Importance: Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity. Compared with disease burden rates in 1990, significant reductions in Disability-Adjusted Life Years (DALYs) burden rates for CVD have been recorded. However, general DALYs rates have not changed in Indonesia in the past 30 years. Thus, assessing Indonesian CVD burdens will be an essential first step in determining primary disease interventions. Objective: To determine the national and province-level burden of CVD from 1990 to 2019 in Indonesia. Design, Setting, and Participants: A retrospective observational study was conducted using data from the Global Burden of Disease (GBD) 2019, provided by the Institute of Health Metrics and Evaluation (IHME), to analyze trends in the burden of CVD, including mortality, morbidity, and prevalence characteristics of 12 underlying CVDs. Exposures: Residence in Indonesia. Main Outcomes and Measures: Mortality, incidence, prevalence, death, and DALYs of CVD. Results: All-age CVD deaths more than doubled from 292 thousand (95% UI: 246 to 339 thousand) in 1990 and increased to 659 thousand (95% UI: 542 to 747 thousand) in 2019. All CVDs recorded increased death rates, except for rheumatic heart disease (RHD) (− 69%) and congenital heart disease (CHD) (− 37%). Based on underlying diseases, stroke and ischemic heart disease (IHD) are still the leading causes of mortality and morbidity in Indonesia, whereas stroke and peripheral artery disease (PAD) are the most prevalent CVDs. Indonesia has the second worst CVD DALYs rates compared to ASEAN countries after Laos. At provincial levels, the highest CVD DALY rates were recorded in Bangka Belitung, South Kalimantan, and Yogyakarta. In terms of DALYs rate changes, they were recorded in West Nusa Tenggara (24%), South Kalimantan (18%), and Central Java (11%). Regarding sex, only RHD, and PAD burdens were dominated by females. Conclusions: CVD mortality, morbidity, and prevalence rates increased in Indonesia from 1990 to 2019, especially for stroke and ischemic heart disease. The burden is exceptionally high, even when compared to other Southeast Asian countries and the global downward trend. GBD has many limitations. However, these data could provide policymakers with a broad view of CVD conditions in Indonesia.

Background: Rhodamine B is a component of xenobiotic substance metabolized by cytochrome P450 in the body to produce free radicals, which affects the activity of Superoxidase Dismutase (SOD), thereby, leading to oxidative stress, injury, increase in cell apoptosis and brainstem. This study aims to determine the effect of Rhodamine B on BAX and BCL-2 in the cerebellum and brainstem tissue of Rattus norvegicus. Design and methods: The True Experimental Design was used to carry out a post-test examination on the control group of twenty-eight Wistar female Rattus norvegicus mice between the ages of 10-12 weeks. Then, samples were categorized into 4 groups in body weight doses of 4.5 mg/200g, 9 mg/200g, and 18 mg/200g. They were administrated with Rhodamine B personde for 36 days. Results: The results showed that Rhodamine B had a direct and indirect effect on BAX and BCL-2 expressions, respectively, in the cerebellum tissue and wistar strain of Rattus norvegicus. In addition, the positive path coefficient of BAX expression has a positive effect on BCL-2. This means that an increase in BAX has a direct impact on decreasing BCL-2 expression in cerebellum tissue and brainstem of Rattus norvegicus wistar strain along with an increased dose of Rhodamine B. Conclusions: In conclusion, Rhodamine B tends to increase BAX expression which directly decreases BCL-2 in Cerebellum tissue and Brainstem in Rattus norvegicus along with increasing doses.

Background: For more than ten years, Indonesia has health law, one of which states that local governments are mandated to establish Smoke Free Area (SFA). The results of 2018 National Basic Health Research shows tobacco consumption is still quite high and increasing compared to the results of 2007 and 2013 National Basic Health Research. The burden of disease in Indonesia is increasing every year. Methods: This study aims to describe SFA regulation and analyze the relationship between the percentage of smokers and the prevalence of smoking attributable morbidity. Data from the 2018 Basic Health Research in Indonesia with the number of units of analysis were 514 districts and cities level. The design of the study was cross-sectional study. The variables analyzed were the percentage of smokers, the prevalence of diabetes, hypertension, upper respiratory tract infections (URTI), pneumonia, lung tuberculosis, asthma, and mental emotional disorders. Geographical mapping of the distribution of District/City with Smoking-Free Areas was made using QGIS 3·16. Results: Around 72% of districts/cities in Indonesia already had local regulations of SFA after more than ten years implementation of the regulation of the health law. There was a significant relationship between the high percentage of smokers and the high prevalence of diabetes (p value: 0·000, PR: 1·342, 95%CI 1·135 to 1·587), hypertension (p value: 0·000, PR 1·631, 95%CI 1·252 to 2·124), and lung tuberculosis (p value: 0·008, PR 1·219, 95%CI 1·049 to 1·417) at the District/City level. However, there was no significant association between URTI, pneumonia, asthma, and mental emotional disorders. Conclusion: The percentage of smokers in an area was associated with diabetes, hypertension, and lung tuberculosis. The implementation of Smoke Free Area should be evaluated.

Objectives To examine trends in the prevalence of diabetes and pre-diabetes in Indonesia from 2013 to 2023 and to explore demographic and socioeconomic factors associated with these changes. Design Secondary data analysis on multiseries cross-sectional study. Setting Three waves of the Indonesian National Health Survey (2013, 2018 and 2023), each employing nationally representative, stratified multistage sampling. Participants Nationally representative respondents aged 15 years and older who completed fasting plasma glucose (FPG) and oral glucose tolerance tests (OGTT). Primary and secondary outcome measures Diabetes and pre-diabetes were defined based on FPG and OGTT tests and self-reported diagnosis. Multivariable and ordinal logistic regression models assessed associations between glycaemic status and demographic, socioeconomic and health-related factors. Results From 2013 to 2023, the prevalence of diabetes rose from 10.7% (95% CI: 10.2% to 11.2%) in 2013 to 11.8% (11.3% to 12.3%) in 2018, before declining to 11.3% (10.7% to 11.9%) in 2023. Meanwhile, pre-diabetes prevalence decreased from 44.5% (43.6% to 45.3%) in 2013 to 39.2% (38.0% to 40.3%) in 2023. Age-standardised and synthetic cohort analysis revealed that younger birth cohorts had lower diabetes prevalence at the same age compared with older generations. In contrast, diabetes prevalence remained high and stable among older adults, suggesting that an increase in diabetes prevalence was due to the increase in older population size rather than increased risk. Multivariable regression confirms that higher age and BMI were strong predictors for diabetes, pre-diabetes and abnormal glycaemic states. Wealth quintiles showed different associations: higher wealth was linked to lower pre-diabetes odds, but not consistently to diabetes. Conclusions The ageing population drives the rise of diabetes prevalence in Indonesia. Generational improvements were shown among younger adults, while persistent high diabetes prevalence in older adults underscores ongoing challenges. These findings highlight the importance of age-targeted and cohort-targeted screening and prevention strategies.

Background: The prevalence of hypertension in Indonesia was 25,80% in 2013 found in people aged above 18 years old. One of the risk factors is obesity. Purpose: This study aimed to analyze the relationship between the demographical characteristic and central obesity with the risk of hypertension in the health center of Sidoarjo. Methods: This analytical observational study design was cross sectional. There were 50 respondents selected through accidental sampling. The independent variables of this study were respondents’ characteristic and central obesity status. However, the dependent variable was hypertension. Overall, respondents were divided into two groups based on sex (female and male) and age (> 59 years old and ≤ 59 years old). Data were analyzed with chi-square statistical analysis. Results: Respondents with central obesity had a higher risk to get hypertension, with majority male respondents aged above 59 years old. Conclusion: There was a correlation between age and hypertension (p = 0,01), sex and hypertension (p = 0,04), also between central obesity status and hypertension (p = 0,01).