Pengaruh Pemberian Jus Mentimun Rosella terhadap Tekanan Darah, Kalium Darah dan Natrium Urin Penderita Hipertensi

Abstract

Hipertensi mempengaruhi sekitar 1,4 miliar atau 31,1 % orang dewasa diseluruh dunia, sementara di Indonesia 30,8% atau sebanyak 566,883 orang pada tahun 2023. Tekanan darah dipengaruhi oleh keseimbangan natrium dan kalium: retensi natrium meningkatkan volume darah, sementara asupan kalium yang lebih tinggi mendukung natriuresis dan vasodilatasi. Strategi gizi biasanya berfokus pada pembatasan natrium dan peningkatan asupan kalium. Mentimun (Cucumis sativus L.) kaya akan kalium dan air dengan potensi efek diuretik, sementara rosella (Hibiscus sabdariffa) mengandung antioksidan dan dapat mendukung ekskresi natrium. Meskipun keduanya telah menunjukkan potensi antihipertensi secara individual, bukti mengenai efek kombinasinya masih terbatas. Tujuan penelitian ini secara umum adalah mengkaji pengaruh pemberian jus mentimun rosella terhadap penurunan tekanan darah, kadar kalium darah, dan natrium urin penderita hipertensi. Adapun tujuan khusus adalah (1) menganalisis formula terpilih jus mentimun rosella berdasarkan karakteristik organoleptik dan kandungan gizi. (2) mengidentifikasi karakteristik sosio demografi dan riwayat hipertensi subjek penderita hipertensi. (3) menganalisis perbedaan tingkat asupan kalium dan natrium antar kelompok sebelum dan setelah pemberian jus mentimun rosella. (4) mengkaji pengaruh jus mentimun rosella terhadap tekanan darah, kadar kalium darah, dan natrium urin penderita hipertensi. Penelitian ini menggunakan desain ekperimental Rancangan Acak Lengkap dan intervensi dengan desain quasi eksperimental dengan rancangan non randomized with control group pre postest two group. Penelitian dilaksanakan pada bulan Juli sampai Desember 2025. Intervensi penelitian dilakukan di wilayah UPT Puskesmas Cangkurawok, Kec. Dramaga, Kabupaten Bogor, Jawa Barat dengan dua desa yaitu Desa Babakan dan Desa Cikarawang. Penelitian ini terdiri dua tahap, yaitu penentuan formula jus didasarkan pada uji organoleptik dan analisis kandungan gizi; dan intervensi jus dan minuman placebo, masing-masing diberikan kepada subjek hipertensi pada kelompok perlakuan dan kontrol. Intervensi jus dan placebo dilakukan selama 14 hari dengan frekuensi 2 x 200 g per hari. Subjek penelitian berjumlah 24 orang dan terdiri dari 2 kelompok, yaitu kelompok intervensi (12 orang) dan kelompok kontrol (12 orang). Kriteria inklusi pada penelitian ini yaitu laki-laki dan perempuan berusia 26 - >65 tahun, mengalami hipertensi dengan tekanan darah sistolik =140 mmHg dan atau diastolik = 90 mmHg, menderita hipertensi esensial tidak mengalami penyakit komplikasi lainnya. Kriteria eksklusi adalah memiliki alergi mentimun dan rosella, pernah atau memiliki penyakit komplikasi atau kronis dan mengalami gangguan penyakit lainnya, dan mengonsumsi minuman sejenis (herbal). Tiga formulasi (F1, F2, dan F3) jus dibuat dengan menggunakan bahan utama mentimun dan rosella. Perbandingan berat mentimun (g); berat rosella (g) pada F1, F2, dan F3 berturut-turut adalah 100:2, 100;3, dan 100;4. Kandungan gizi jus yang dianalisis adalah kadar air, abu, protein, lemak, karbohidrat, dan mineral (kalium dan natrium). Hasil uji organoleptik menunjukkan bahwa daya terima hedonik panelis terhadap warna dan rasa berpengaruh signifikan dan berada pada rentang (nilai 5 = netral) hingga (nilai 7 = suka). Uji mutu hedonik juga menunjukkan perbedaan yang signifikan terhadap aroma rosella, rasa rosella, rasa masam, dan tekstur berpengaruh signifikan dan berasa pada rentang (nilai 5 = netral) hingga (nilai 8 = sangat kuat). Hal ini disebabkan karena penambahan rosella dapat mengurangi tingkat kesukaan panelis. Hasil penelitian pada kandungan gizi juga menunjukkan bahwa proporsi rosella terhadap mentimun berpengaruh signifikan terhadap kadar kalium dan natrium jus. Tiga formula yang dibuat selanjutnya dipilih satu formula yang digunakan dalam intervensi. Dasar pemilihan formula adalah pertimbangan dari penerimaan panelis dan kandungan gizi dari jus. F2 memiliki penerimaan terbaik dengan kandungan gizi yang masih tergolong tinggi. Mempertimbangkan aspek daya terima dan nilai gizi secara keseluruhan, F2 ditetapkan sebagai formula terpilih dengan proporsi mentimun:rosella yakni 100 g : 3 g. Jus mentimun rosella terpilih (F2) mengandung air 95,23 %, abu 0,29%, protein 0,43%, lemak 0,04%, karbohidrat 4,01%, kalium 179,62 mg/L, natrium 11,00 mg/L, dan magnesium 3,38 mg/L. Adapun kandungan energi per 100 g jus adalah sebanyak 18,25 kkal. Subjek didominasi dengan perempuan pada masing-masing kelompok. Karakteristik subjek pada kelompok kontrol dan intervensi umumnya relatif serupa. Sebagian besar subjek berusia 56–65 tahun, tidak bekerja/IRT, tidak merokok, serta memiliki status gizi obesitas. Seluruh subjek telah terdiagnosis hipertensi dan mengonsumsi obat hipertensi. Uji statistik menunjukkan terdapat perbedaan bermakna pada karakteristik pekerjaan dan kebiasaan merokok (p<0,05), sedangkan karakteristik lainnya tidak berbeda signifikan antar kelompok (p>0,05). Jus mentimun–rosella secara signifikan meningkatkan asupan kalium harian (p<0,05), menurunkan tekanan darah sistolik (?-8±11,26 mmHg; p=0,007), dan meningkatkan kadar kalium serum (?0,13±0,20 mmol/L; p=0,000) pada kelompok intervensi. Namun, kadar natrium urin tidak mengalami penurunan yang signifikan. Pengaruh placebo tidak signifikan, sedangkan kalium serum terjadi penurunan pada kelompok kontrol. Hal ini menunjukkan bahwa jus mentimun rosella berpotensi dalam menurunkan tekanan darah dan meningkatkan kalium darah. Jus mentimun rosella menunjukkan bahwa formula 2 (100 g mentimun : 3 g rosella) dipilih sebagai formula terbaik berdasarkan tingkat penerimaan panelis dan kandungan gizinya. Pemberian jus mentimun rosella F2 selama 14 hari pada penderita hipertensi terbukti meningkatkan asupan kalium dan kadar kalium serum serta menurunkan tekanan darah sistolik secara signifikan, namun belum memberikan pengaruh yang bermakna terhadap natrium urin. Dengan demikian, jus mentimun rosella berpotensi menjadi alternatif terapi diet pendukung dalam membantu pengendalian hipertensi.

Hypertension affects approximately 1.4 billion adults worldwide (31.1%). In Indonesia, the prevalence of hypertension is 30.8%, with approximately 566,883 reported cases in 2023. Blood pressure is regulated by the balance between sodium and potassium: sodium retention increases blood volume, whereas higher potassium intake promotes natriuresis and vasodilation. Therefore, nutritional strategies for hypertension management typically emphasize sodium restriction and increased potassium intake. Cucumber (Cucumis sativus L.) is rich in potassium and water, contributing to its potential mild diuretic effects, while roselle (Hibiscus sabdariffa L.) contains antioxidants and may enhance urinary sodium excretion. Although both have demonstrated antihypertensive potential individually, evidence regarding their combined effects remains limited. The general objective of this study was to evaluate the effect of cucumber–roselle juice administration on blood pressure, serum potassium levels, and urinary sodium excretion in patients with hypertension. The specific objectives were to: (1) determine the selected cucumber–roselle juice formulation based on its organoleptic characteristics and nutritional composition; (2) identify the sociodemographic characteristics and hypertension history of the study participants; (3) analyze differences in potassium and sodium intake between groups before and after the administration of cucumber–roselle juice; and (4) assess the effect of cucumber–roselle juice on blood pressure, serum potassium levels, and urinary sodium excretion in patients with hypertension. This study employed an experimental design using a Complete Randomized Design (CRD) and a quasi-experimental intervention with a non-randomized control group pre-test post-test two-group design. The study was conducted from July to December 2025. The research intervention was carried out in the working area of the Cangkurawok Public Health Center (Puskesmas), Dramaga District, Bogor Regency, West Java, covering two villages, namely Babakan Village and Cikarawang Village. This study consisted of two phases: first, the determination of the juice formula based on organoleptic testing and nutritional content analysis; and second, the intervention involving juice and placebo drinks, each administered to hypertensive subjects in the treatment and control groups, respectively. The juice and placebo interventions were conducted over 14 days with a frequency of 2 × 200 g per day. The study subjects totaled 24 individuals, divided into two groups: the intervention group (12 subjects) and the control group (12 subjects) The inclusion criteria for this study were: males and females aged 26 to >65 years, diagnosed with hypertension with systolic blood pressure =140 mmHg and/or diastolic blood pressure =90 mmHg, and having essential hypertension without any other complicating diseases. The exclusion criteria were: having allergies to cucumber and roselle, having a history of or currently suffering from complicating or chronic diseases and other medical disorders, and consuming similar types of beverages (herbal). Three formulations (F1, F2, and F3) of the juice were prepared using cucumber and roselle as the main ingredients. The weight ratios of cucumber (g) to roselle (g) for F1, F2, and F3 were 100:2, 100:3, and 100:4, respectively. The nutritional components analyzed in the juice included water content, ash, protein, fat, carbohydrate, and minerals (potassium and sodium). The organoleptic test results showed that the panelists' hedonic acceptance of color and flavor was significantly influenced, falling within the range of (score 5 = neutral) to (score 7 = like). The hedonic quality test also revealed significant differences in roselle aroma, roselle flavor, sour taste, and texture, with scores ranging from (score 5 = neutral) to (score 8 = very strong). This was attributed to the addition of roselle, which reduced the panelists' level of preference. The results of the nutritional content analysis also showed that the proportion of roselle to cucumber significantly affected the potassium and sodium levels of the juice. Among the three formulations, one formula was selected for use in the intervention. The selection was based on considerations of panelist acceptance and nutritional content of the juice. F2 demonstrated the best acceptance while still having relatively high nutritional content. Considering both acceptability and overall nutritional value, F2 was determined as the selected formula, with a cucumber-to-roselle ratio of 100 g : 3 g. The selected cucumber roselle juice (F2) contained 95.23% water, 0.29% ash, 0.43% protein, 0.04% fat, 4.01% carbohydrates, 179.62 mg/L potassium, 11.00 mg/L sodium, and 3.38 mg/L magnesium. The energy content per 100 g of juice was 18.25 kcal. Female subjects dominated both groups. The characteristics of subjects in the control and intervention groups were generally relatively similar. Most subjects were aged 56–65 years, unemployed/housewives, non-smokers, and had obese nutritional status. All subjects had been diagnosed with hypertension and were taking antihypertensive medication. Statistical analysis showed significant differences in employment status and smoking habits (p<0.05), while other characteristics did not differ significantly between groups (p>0.05). Cucumber–roselle juice significantly increased daily potassium intake (p<0.05), reduced systolic blood pressure (?-8±11.26 mmHg; p=0.007), and increased serum potassium levels (?0.13±0.20 mmol/L; p=0.000) in the intervention group. However, urinary sodium levels did not show a significant decrease. The placebo effect was not significant, whereas serum potassium levels decreased in the control group. This indicates that cucumber–roselle juice has the potential to lower blood pressure and increase blood potassium levels. Cucumber–roselle juice showed that Formula 2 (100 g cucumber : 3 g roselle) was selected as the best formula based on panelists' acceptance and nutritional content. Administration of cucumber–roselle juice Formula 2 for 14 days in hypertensive patients was proven to significantly increase potassium intake and serum potassium levels, as well as reduce systolic blood pressure, although it did not have a significant effect on urinary sodium. Thus, cucumber–roselle juice has the potential to serve as an alternative supportive dietary therapy in helping to manage hypertension.