg. . This hypertension when

viewed from the theory classified by Triyanto is in Stage 1 (mild hypertension).

Sistole: 140-159 as many as 7 people or 21%, normal-high stage as many as 22 people

or 67% and normal < 130 as many as 4 people or 12%, while the control group Stage

1 (Mild Hypertension). Sistole: 140-159 as many as 17 people or 52%, normal-high

stage as many as 16 people or 48%. Judging from diastole data, Normal-high stage

Diastole score: 85-89 as many as 3 people or 9%, Normal diastole value < 85 as many

as 30 people or 91%, atau 91 %, (E.Triyanto, 2017) . Thus it means that there has

been a decrease in both systole and diastole after biomassage. The same thing was

stated by Rindang et al in his research which stated that foot reflexology could

reduce blood pressure, in his research which stated that foot reflexology could

reduce blood pressure, 80% of respondents fell to the normal classification, 10%

were in the mild classification, and 10 % are in the moderate classification. , (Rindang

Azhari Rezki, Yesi Hasneli, 2015) Likewise, research on Slow Stroke Back Massage on

Blood Pressure in Menopause found that there was a significant difference with a

confidence level of 0.030. Blood pressure decreased with a sample of 30 people at

the treatment level and 30 people in the control group. (Sari Dewi, 2020)

Based on the data there was a decrease in systole blood pressure in the

experiment by 18 mmHg and in the control by 12 mmHg.This difference is one of

them because in the experimental group that triggers a decrease in blood in addition

to drugs taken also because the action of biomassage contributes quite effectively

(Nyoman Ribek, 2023). When compared to the research conducted by supaat states

that once done massage there was a decrease in systolic from 143 mmHg to 137 mm

Hg (Supa'at, 2013). Biomassage it itself is a Branded from bioenergy and massage,

Bioenergy comes from two syllables, namely Bio and Energy, Bio means life and

Energy means force while massage is applied with acupressure. or 91%,( (Nyoman

Ribek, 2023). There are three types of acupressur points, namely: a). general massage

points, namely meridium massage points outside the meridium duct, b). special

massage points, namely acupressure points outside the meridium duct, c). pain points

or yes points / ashe points are points that if massaged feel pain and are not located

in general points or at special points. (Ministry of Health RI 2012).

Analysis of differences in blood pressure measurement results between the

experimental group and the control group in menopausal women who had

hypertension.

After the normality test of systolic data has a value of > 0.05, then the data

is normal spark plugs, then a t test was carried out between the experimental group

and the control group, the results were obtained sig value 0.00 for systole means 0.00

< 0.05 meaning there is a significant difference in blood pressure in systole after

biomassage. When analyzed the difference between the experimental group and the

control group of systole data obtained a difference of 7 mmHg where in the

experimental group there was a decrease of 18 mmHg where the average score of

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systole dropped to 136 mmHg from 154, while in the control group there was a

decrease of 11 mmHg from 151 mmHg to 140 mmHg. Diastole data was analyzed

using the vilcoxon test because the normality test was abnormal, the results of

diastole data obtained a difference of 4 mmHg where in the experimental group there

was a decrease of 8 mmHg where the average diastole score dropped to 81 mmHg

from 89, while in the control group there was a decrease of 4 mmHg from 86 mmHg

to 82 mmHg. By looking at the difference in blood pressure reduction between the

experimental group and the control group for systole by 7 mmHg while diastole by 4

mmHg, statistically the statistical hypothesis is that there is an effect of Biomassage

on reducing blood pressure in menopausal hypertension. Thus, it means that the

hypothesis of this study can be mentioned that biomassage is effective in lowering

blood pressure in menopausal hypertension.

CONCLUSION

The results of this study concluded that manaupause tends to experience

hypertension at the age of 54-56 years, education is still in elementary and junior

high schools, and the most jobs are housewives. The results of blood pressure

measurement after biomassage decreased systolic by 18 mm Hg while in the control

group there was a decrease of 11 mmHg, as well as in diastole there was a decrease

in diastolic 8 mm Hg and in the control group there was a decrease of 4 mmHg

There is an effect of biomassage on lowering blood pressure in hypertension

experienced by menapause women with a sig of 0.00 which means 0.00 < 0.05 so

that Biomassage is effective in reducing blood pressure in hypertension experienced

by women menapause.

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วารสารวิชาการมหาวิทยาลัยอีสเทิร ์นเอเชีย (Vol. 4, Issue 1).

I Nyoman Ribek, Ni Putu Dyah Aditya Pradnyani, I Dewa Ayu Ketut Surinati

Ni Nyoman Hartati, V.M.Endang S.P.Rahayu (2023)

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