Hypertension is one of the leading causes of mortality and morbidity in Indonesia. Resistant hypertension is a case of hypertension whose blood pressure remains high, after a change in lifestyle and obtaining management of 3 anti-hypertensive drugs with optimal doses with a different mechanism of action. The exact prevalence of HR is not known with certainty. The lack of data on the prevalence of resistant hypertension is the aim of this study to complete the data on the prevalence of resistant hypertension in UKI General Hospital. This research is descriptive. Data is taken from UKI General Hospital medical records from January to December 2019 with inclusion and exclusion criteria. Of the 1,030 in patients with hypertension, 139 patients are suffering from resistant hypertension. With the number of men and women not very different, the average age is 58 years, and most cases are in the age group> 65 years. Chronic kidney failure (CKD) is the most common comorbid disease, followed by DM and heart failure. Patients with more resistant hypertension have very high initial blood pressure, and most use a combination of 3 drugs to control their blood pressure.
Introduction: Bullous haemorrhagic dermatosis is a rare clinical disorder which is usually related to a treatment with unfractionated heparin (UFH) or low molecular weight heparin (LMWH), characterized by multiple intra-epidermal haemorrhages distant from the site of injection. Presentation of Case: A 62-year-old male patient with coronary heart disease who received heparin treatment experienced several tense, haemorrhagic bullae located on the right arm area, close to the injection site, and followed by the formation of several hematomas on his back trunk 2 days after he had received UFH. The lesions regressed after discontinuation of heparin and supportive topical treatments. Discussion: The lesions in this patient have similar characteristic with heparin-induced skin necrosis and demonstrate thrombocytopenia probably related to heparin. There are some proposed hypotheses of pathophysiology which include hypersensitivity reaction and idiosyncratic dose-related reaction. Given the clinically course, the discontinuation of heparin treatment was essential for lesion regression in addition other supportive measures. Conclusion: Heparin-induced skin lesions may indicate the presence of life-threatening heparin-induced thrombocytopenia. An early diagnosis is crucial to enable discontinuation of heparin if required.
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