Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.4
,
No
.1
, Mar
c
h 201
5,
p
p
.
3
7
~
43
I
S
SN
: 225
2-8
8
0
6
37
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Raja Bandung Banana (
Musa paradisiaca
L. cv Raja Bandung)
Prevents Increased Systolic Blood
Pressure in Rats Given Acute
Stress Test
Dina Sep
t
ari
Anind
y
ah
1
, A
r
ta
Far
m
aw
at
i
2
1
Department
of
Health
and
Nutrition, Faculty
of
Medicin
e
, Gadjah Mada
University
, Indon
esia
2
Department of Bioche
mistr
y
, Faculty
of
Medicine, G
a
dj
a
h
Ma
da
Unive
r
sity
, Indone
sia
Article Info
A
B
STRAC
T
Article histo
r
y:
Received
Ja
n 06, 2015
Rev
i
sed
Jan 29, 201
5
Accepted
Feb 15, 2015
The r
e
lationships between
stress and
h
y
perten
sion have been
evaluated.
Heighten
ed blo
od pres
s
u
re (BP
)
react
ions
to acut
e
s
t
res
s
have be
en
im
plicat
ed in c
a
r
diovas
c
ul
ar dis
eas
e’s
development. Consumptio
n of fruit or
vegetables
lowering BP. Th
is stud
y
aime
d
to
evalu
a
te
the
eff
ect
of Ra
j
a
Bandung Banan
a
(
Musa paradisiaca
L. cv Raja
Bandung) on blood pressure
after acute restraint stress and
forced swim
test.T
went
y
m
a
l
e
Sprague dawley
rats were d
i
vided into 4 groups (
A
,B
,C,D) and
ad
apted for
3 day
s
. At 4
th
day
,
groups were administered 2 g/200gBw AIN-9
3
M, then exposed to acute
restrain
t (1hour)
,
ex
cept g
r
oup
A. After
r
e
straint, A&B r
eceiv
ed water, C
rece
ived dia
zep
am
0.5m
g/kgBW
,
and D recei
ved banana 2
.
5
2
g/200gBW
.
One hour later
,
the for
ced swim test
was
carr
i
ed out (45 minutes). Bloo
d
pressure was
measured 1 hour after
swim. Result showed, mean of blood
pressure significantly
in
cr
e
a
sed
after t
r
ea
tm
ent (
p
<0.01) a
ll grou
ps. But, the
increasing of blo
od pressure in C
and
D group was lower than unr
estrain
t
(A)
and control (B)
group. There
was signi
ficant
differen
ce of blood pressure
between
control (A&B) and interventi
on group
(C&D), but no
significant
differen
c
e between C
and D.
Thi
s
result ind
i
c
a
tes
that
Ra
ja B
a
ndu
ng Banan
a
can pr
even
t in
cr
eased b
l
ood pr
essure on acute str
e
ss condition as
effective as
diaz
epam
.
Keyword:
B
l
oo
d press
u
re
Forced swim
test
Raj
a
Bandu
ng
Ban
a
n
a
Restraint stress
Copyright ©
201
5 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Arta Farm
awati,
Depa
rt
em
ent
of B
i
oc
hem
i
st
ry,
Gad
j
a
h
M
a
da
Uni
v
ersity
,
R
a
di
o
poet
r
o B
u
i
l
d
i
n
g
6
th
fl
oo
r, F
a
rm
ako st
re
et
, Seki
p
Ut
ara
,
Y
o
gy
aka
r
t
a
5
5
2
8
1
,
I
n
d
o
n
esi
a
.
Em
a
il: a.farm
a
w
ati@ug
m
.
ac.id
/a.farm
a
wati
@g
m
a
il.co
m
1.
INTRODUCTION
Health
is no
t
merely th
e ab
sen
ce of
d
i
sease o
r
i
n
firm
ity
b
u
t
a
po
sitiv
e
state o
f
co
m
p
l
e
te p
h
y
sical,
m
e
nt
al
and s
o
ci
al
wel
l
-
bei
ng
[1]
.
In t
h
e fact
, l
i
v
i
n
g
i
n
t
oday
’
s
wo
rl
d i
s
near
l
y
im
possi
bl
e wi
t
h
o
u
t
encountering s
t
ress. Stress ca
n be self-controlled. T
h
e pre
s
ence of certain am
ount of st
ress is necessa
ry for
every
one t
o
p
e
rf
orm
t
h
ei
r best
, but
w
h
en i
t
s
l
e
vel
s
pus
h t
o
t
h
e l
i
m
i
t
,
ho
weve
r, st
ress
becom
e
di
st
ress and
p
e
op
le
will no
lo
ng
er fu
n
c
ti
o
n
effectively [2
]
.
Peo
p
l
e
ha
ve
b
een ex
p
o
se
d m
a
ny
va
ri
o
u
s p
r
essur
e
s t
h
at
ca
n be
de
vel
o
pe
d t
o
st
re
ss. M
o
re t
h
a
n
t
w
o-
th
ird
s
of co
lleg
e
stud
en
ts exp
e
rien
ce so
m
e
typ
e
o
f
st
ress,
3
8
% of fem
a
le
co
lleg
e
stud
ents an
d
27
% of
males
reporte
d
that t
h
eir st
ress le
vel were
so hi
gh [3].
T
h
e
em
ployees get pressure
at
workplace. Working under
press
u
re ha
s becom
e
the rule
rathe
r
tha
n
exception, as t
h
e
result, st
re
ss
h
a
s bec
o
m
e
one
of t
h
e m
o
st
co
m
m
o
n
pr
o
b
l
e
m
s
. The num
ber of cas
es of w
o
r
k
-
r
el
at
ed st
ress, de
pressi
o
n
, an
d anxi
et
y
i
n
UK i
n
2
0
1
3
/
1
4 we
r
e
39%
[4]
.
I
n
I
n
do
nes
i
a,
t
h
e pre
v
al
e
n
ce of
psy
c
h
o
l
ogi
cal
di
st
ress
was 6%
i
n
20
1
3
[5]
.
C
u
r
r
e
n
t
est
i
m
a
t
e
s
i
ndi
cat
e
t
h
at
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:2252
-88
06
IJP
H
S
V
o
l
.
4,
No
. 1,
M
a
rc
h 20
1
5
:
3
8
– 43
38
th
e an
nu
al co
st o
f
stress and stress-related
d
i
sease ex
ceeds $
100
b
illio
n
in
US and
6
17 Eu
ro
in
Europ
e
in
2013 as a
dire
ct result of
he
alth
care c
o
st, lost productivity, absenteeis
m
, and social
welfare
costs
[2],[6].
St
ress
not
onl
y
affect
s t
h
e
econ
o
m
i
cal
aspect
, b
u
t
wo
ul
d be
de
vel
o
pe
d as se
ri
o
u
s a
nd c
o
nt
i
n
ued
heal
t
h
di
so
rde
r
i
f
not
han
d
l
e
d
p
r
o
p
er
l
y
, such as c
o
r
ona
ry
hea
r
t
di
s
ease, hy
pe
rt
en
s
i
on, eat
i
n
g
di
sor
d
er
, ul
ce
r di
a
b
et
es,
dep
r
essi
on
, m
i
grai
ne
headac
h
e
, sl
eep
di
s
o
r
d
er, a
n
d c
h
r
oni
c
fat
i
g
ue.
Th
e
regu
lar ph
ysical activ
ity o
r
ex
ercise is
go
od
for our h
ealth
. Th
eir
b
e
n
e
fits
are
sig
n
i
fican
tly
red
u
ce
ri
sk
f
o
r
devel
opi
ng
o
r
dy
i
n
g
f
r
om
hea
r
t
di
sease
,
st
r
o
ke, t
y
pe
2
di
a
b
et
es, col
o
n
an
d
br
east
canc
e
rs
, hi
gh
bl
o
od
p
r
ess
u
re
, an
d ost
e
o
p
o
r
ot
i
c
fract
u
r
e
[7
]
.
It
al
so seem
s t
o
re
duce
sy
m
p
t
o
m
s
of de
pressi
o
n
, a
nxi
e
t
y
,
and
im
pro
v
e m
ood
[2]
.
B
u
t
,
peo
p
l
e oft
e
n
do e
x
e
r
ci
se wi
t
h
w
r
o
ng
way
suc
h
a
s
not
i
n
go
o
d
con
d
i
t
i
on
or t
o
o
hi
g
h
in
ten
s
ity and
du
ration
,
so th
ey d
on’t g
e
t t
h
e
b
e
n
e
fits
.
Nowa
days, the
r
e are som
e
sudde
n death cas
es in
athlete. Since 1966 un
til 2004, t
h
ere
were
1.101
cases o
f
su
d
d
e
n
deat
h
on y
o
u
ng at
hl
et
e t
h
at
have
bee
n
re
porte
d
,
40%
cas
es were
ha
ppe
n
ed
on young
athlete
un
de
r 1
8
y
ears
ol
d an
d 3
3
%
on
un
de
r 1
6
y
ears ol
d at
hl
et
e. The 9
0
% ca
se caused
by
cardi
ovasc
ul
ar
, 50
% o
f
t
h
em
have car
di
om
y
opat
h
y
and
co
n
g
eni
t
a
l
hea
r
t
di
sease
,
an
d
10%
ha
v
e
at
her
o
scl
e
r
o
si
s at
t
h
ei
r c
o
ro
nary
artery [8]. It
has
been i
d
ent
i
fied
t
h
at
an e
x
cessi
ve el
e
v
a
t
i
on o
f
SB
P
d
u
ri
ng e
x
erci
se
t
e
st
i
ng ha
d
b
een a
stron
g
e
r pred
icto
r of
m
o
rtalit
y d
u
e
to
CVD th
an
SBP at
rest in so
m
e
previous st
ud
ies [
9
]-[
11
].
H
e
igh
t
ened
bl
o
od
press
u
re
(B
P) react
i
o
ns
t
o
acut
e
st
ress have bee
n
implicated in cardiovasc
u
lar dis
ease’s de
velopment.
St
udy
s
h
o
w
e
d
t
h
at
hy
pert
e
n
si
on
was occ
u
rre
d an
d de
vel
ope
d
on
peo
p
l
e
wh
o are e
x
p
o
se
d t
o
st
ress,
ei
t
h
er
phy
si
cal
, s
o
ci
a
l
, o
r
psy
c
h
o
l
o
g
i
cal
st
ress [
1
2]
-[
14]
.
One
o
f
t
h
e m
e
di
cat
i
ons
t
o
m
a
nage
st
res
s
i
s
di
aze
pam
dru
g
.
Hi
g
h
co
ns
u
m
pti
on
of
ben
z
odi
aze
pi
nes
(BDZ
) occ
u
rs
in p
o
p
u
latio
ns e
x
p
o
se
d to
stress.
In
Se
rbi
a
a
nd M
o
n
t
eneg
ro
, t
h
e t
o
t
a
l
con
s
um
pt
i
on
of
psychiatric drugs signi
ficantl
y increas
ed in 2000-2004 [15]. Diazepam r
eaching the first
place on the list of
th
e m
o
st freq
u
en
tly p
r
escrib
ed
d
r
ug
s
ass
o
cia
t
ed with hy
pert
ension
[16].
Th
e m
o
re n
a
tural
m
e
d
i
catio
n
is n
eed
ed
to
prev
en
t
h
i
gh
b
l
oo
d
p
r
essure on stress con
d
ition
.
Fo
od
is
a
go
o
d
ch
oi
ce for st
ress a
nd
hy
pe
rt
ensi
o
n
m
a
nagem
e
nt
.
Pot
a
ssi
um
can
m
odul
at
e t
h
e vaso
di
l
a
t
a
t
i
o
n
,
and
i
n
fl
ue
nce t
h
e
m
echani
s
m
of
reni
n-a
ngi
ot
en
si
n sy
st
em
– i
n
hi
bi
t
i
on
of re
ni
n secret
i
o
n an
d
i
n
crease t
h
e s
odi
um
excret
i
o
n-
, s
o
t
h
at
i
t
can de
cr
ease t
h
e bl
o
o
d
pres
su
re. C
o
n
s
um
pt
i
on o
f
K
e
po
k B
a
nana
c
a
n l
o
wer t
h
e
n
o
rm
al
blood press
u
re
significantly,
from
114.9//68.7 m
m
Hg to 103.2/
6
2.8 m
m
H
g
[17]. In a
d
dition,
diet influence
s
brai
n
neu
r
o
n
al
act
i
v
i
t
y
by
m
o
di
fy
i
n
g t
h
e
rat
e
o
f
sy
nt
hesi
s a
n
d
rel
ease
o
f
s
p
eci
fi
c
neu
r
ot
r
a
nsm
i
tt
ers [1
8]
.
C
e
reb
r
al
dy
s
f
u
n
ct
i
o
n
of
ser
o
t
oni
n
(5
H
T
)
ha
s bee
n
a
ssoci
at
ed
wi
t
h
st
ress
r
e
sp
onse
a
n
d
wi
t
h
af
fect
i
v
e
di
so
rde
r
s. St
ud
y
i
nvest
i
g
at
ed t
h
at
cerebral
d
y
s
fu
nct
i
on
of s
e
rot
oni
n achi
e
ved t
h
ro
u
gh a l
o
w t
r
y
p
t
o
p
h
a
n
di
et
,
in
crease th
e sen
s
itiv
ity o
f
rats to
stressfu
l
sti
m
u
l
i
[1
9
]
. Tryp
to
ph
an
is sero
t
o
n
i
n
p
r
ecurso
r th
at im
p
o
r
tan
t
to
st
ress, m
o
o
d
,
sl
eep re
g
u
l
a
t
i
o
n, a
n
d se
ns
ory
t
r
ansm
i
ssi
on
cont
rol
.
Ot
her
ne
ur
ot
ra
nsm
i
tt
er t
h
at
ben
e
fi
t
s
fo
r
str
e
ss an
d d
e
pr
ession
is
do
pa
m
i
n
e
. I
t
is
f
o
r
m
ed
f
r
o
m
a
m
in
o
aci
d
Tyro
sin
e
. Ban
a
n
a
has bo
th of
th
e amino
aci
ds al
t
h
ou
g
h
t
h
ey
are i
n
sm
al
l
am
ount
s
[2
0]
-[
21]
.
From
the facts above, t
h
is study aim
e
d to evaluate
ba
na
n
a
especi
al
l
y
t
h
e In
do
nesi
a
n
l
o
cal
ba
nan
a
because Indonesia is one
of the
bin
gge
st ba
nana
producing c
o
untries. R
a
ja Ba
ndung B
a
nana
is local
bana
na
th
at read
ily availab
l
e in
In
don
esia in
larg
e
q
u
a
n
tities.
In
mark
ets, it h
a
s v
e
ry l
o
w
price co
m
p
ared
wi
th
o
t
h
e
r
bana
na. B
eca
u
s
e som
e
of t
h
i
s
banan
a
has
seed i
n
si
d
e
,
it
mak
e
s th
is b
a
n
a
n
a
less pu
b
lic attractiv
e an
d
desi
ra
bl
e. Pe
o
p
l
e are m
o
re f
r
e
que
nt
use t
h
i
s
bana
na t
o
feed
t
h
e bi
rd
t
h
a
n
fo
r t
h
ei
r
o
w
n c
o
n
s
um
pt
i
on.
2.
R
E
SEARC
H M
ETHOD
2.
1.
Animals
The st
u
d
y
was
pre-
p
o
st
t
e
st
cont
rol
g
r
o
u
p
d
e
si
gn ex
pe
ri
m
e
nt
al
t
h
at
con
duct
e
d at
t
h
e Pusat
St
u
d
i
Pang
an d
a
n
Gi
zi (PSPG),
Pu
sat An
tar Un
iversitas, Un
iv
er
si
tas G
a
dj
ah
Mad
a
(UG
M
)
,
Indo
n
e
sia and
appr
ov
ed
by
t
h
e
Et
hi
cs
C
o
m
m
i
tt
ee of
M
e
di
cal
Facul
t
y
,
UGM
. T
w
ent
y
m
a
l
e
Spr
a
gue
dawl
ey
r
a
t
s
, 2
-
3
m
ont
h
s
ol
d,
weigh
i
ng
ab
out 1
5
0
-
20
0
g
were ob
tain
ed
fro
m
th
e Lab
o
rato
ry An
im
al o
f
PSPG
UGM
. Th
e an
im
als
were
ho
use
d
i
n
gr
o
u
p
(n=
5
)
i
n
h
o
m
e
cages
,
m
a
in
tain
ed und
er
a stan
d
a
rd d
a
rk
-li
ght cycle at
room
te
m
p
erature. T
h
e
rats ha
d
free
ac
cess to
f
o
o
d
a
n
d
water
(
ad
lib
i
t
u
m
).
2.
2.
Treatme
n
t
Rats were rand
o
m
ized
in
to
fo
ur gro
u
p
s
: (A) un
-restrai
n
t
+ water + swim
, (B) restraint + water +
swim
, (C) restraint + diazepa
m
drug 0.5
m
g
/kgB
W
+
swim
, (D) restraint + Raja
Bandung Bana
na 2.52
g/200gB
W
+ s
w
im
. First, rats were ada
p
ted for
3 days
and received standard
diet AIN-93M. At the 4t
h day,
all g
r
oup
s w
e
re ad
m
i
n
i
ster
ed
2
g
A
I
N-
93
M. A
f
ter
t
h
at, grou
p
s
w
e
r
e
exposed
to
1
h
o
u
r
restr
a
in
t str
e
ss,
ex
cep
t
group
A. After rest
raint stre
ss,
A
&
B group receive
d water,
C r
ecei
ved
diaze
pam
0.5m
g/kgB
W, and D
received bana
na 2.52
g/200gB
W
. One
hour late
r, the
forced swim
test
was
carried out (45 m
i
nutes). The
bl
o
o
d
p
r
ess
u
re
l
e
vel
was
m
easure
d
1
h
o
u
r
a
f
t
e
r t
h
e
en
d
of
f
o
rced
swi
m
t
e
st
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Raja Bandung
Banana
(Mus
a paradisiac
aL.cv Ra
j
a
B
a
ndung)
Prevents
.... (Dina
Se
ptari
A
nindy
ah)
39
2.
3.
Ma
terials
R
a
ja B
a
n
d
u
n
g
B
a
nana
was s
u
ppl
i
e
d
by
Pl
as
m
a
Nut
f
a
h
Pi
s
a
ng
Y
ogy
a
k
art
a
, I
n
d
o
n
esi
a
. T
h
e m
e
di
um
si
ze
R
a
ja
B
a
n
d
u
n
g
B
a
na
na ha
s wei
ght
ave
r
a
g
e ±7
0
-
1
0
0
g.
In t
h
i
s
st
u
d
y
,
1
40
g bana
na w
a
s used (ass
um
pt
i
on
on
hum
an con
s
um
pt
i
on of
2 m
e
di
um
bana
n
a
s). F
o
r i
n
t
e
r
v
e
n
t
i
on
on
rat
s
, t
h
e wei
g
ht
o
f
b
a
nana
was m
u
lt
i
p
l
i
e
d
wi
t
h
0
.
0
1
8
(c
o
nve
rsi
o
n
fact
or
). B
a
na
na
has
been
h
o
m
ogen
i
zed wi
t
h
h
o
m
oge
ni
zer t
ool
(
A
rm
fi
el
d m
odel
L4R
)
before
it gi
ven. Ot
her treatment group
use
d
diazepam
drug. T
h
e a
d
m
i
nistered
of diaz
epam
0.2 m
g
/kgB
W
red
u
ce
d t
h
e
6
3
.
5
% c
o
rt
i
s
ol
on
rat
s
t
h
at
gi
ve
n el
ect
ri
c
cur
r
e
n
t
[2
2]
.
An
ot
he
r st
ud
y
sho
w
e
d
,
on
l
y
l
o
w
(0
.5m
g
/
k
g
)
a
n
d m
e
di
um
-dos
e (
1
m
g
/
kg)
di
a
zepam
bl
ocke
d
t
h
e
det
r
i
m
ent
a
l
effect
s
o
f
c
h
r
o
ni
c st
ress
[
23]
,
s
o
t
h
e 0
.
5
m
g
/
kg
dos
e w
a
s
use
d
i
n
t
h
i
s
st
udy
.
2.
4.
Stress Tes
t
The
psy
c
hol
og
i
cal
st
resso
r t
h
at
use
d
i
n
t
h
i
s
expe
ri
m
e
ntal was
restrai
n
t st
ress. The a
n
im
al was
place
d
i
n
a 1
2
cm
x 5
cm
pl
ast
i
c
t
ube
w
h
i
c
h i
s
m
a
de fr
om
PVC pipe, encl
osed, to
imm
obilize the anim
al. There
was
a 1 cm
hole at
one
end of t
u
be for the tail a
n
d fi
ve sm
a
ller ho
les at t
h
e
o
t
h
e
r end
fo
r
breath
in
g. Th
e
restrain
t
had
bee
n
carri
ed o
u
t
f
o
r
1 ho
u
r
. A
f
t
e
r t
h
e rest
rai
n
t
,
t
h
e
ani
m
al
got
vi
go
r
ous e
x
erci
s
e
im
m
e
di
at
el
y aft
e
r
restraint end. It
was force
d
s
w
im
tes
t
. The anim
als were
placed in large boxes (40 cm
width
x 48 cm
le
nght x
4
1
cm
d
e
p
t
h) t
h
at were
filled
with
water
un
til th
e rats
wo
u
l
d
n
o
t
b
e
ab
le t
o
tou
c
h
th
e bo
t
t
o
m
o
f
bo
x durin
g
t
h
e
swi
m
m
i
ng t
e
st
. The
hei
g
ht
o
f
bo
x s
h
oul
d be
hi
g
h
e
n
o
u
gh t
o
pre
v
e
n
t
t
h
e r
a
t
s
fr
om
escapi
n
g f
r
om
t
h
e b
o
x
.
The
swi
m
m
i
ng t
e
st
ha
d
been
car
ri
ed
out
f
o
r
1
h
o
u
r
,
i
n
g
r
o
u
p
s.
After th
e
swimmin
g
test, th
e rats were dried
g
e
n
tly
usi
n
g t
o
wel
s
a
n
d
pl
ace
d
un
de
r t
h
e
su
n l
i
g
ht
bef
o
re
t
h
e
bl
o
o
d
press
u
re m
e
asure
d
.
2.
5.
B
l
ood
Pressur
e
An
al
ysi
s
On the
4
th
day
,
t
h
e sy
st
ol
i
c
bl
o
od
press
u
re
was
m
easur
e
d
twice, at the early
m
o
rning be
fore any
treatm
e
nt and 1 hour afte
r the en
d o
f
forc
ed s
w
im
test. The bl
ood press
u
re
m
easurem
ent used
Sph
y
g
m
o
m
an
ometer
S-
2
,
V
e
rsi 6
.
90
fro
m
H
S
E (H
ugo
Sach
s Elek
tron
ik)
D
-
7
806
Mar
c
h/Fr
eibu
rg
,
w
ith tail
-
cuf
f
m
e
t
hod.
2.
6.
Statistica
l Ana
l
y
s
is
Dat
a
we
re e
x
p
r
esse
d as m
ean
± st
an
da
rd
devi
at
i
o
n a
n
d
anal
y
zed
usi
n
g S
PSS
ve
rsi
o
n
14
.0
. T
h
e
no
rm
al
di
st
ri
but
i
on
of
vari
a
b
l
e
was t
e
st
ed an
d co
nfi
r
m
e
d by
Saphi
ro
Wi
l
k
t
e
st
. The dat
a
wi
t
h
norm
a
l
di
st
ri
b
u
t
i
on
we
re anal
y
zed usi
ng
param
e
t
r
i
c
t
e
st
. The chan
ge i
n
bl
o
o
d
p
r
essur
e
bet
w
ee
n pr
et
est
and p
o
st
t
e
st
were
com
p
are
d
by
paired-sa
m
ple t test in each
group.
T
h
e m
ean di
ffe
rence
betwee
n
groups
we
re c
o
m
p
are
d
b
y
on
e
w
a
y
A
NOV
A,
if
th
e r
e
su
lt sh
owed
sign
ificant d
i
fferen
t
, the test was con
tin
u
e
d
with
m
u
l
tip
le
co
m
p
ar
iso
n
used
p
o
st ho
c
bon
f
e
r
r
on
i
test to see th
e m
o
st effectiv
e
group
. Th
e sign
ificance lev
e
l
was set at P
< 0
.
01
(99
%
C
I)
fo
r all statistical co
m
p
arison
.
3.
RESULTS
A
N
D
DI
SC
US
S
I
ON
The e
ffect
s
o
f
t
r
eatm
e
nt
on
bl
oo
d
p
r
essu
re a
r
e s
h
o
w
n i
n
Ta
bl
e 1
.
In
t
h
e
be
gi
n
n
i
n
g,
be
fo
r
e
t
h
e st
re
ss
adm
i
ni
st
rat
i
on,
t
h
e rat
s
’
s
bl
oo
d p
r
ess
u
re
sh
o
w
n
o
t
si
g
n
i
f
i
c
a
n
t
l
y
di
ffe
rent
(
P
>0.
0
5)
. That
can be
co
ncl
u
d
e
d, al
l
rats in
all
g
r
oup
s are in th
e
same co
nd
itio
n.
Tabl
e
1. M
e
a
n
± S
D
of
t
h
e
Sy
st
ol
i
c
B
l
oo
d P
r
essur
e
Gr
oup Pr
e-
test
(m
m
H
g)
Post-test
(m
m
H
g)
P*
A (
un-
r
e
str
a
int +
water
+ swi
m
)
89.
40 ± 4,
67
130.
20± 1,
9
2
a
0.
000
B (
r
e
str
a
int +
water
+ swi
m
)
84.
20 ± 4,
38
134.
20 ± 4,
43
a
0.
000
C (
r
e
str
a
int +
Diazepam
+ swi
m
)
83.
80 ± 4,
14
106.
60 ± 4,
50
b
0.
002
D (
r
estr
aint + Banana + swi
m
)
87.
00 ±5,
0
9
107.
20 ± 2,
77
b
0.
000
P
**
0.
222
0.
000
*)
pai
r
e
d
sam
p
l
e
t
t
e
st
, si
g
n
i
f
i
cant
di
ffe
rent
i
f
p<0
.
0
1
(9
9%
C
I
)
**
) o
n
e way
AN
O
V
A
t
e
st
, si
gni
fi
ca
nt
di
ff
erent
i
f
p<0
.
0
1
(9
9%
C
I
)
.
T
h
e resul
t
o
f
m
u
lt
i
p
l
e
co
m
p
ari
s
o
n
s (P
ost
hoc
bo
nf
er
ro
ni
t
e
st
) was sho
w
n
by
supe
rsc
r
i
p
t
.
Sam
e
su
perscrip
t m
e
an
s
no
sign
ifican
t d
i
fferen
c
e
b
e
tween
g
r
ou
ps.
Aft
e
r t
h
e t
r
eat
m
e
nt
, t
h
e bl
oo
d p
r
ess
u
re i
n
c
r
ease si
g
n
i
f
i
c
a
n
t
l
y
i
n
al
l
gro
ups
(P<
0
.
0
1)
.
Gr
ou
ps t
h
at
o
n
l
y go
t o
r
al in
terv
en
tion
with
water (Grou
p
A and
B)
sh
ow
th
e
h
i
gher
elev
ation
of
b
l
ood
pr
essur
e
in
p
o
s
ttest. Co
m
p
ared
b
e
t
w
een th
at two
group
s, th
e
b
l
ood
press
u
re after
swimming test increases
higher i
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:2252
-88
06
IJP
H
S
V
o
l
.
4,
No
. 1,
M
a
rc
h 20
1
5
:
3
8
– 43
40
g
r
ou
p th
at
g
o
t
restrai
n
t th
an un
rest
rain
t
one, altho
ugh
the d
i
fferen
ce is no
t sign
if
icant statistical
ly (sh
o
wn
with
sam
e
su
perscri
p
t).
This study shows that acute s
t
ress adm
i
nistration can
i
n
cre
a
se the blood
pres
sure sign
ifican
tly. Th
e
p
r
ev
iou
s
stud
y sho
w
ed th
e i
n
creases in SBP and
DBP to
th
e m
e
n
t
al stress task
were sub
s
tan
tial an
d
si
gni
fi
ca
nt
(
5
7
.
6
1
m
m
Hg and
3
8
.
31m
m
H
g;
p<
0.
00
1)
[
2
4
]
. A m
e
t
a
anal
y
s
i
s
of c
o
h
o
r
t
st
udi
es
sh
o
w
ed t
h
at
i
ndi
vi
dual
s
w
h
o ha
d st
r
o
nge
r
resp
o
n
ses t
o
st
resso
r t
a
sk
s were
2
1
% m
o
re l
i
k
el
y
t
o
de
vel
o
p bl
oo
d
pr
essur
e
increase
whe
n
com
p
ared to
those
with les
s
strong
re
s
p
o
n
ses i
n
a
d
ul
t
aged
bet
w
ee
n
1
8
an
d
64 y
ear
s [2
5]
.
Adm
i
nistration of stress
with air press
u
re
5 tim
e
s
a
week, each 30 m
i
nutes, could i
n
c
r
eases the SB
P 13
m
m
H
g [
26]
wi
t
h
l
i
ght
e
x
po
su
re
3 t
i
m
es a week eac
h
30
m
i
nut
es i
n
crease
s
SB
P si
gni
fi
cant
l
y
[2
7]
, a
n
d
wi
t
h
restrain
t a week
in
crease
49
.5 mm
Hg
[28
]
.
The b
ody
res
p
on
ds t
o
st
ress
by
act
i
v
at
i
ng t
h
e fi
g
h
t
-
or
-fl
i
g
ht
m
echani
s
m
,
whi
c
h p
r
e
p
are
s
a perso
n
t
o
t
a
ke act
i
o
n
by
st
im
ul
at
i
ng t
h
e vi
t
a
l
d
e
fe
nse
sy
st
em
s. Thi
s
st
im
ul
at
i
on
or
i
g
i
n
at
es i
n
t
h
e
hy
pot
hal
a
m
u
s a
n
d
p
itu
itary g
l
ands in
th
e b
r
ain. Th
e h
y
p
o
t
h
a
lam
u
s act
iv
at
es the release of catecholam
ines
from
adrenal glands
.
Th
ese
ho
r
m
o
n
al ch
an
g
e
s in
cr
ease
h
ear
t
h
r
a
te, b
l
o
o
d
p
r
essu
r
e
, an
d b
l
o
od f
l
ow
, b
l
o
o
d
glu
c
o
s
e, an
d oxyg
en
upt
a
k
e [2]
.
In
rece
nt
st
u
d
y
,
t
h
e
l
e
vel
of
b
l
oo
d
pres
su
re
aft
e
r e
x
erci
se
on
rest
rai
n
t
gr
ou
p i
s
hi
ghe
r.
The sy
st
ol
i
c
blood
pres
sure
also increase
after th
e vi
go
r
ous e
x
erci
se
, 1
5
.
6
m
m
Hg after hi
g
h
i
n
t
e
n
s
i
t
y
t
r
ead
m
i
ll
[29]
an
d
19
.2
m
m
Hg aft
e
r
1
ho
u
r
s
w
i
m
t
e
st
[
28]
.
B
u
t
,
com
b
i
n
at
i
on
of
psy
c
hol
ogi
cal
and
p
h
y
s
i
cal
st
ress a
d
m
i
ni
st
rat
i
on
can inc
r
ease
the catecholamine
hi
g
h
e
r
t
h
a
n
a
l
one
[
30]
.
Figure
1. Mean of Pretest and
Posttest Blood
Pr
ess
u
re
± SD.
Gr
ou
p A:
u
n
re
strain
t+water+swim
; B
:
restrain
t+water+swim
; C
:
restrain
t+d
i
azep
a
m+swi
m
; D: restrain
t+Raj
a
B
a
n
dun
g b
a
n
a
n
a
+swim
The l
e
vel
bl
o
o
d
pre
ssu
re o
n
post
t
e
st
are si
g
n
i
f
i
cant
di
f
f
e
r
e
n
t
bet
w
ee
n g
r
o
ups
(P<
0
.
0
1
)
.
Gr
ou
p t
h
at
g
o
t
water after restrain
t test has th
e h
i
gh
est lev
e
l o
f
b
l
ood
p
r
essure (1
34
.2
mm
Hg
) th
an wh
ich
go
t b
a
nan
a
or
diazepam
. The
m
u
ltiple compar
is
ons s
h
ow that the
m
ean differe
n
ce
of
posttest blood press
u
re
between
B
gr
o
u
p
an
d C
g
r
ou
p i
s
si
g
n
i
f
i
c
a
n
t
,
al
s
o
bet
w
ee
n B
gr
o
u
p
an
d
D
gr
ou
p
(P<
0
.
0
1
)
.
0
20
40
60
80
100
120
140
160
AB
C
D
Blood Pressure
(mmHg)
Gr
oups
pretest
posttest
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Raja Bandung
Banana
(Mus
a paradisiac
aL.cv Ra
j
a
B
a
ndung)
Prevents
.... (Dina
Se
ptari
A
nindy
ah)
41
Fi
gu
re 2.
The
El
evat
i
o
n
o
f
B
l
oo
d Press
u
re A
f
ter T
h
e Restra
int and
Oral
Treatm
e
nt. Group
(A)
unrestrai
n
t+wa
ter+swim
; (B) restraint+
water+swim
;
(C) res
t
raint+diazepa
m
+swim
;
(D)
restraint+Raja
B
a
nd
u
n
g
ba
na
na+swi
m
.
*
p
<
0
.
05=
g
r
ou
p
A
com
p
ared
wi
t
h
g
r
o
u
p
B
,
a
n
d
p<0
.
0
1
c
o
m
p
ar
ed
wi
t
h
C
,
an
d
D.
**
p<
0.
01=
g
r
o
u
p
B
c
o
m
p
ared
wi
t
h
C
an
d
D.
From
Fi
gu
re
2,
t
h
e c
h
an
ge
of
bl
o
o
d
p
r
ess
u
re
aft
e
r t
r
eat
m
e
nt
s i
s
sh
ow
n.
A
m
ong t
h
e
rest
r
a
i
n
t
gr
o
u
p
s
(B
, C
,
D
)
,
g
r
o
u
p
D
ha
s t
h
e
l
o
west
i
n
crea
se
(
2
3
.
2
2
%
)
of
b
l
oo
d
pres
su
re,
t
h
en
f
o
l
l
o
we
d
by
g
r
ou
p C
(
2
7.
21
%)
.
The G
r
o
u
p
B
has t
h
e hi
ghest
i
n
crease am
ong t
h
em
(59
.
3
8
%)
. St
at
i
s
t
i
c
al
l
y
, t
h
e i
n
creasi
ng o
f
bl
oo
d p
r
essu
r
e
on
restrai
n
t groups is signifi
cant differe
n
t
betwee
n
wate
r treatm
e
nt (B) and
diazepam
(C) or
betwee
n water
and Ra
ja Bandung Bana
na
(D).
Diazepam and Ra
ja
Ba
ndung Ba
nana
adm
i
nistratio
n can s
u
ppres
s
ed the
elevation of SBP, but t
h
e m
e
an
diffe
ren
ce i
s
no
t sign
ificant (P>0
.0
5).
Benzodiazepi
n
es (BZ
D
s),
pa
rticularly diaze
pam
,
ha
ve
bee
n
am
ong the
m
o
st frequentl
y pres
cribe
d
dr
u
g
s, espe
ci
al
l
y
i
n
devel
o
p
e
d co
unt
ry
. Thi
s
dr
u
g
i
s
used as an
xi
ol
y
t
i
c
, hy
pnot
i
c
,
sedat
i
v
e, am
nesi
c
,
antiepileptic, a
n
d m
u
scle relaxant
properties
[31].
Di
azepa
m
reaching the
first
place
on
the list of t
h
e
m
o
st
fre
que
nt
l
y
p
r
e
s
cri
b
e
d
dr
u
g
s
associ
at
ed
wi
t
h
hy
pe
rt
ensi
on
in
Serb
ia
[16]. In
th
is recen
t
stud
y, th
e
d
o
s
age
treat
m
e
n
t
is 0
.
5
m
g
/
k
g
B
W, so th
e av
erag
e rats with
we
igh
i
n
g
2
0
0
g
will
g
e
t 0
.
1
m
g
/d
ay
. Th
is do
sag
e
is sa
m
e
with
5.5
m
g
/day in
h
u
m
an
.
Prev
iou
s
stud
y
h
a
s ev
alu
a
ted th
at BZDs (C
lo
n
azep
a
m
)
1
-
2
m
g
/d
can
st
ab
ilize
bl
o
od
pres
su
re
fl
uct
u
at
i
o
ns i
n
82%
pat
i
e
nt
s wi
t
h
u
n
st
abl
e
hy
pe
rt
ensi
o
n
si
gni
fi
cant
l
y
[3
2
]
. The recom
m
e
nde
d
dos
es
of
diaze
pam
in the trea
tm
ent of a
n
xiety are
4
−
4
0
m
g
/
d
ay
di
vi
de
d i
n
t
w
o
d
o
ses at
l
e
ast
[3
3]
.
B
e
si
des t
h
at
,
t
h
e a
d
m
i
ni
st
rat
i
on
o
f
R
a
ja B
a
nd
u
n
g Bana
na
can l
o
we
r t
h
e
increase
s
blood press
u
re
after vigorous exercise
m
o
re than
t
h
at diazepam
did.
Ra
ja Bandung
Bana
na weighing
100
g
consists of 28.64
g car
b
ohy
drat
e
s
;
0.5
g
fat
;
1.
2 g
pr
ot
ei
n;
2.
47
g fi
ber;
10
5
.
2
4
m
g
phe
nol
.
The
pre
v
i
o
us
st
udy
o
n
s
u
bje
c
t
wh
o
was
fr
ust
r
at
i
o
n,
an
gry
,
or
dep
r
essi
on
u
n
d
er
p
r
ess
u
re
s
h
o
w
e
d
t
h
at
hi
gh
car
b
ohy
dra
t
es co
ns
um
pt
ion
ca
n
d
ecrease an
d
h
e
lp th
em
m
a
n
a
g
e
th
ese resp
on
ses [34
]
.
In add
itio
n,
ban
a
n
a
h
a
s
dop
am
in
e, on
e
o
f
th
e
neu
r
ot
ran
s
m
i
t
t
er.
D
opam
i
ne i
s
fo
rm
ed by
Am
i
no aci
d T
y
rosi
ne
, a
nat
u
ral
com
p
o
u
n
d
t
h
at
can
be
f
o
un
d
i
n
ani
m
al
pro
d
u
ct
, oat
,
ba
nana
, a
nd
g
r
ai
ns.
B
a
s
e
d o
n
t
h
e resea
r
ch
,
Musa c
a
ve
ndis
h
ii
ba
nana
fl
esh
had
2
.
5
-
1
0
m
g
do
pam
i
ne [20]
, ot
he
r st
u
d
y
sho
w
e
d
0
,
4
2
m
g
/
1
00
g d
o
p
am
i
n
e o
n
fl
eshe
d
bana
na [
2
1]
. A
not
her am
i
no aci
d i
s
t
r
y
p
t
o
pha
n, t
h
e
serot
oni
n p
r
ec
urs
o
r
.
T
h
e adm
i
ni
st
rat
i
on
of t
r
y
p
t
o
p
h
a
n
i
n
c
r
e
a
ses t
h
e b
r
ai
n
serot
oni
n sy
nt
hesi
s.
Ser
o
t
o
ni
n
has
som
e
psy
c
hol
o
g
i
cal
f
unct
i
o
n
and
be
ha
vi
o
r
s
u
ch
as m
o
o
d
a
n
d
sl
eep
re
gul
a
t
or.
A
b
n
o
r
m
a
lit
i
e
s o
f
brai
n ser
o
t
o
ni
n
have
bee
n
r
e
l
a
t
e
d t
o
dep
r
essi
on
, an
xi
et
y
,
and
aggr
ession
(Tank
e
,
2
008
). The
inc
r
eases of both
neu
r
ot
ran
s
m
i
t
t
er
m
a
y
gi
ve rel
a
x sensat
i
o
n
and dec
r
eas
e
st
ress, so t
h
e
el
evat
i
on of
bl
o
od
press
u
re
aft
e
r
exercise does not
hi
gh.
B
e
si
de t
h
e c
o
m
poun
d w
h
i
c
h ha
s psy
c
hol
ogi
cal
ef
fect
,
bana
na i
s
one
of t
h
e f
r
ui
t
s
t
h
at
ri
ch i
n
pot
assi
um
. R
e
gul
a
r
1
0
0
g
ba
nana
co
nt
ai
ns
35
8 m
g
p
o
t
a
ss
i
u
m
and 8
.
7
m
g
vi
t
a
m
i
n C
[3
5]
. C
o
ns
um
pt
ion
o
f
Kep
o
k
B
a
na
na
(an
o
t
h
er l
o
cal
bana
na i
n
I
n
d
one
si
a) can l
o
wer t
h
e
no
rm
al
bl
oo
d p
r
ess
u
r
e
si
gni
fi
cant
l
y
,
from
114.9//68.7 mm
Hg to 103.
2/62.8 mm
Hg [17].
Decrea
se
d of bl
ood
pressure can
be
expla
n
ation
because
pot
assi
um
can
m
odul
at
e t
h
e vessel
vaso
di
l
a
t
a
t
i
on, an
d i
n
fl
uence t
h
e m
e
chani
s
m
of reni
n-a
n
gi
ot
ensi
n s
y
st
em
with
in
h
i
b
itio
n o
f
ren
i
n
secretio
n
and
in
crease th
e so
d
i
u
m
e
x
cretion
,
so
that it can
d
ecrease th
e b
l
oo
d
p
r
essu
re
[3
6]
.
*
45,64%
**
59,38%
27,21%
23,22%
0
10
20
30
40
50
60
AB
C
D
mmHg
Groups
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:2252
-88
06
IJP
H
S
V
o
l
.
4,
No
. 1,
M
a
rc
h 20
1
5
:
3
8
– 43
42
4.
CO
NCL
USI
O
N
The ac
ute st
res
s
test could inc
r
ease t
h
e systol
ic bl
ood
p
r
essure si
g
n
i
fican
tly bu
t th
e ad
m
i
n
i
stratio
n of
R
a
ja B
a
nd
u
n
g
B
a
na
na
has
been
dem
onst
r
at
ed t
o
p
r
ev
en
t it and h
a
s th
e
similar effect co
m
p
ared
with
diazepam
. From this result, consum
ption of two m
e
di
um sizes of Raja
Bandung Bananas gi
ves the
better
co
nd
itio
n fo
r st
ress
o
r
und
er pressure
p
e
rson
who
will tak
e
v
i
go
rou
s
ex
ercise.
ACKNOWLE
DGE
M
ENTS
Th
e pr
esen
t stu
d
y
w
a
s f
i
nancial su
pp
or
t by “H
ib
ah
Un
gg
u
l
an
Pergu
r
uan
Tingg
i, Ang
g
a
r
a
n
DI
PA
2
014
Un
iv
ersitas Gadj
ah
Mad
a
, In
don
esia.
We also
th
ank to
Mr. Yu
lianto
,
th
e tech
n
i
cian
s an
d
laboran
o
f
Ani
m
al
Labor
at
ory
o
f
“Pus
a
t
St
udi
Pan
g
a
n
dan
Gi
zi
” UGM for the as
sistance an
d a fr
i
e
ndl
y
ad
vi
ce du
ri
n
g
th
e p
r
oj
ect wo
rk
. Fadh
ila Ik
a San
i
an
d
Han
a
Am
alia
Karim
a
,
m
e
mb
ers
o
f
th
is
proj
ect, fo
r th
eir k
i
nd
coope
r
ation and e
n
couragem
ent.
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ccupa
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ber
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Hoeger W
W
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Hoeger SA.,
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L
ife
tim
e Ph
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itio
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ai
z
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m
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i
lho
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u
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a
rvalho
TD., Va
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i
LC.
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e
nti E
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ste
r
na
s JR.
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rreira
C., “Sudden Car
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iac Death Ath
l
et
es: A S
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stematic Review”,
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y
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o
l. 2
,
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. 1186
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Mundal R., Kjedsen SE., Sandvik L.,
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low
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essure Predicts
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l
ar
Mortalit
y in
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d
le-ag
e
d
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pe
rte
n
sion
, v
o
l. 24
, pp
. 56–62
, 1994
.
[10]
Mundal R., Kjeldsen SE., Sandv
ik L
., Erikssen G.,
Th
aulow E.,
Erikssen
J.
, “Exercise Blood P
r
essure Predicts
Mortality
from M
y
ocardial
Inf
a
r
c
tion
”
,
Hyperten
sion,
vol/issue: 2
7
(1), pp
. 324–32
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[11]
Filipovsk
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