The Relationship between Cupping Therapy and Herbs on Stress Levels in Hypertensive Patients

The purpose of this study was to determine the relationship between cupping and herbal therapy on stress levels in hypertensive patients at Griya Sehat Bogor Islami Johar bru, Bogor City. In this study, the authors used a quantitative descriptive design with a Cross Sectional approach. The researcher used a cross sectional approach. The population in this study were hypertensive patients with anxiety who were treated at Griya Sehat Bogor Islami Johar Baru, Bogor City, taken from the average monthly patient in the last 4 months. The sampling technique used in this study is incidental sampling. The sample taken in this study is purposive sampling, which is a sampling technique that is included in non-probability sampling. The distribution of respondents by gender showed that there were 3 patients with hypertension who experienced stress (20%) and 12 women or (80%). The distribution of respondents by age shows that the most age is 35-45 years as many as 9 people or (60%) and the smallest age is 4565 years. The distribution of respondents according to education shows that the most junior high school education is 6 people or (40%) and the lowest is PT as much as 1 person or (6.7%). The distribution of respondents by occupation shows that the most education is self-employed and laborers respectively as many as 7 people or (46.7%) and the lowest is civil servants as much as 1 person or (6.7%). There is an effect of cupping and herbal therapy at the Johar Islamic Herbal Healthy House in Bogor City on the level of stress with a significance of p value = 0.001 < = 0.05.


Introduction
Hypertension is a disease that gets the attention of all circles of society, considering the impact it causes both in the short and long term so that it requires a comprehensive and integrated long-term response. Hypertension causes high morbidity (illness) and mortality (death). Hypertension is a disease that arises due to the interaction of various risk factors that a person has. Various studies have linked various risk factors to the onset of hypertension.
Hypertension is a disease that is increasingly found in Indonesia, especially in big cities. Hypertension is an increase in blood pressure that exceeds normal blood pressure as agreed by experts, which is more than or equal to 140/90 mmHg. Diastolic is the lowest number when the heart expands at the end of relaxation. For example, blood The Relationship between Cupping Therapy and Herbs on Stress Levels in Hypertensive Patients pressure 120/80 mmHg means systolic pressure is 120 and diastolic pressure is 80 mmHg.
Blood pressure in a person's life varies naturally. Babies and children normally have much lower blood pressure than adults. Blood pressure is also affected by physical activity, which is higher during activity and lower when resting. Blood pressure in one day is also different, highest in the morning and lowest during sleep at night.
From Anas bin Malik r.a, (asked) regarding Hijamah, he said: "Verily the Messenger of Allah used cupping/hijama and ordered his family", and the Messenger of Allah said: "The best treatment you can do is with Hijamah/Cupping." The hadith of Ibn Abi Umar also mentions this. (Sahih Muslim 1577).
Interest in the importance of health is very important in changing people's behavior to live healthy. Various kinds of interventions that can be applied to the community, one of which is the most effective is self-detoxification. The problem that often arises in Lemper village is the risk of disease due to unhealthy circulation (uric acid, high blood pressure and cholesterol). This is related to the lack of people maintaining a healthy ADL.
The importance of health checks and independent detoxification for the community has a very positive impact in changing people's behavior in the process of recognizing problems, so they are interested in solving problems by trial (trying) until finally they will adopt the values or goodness that is carried out.
The diversity and methods of treatment in getting healing are growing along with advances in science and technology. However, there are still many errors in diagnosing a disease and errors in taking treatment actions. This makes the patient traumatized because he feels himself to be a guinea pig.
In fact, there are some people who pursue the classical method of medicine, there are also those who pursue the modern method, and there are also those who combine the two such as the Alhijamah (cupping) method. But it turns out that this method of cupping still has not got a place in some circles to cure the disease that is suffered. Even though this method has no side effects and its practice uses healing revelations from the words of a Prophet and the Prophet.
At this time in western countries (Europe and America) through scientific research, seriously and continuously conclude scientific facts how the miracle of cupping so that it can cure various diseases more safely and effectively than modern medical methods. So they applied cupping in everyday life and cupping experts and cupping clinics emerged in big cities in America and Europe. Even in recent years the treatment with cupping has been studied in the curriculum of medical schools in America, although they never want to follow that cupping is the legacy of the Prophet Muhammad, the best doctor of all time.
The purpose of this study was to determine the relationship between cupping and herbal therapy on stress levels in hypertensive patients at Griya Sehat Bogor Islami Johar bru, Bogor City. While the specific objectives are to identify the characteristics of hypertensive patients, identify cupping and herbal therapy in hypertensive patients and identify stress levels in hypertensive patients, and identify the relationship between cupping and herbal therapy to stress levels in hypertensive patients at Griya Sehat Bogor Islami Johar Baru, Bogor City.

Method
The Relationship between Cupping Therapy and Herbs on Stress Levels in Hypertensive Patients In this study, the authors used a quantitative descriptive design with a Cross Sectional approach. This quantitative descriptive design is carried out with the aim of solving problems or answering problems that are being faced in the current situation and is used to process data in the form of numbers, both as a result of measurement and as a result of conversion. The researcher used a cross sectional approach.
The population in this study were hypertensive patients with anxiety who were treated at Griya Sehat Bogor Islami Johar Baru, Bogor City, taken from the average monthly patient in the last 4 months. The sampling technique used in this study is incidental sampling. The sample taken in this study is purposive sampling, which is a sampling technique that is included in non-probability sampling.
The data in this study consisted of primary data used to assess the anxiety level of patients suffering from hypertension. The variables to be studied are described in the form of observation sheets and used as data collection instruments. In this study the authors used HRS-A (Hamilton Rating Scale for Anxienty). Anxiety levels can be measured using the Hamilton Rating Scale for Anxiety (HRS-A) which has been developed by the Jakarta Biology Psychiatry Group (KPBJ) in the form of the Anxiety Analog Scale (AAS).

Characteristics of Sample/ Univariate Data
This research was conducted at Griya Sehat Bogor Islamy Johar Baru Bogor on January 10 to February 3, 2021. This study aims to determine the Effect of Cupping and Herbal Therapy on Stress Levels in Hypertensive Patients. The sample studied amounted to 15 people using a questionnaire. Based on the answers given through the questionnaire, data were obtained which were then processed according to the research objectives and presented in the form of tables and explanations as follows: Based on the results of the analysis, it was found that the number of female respondents was 12 respondents with a percentage of 80% while male respondents amounted to 3 respondents with a percentage of 20%.  Based on the results of the analysis, it was found that most of the respondents' last education was junior high school graduates as many as 6 people (40%). Based on the results of the analysis, it was found that most of the respondents' occupations were self-employed and as many as 7 people (46.7%) of the respondents were civil servants as much as 1 person (6.7%). Based on the results of the research on stress levels prior to cupping and herbal therapy, it showed that 14 respondents (93.3%) had unstable stress levels. Based on the results of the research on stress levels after cupping and herbal therapy actions showed that 12 respondents (80%), had stable stress levels, and 3 respondents (20%) had unstable stress levels.

Bivariate data.
The Effectiveness of Cupping Therapy and Herbs The results of the analysis showed the results of stress levels before cupping and herbal therapy and after cupping and herbal therapy. For stress levels before cupping and herbal therapy the average stress level is .00, the mean value. Meanwhile, the stress level after cupping and herbal therapy was on average 6.00. It can be seen that the mean value of the difference between the first and second measurements, the P-Value (sig.2-tailed) value is 0.001 which is smaller than the alpha value of 0.05, so it can be concluded that there is a significant effect between Cupping and Herbal Therapy on Stress Levels in Patients Hypertension.

Characteristics of Respondents Based on Gender
Based on the results of the study, the number of respondents was dominated by female sex as many as 12 people or 80% of respondents while men as many as 3 people or 20%. There are two risk factors for hypertension, namely uncontrolled and controlled risk factors. Factors that cannot be controlled are age, gender and family history, while factors that can be controlled are obesity (obesity), sodium intake, alcohol consumption, lack of exercise, stress, and smoking habits.

Characteristics of Respondents Based on Age
Based on the results of the study, it was found that the majority of respondents who had hypertension were dominated by age (35-45 years) as many as 9 people or 60% while a small proportion of age (45-65 years) were 6 people or 13.3%. The high rate of hypertension in line with growing age, is caused by changes in the structure of large blood vessels, so that the lumen becomes narrower and the walls of the blood vessels become stiffer, as a result of which the systolic blood pressure increases. Structural and functional changes in the vascular system need the peripheral vascular system to be responsible for changes in blood pressure that occur in the elderly.

Characteristics of Respondents Based on Education
Based on the results of the study, it was found that most of the respondents who had junior high school education were 6 people or 40% and the lowest was 1 person or 6.7% PT. A person's level of education affects a person's ability to receive information and process it before it becomes good or bad behavior so that it The Relationship between Cupping Therapy and Herbs on Stress Levels in Hypertensive Patients has an impact on his health status. The higher the individual's knowledge about the causes of hypertension, trigger factors, signs and symptoms, and normal and abnormal blood pressure, the individual will tend to avoid things that can trigger hypertension, such as smoking, drinking coffee, and obesity.

Characteristics of Respondents Based on Occupation
Based on the results of the study, it was found that most of the respondents who worked as entrepreneurs were 7 people (46.7%) and 7 workers (46.7%) while the civil servants were 1 person or (6.7%). The type of work affects the pattern of physical activity, where work that does not rely on physical activity affects blood pressure, people who work involving physical activity can be protected from hypertension.
Based on data analysis using a computerized program with the Wilcoxon test in table 4.5, it is found that the value of . value = 0.001 which is smaller than = (0.05), then H1 is accepted. This means that it can be concluded that there is a significant effect between Cupping Therapy and Herbs on Stress Levels in Hypertensive Patients.
Based on the results of the research, theory and related research above, the researcher argues that a person's blood pressure tends to increase and if the increase is not controlled it can cause various negative effects so that to keep blood pressure in normal conditions, various ways are carried out, one of which is by cupping Hypertension or high blood pressure is often referred to as the silent killer because the patient does not know that he has hypertension. Hypertension is also known as heterogeneous group disease because it can affect anyone from various age, social, and economic groups. Hypertension is also the third biggest risk factor that causes premature death because it can trigger congestive heart failure and cerebrovascular disease.
Lowers blood pressure in blood vessels which can lead to higher blood pressure. If a person has high blood pressure and does not get regular (routine) treatment and control, this can lead to serious cases and even death. Continuous high blood pressure causes a person's heart to work extra hard, eventually this condition results in damage to the blood vessels of the heart, kidneys, brain and eyes. The results of the research above are supported by the theory which states that the effects of cupping on hypertension include the role of cupping in calming the sympathetic nervous system. This agitation in the sympathetic nervous system stimulates the secretion of enzymes that act as the renin-angiotensin system. Once the system is calm and its activity is reduced blood pressure will drop. Cupping plays a role in reducing the volume of blood that circulates blood in the blood vessels, thereby reducing blood pressure.
Handling hypertension can be done pharmacologically, nonpharmacologically, or alternative medicine. Lately, many people like alternative therapy, for several reasons, including: the cost is affordable, does not use chemicals and the healing effect is quite significant and one of the alternative treatments that can treat hypertension is cupping therapy.

Summary
The distribution of respondents by gender showed that there were 3 patients with hypertension who experienced stress (20%) and 12 women or (80%). The distribution of respondents by age shows that the most age is 35-45 years as many as 9 people or (60%) and the smallest age is 45-65 years. The distribution of respondents according to education shows that the most junior high school education The Relationship between Cupping Therapy and Herbs on Stress Levels in Hypertensive Patients is 6 people or (40%) and the lowest is PT as much as 1 person or (6.7%). The distribution of respondents by occupation shows that the most education is selfemployed and laborers respectively as many as 7 people or (46.7%) and the lowest is civil servants as much as 1 person or (6.7%). There is an effect of cupping and herbal therapy at the Johar Islamic Herbal Healthy House in Bogor City on the level of stress with a significance of p value = 0.001 < = 0.05.