Diuretic Potency of Belalai Gajah Plants (Clinacanthus nutans (Burm.fil.) Lindau)

Abstract

Hypertension is a major risk factor for cardiovascular disease and chronic kidney disease, the leading cause of death globally. 1 Hypertension or high blood pressure is a condition where after two separate measurements there is an increase in systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg. [2][3][4] If left unchecked, this disease can interfere with the function of other organs such as the heart and kidneys which are vital organs. 5 Symptoms that can be caused in people with hypertension are chest pain, vision problems, ringing in the ears, fatigue, confusion, headache, feeling of heaviness in the back of the neck, vertigo, nosebleeds, dyspnea/ shortness of breath, increased frequency of urine, nausea, sleep apnea, irregular heartbeat regular. 6,7 Factors that cause hypertension are age, family history, being overweight/obese, not being physically active, using tobacco, consuming too much salt (sodium) in the food consumed, too little potassium in the food consumed, consuming too much alcohol. 8 Hypertension often occurs in patients with chronic kidney disease. Hypertension management is needed to control blood pressure and prevent complications. Prevention of hypertension can be done with non-pharmacological efforts such as weight loss and limiting salt intake. As for pharmacological treatment such as therapy with antihypertensive drugs, one of which is diuretics. 7 Diuretics are drugs that can increase urine production due to the excretion of water and electrolytes by the kidneys. 10,11 The accumulation of fluid in the body's tissues is due to the inability of the kidneys to release sodium and water which are excreted together. Diuretics can be used to treat edema, heart failuure, and hypertension. 11 Diuretics can be categorized into three groups: loop diuretics, thiazide diuretics, and potassium-sparing diuretics. [12][13][14] Diuretics are used to improve the composition and volume of fluids in the body, which treats hypertension. 15,16 The mechanism of action of diuretic drugs in lowering blood pressure is by helping the kidneys function in filtering, removing salt and water, which in turn reduces the volume of fluids in the body so that blood pressure also decreases. 7,17 Hypertension is generally treated using synthetic drugs such as furosemide. [18][19][20][21] Furosemide is a loop diuretic that can reduce the reabsorption of sodium produced by the kidneys. Furosemide can inhibit the luminal Na-K-Cl co-transporter in the loop of Henle by binding to the chloride transport channel. In this case, elevated levels of Na, Cl, and K remain in the urine. 22 Long-term use of furosemide is known to cause electrolyte balance disturbances (excessive loss of sodium and potassium),