{"id":55551,"date":"2024-03-20T10:52:10","date_gmt":"2024-03-20T10:52:10","guid":{"rendered":"https:\/\/biomedpharmajournal.org\/?p=55551"},"modified":"2024-04-02T04:09:58","modified_gmt":"2024-04-02T04:09:58","slug":"effect-of-breadfruit-artocarpus-altilis-leaf-extract-on-blood-pressure-in-obese-adults-in-makassar-indonesia","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol17no1\/effect-of-breadfruit-artocarpus-altilis-leaf-extract-on-blood-pressure-in-obese-adults-in-makassar-indonesia\/","title":{"rendered":"Effect of Breadfruit (Artocarpus Altilis) Leaf Extract on Blood Pressure in Obese Adults in Makassar, Indonesia"},"content":{"rendered":"\n

Introduction<\/strong><\/p>\n\n\n\n

Obesity is an\nexcessive or abnormal accumulation of fat that can interfere with health.1.\nObesity results from an imbalance in the caloric intake and energy expenditure\nequation, wherein caloric consumption exceeds energy demands or utilization\n(energy expenditure). This surplus of energy within the body leads to the\naccumulation of adipose tissue. One of the medical conditions prevalent among\nindividuals grappling with obesity is hypertension.<\/p>\n\n\n\n

Hypertension, a\nprevalent chronic health condition, affects a significant portion of the global\npopulace and is linked to an elevated risk of heart attacks, arteriosclerosis,\nstrokes, and kidney failure. Projections suggest that by 2025, as many as 30%\nof adults worldwide will grapple with hypertension. Factors such as a sedentary\nlifestyle, stress, obesity, and excessive sodium intake are contributing\nvariables that elevate the likelihood of developing high blood pressure.2<\/sup>.\n<\/p>\n\n\n\n

The term\n“silent killer” refers to hypertension since it can go years without\nsymptoms before developing into other illnesses such as heart failure,\ndiabetes, peripheral artery disease (PAD), and cerebrovascular disease\n(stroke).3<\/sup>.<\/p>\n\n\n\n

Ethnobotany has a\nsignificant impact on drug and food discovery. The practices of traditional\ncommunities regarding their relationship with plants in their daily lives can\nlead to research by scientists looking for evidence of local knowledge.\nArtocarpus altilis, known locally as breadfruit, is one of Indonesia’s most\nwidely utilized plants. Artocarpus altilis belongs to the Moraceae or mulberry\nfamily.4<\/sup>.<\/p>\n\n\n\n

Breadfruit is one\nof the Indonesian plants used for disease treatment and prevention. The plant\nknown as the breadfruit is widespread throughout practically all of Indonesia.\nThe fruit of the breadfruit plant, which is high in fiber, is the component the\ncommunity has traditionally used. Another breadfruit component used for illness\ntreatment and prevention is the leaves.5.<\/sup> Artocarpus altilis also\npossesses several proven therapeutic qualities; for instance, its leaves have\nhistorically been used to treat diabetes, hypertension, and liver cirrhosis.4<\/sup>.\n<\/p>\n\n\n\n

Tropical and\nsubtropical areas are home to the breadfruit plant Artocarpus altilis. The tea\nmade from the withering leaves is traditionally used to alleviate hypertension.\nIn a rat model of hypertension brought on by the hormone angiotensin II, tea made\nfrom the plant’s leaves significantly reduced mean arterial pressure (40\u201350\nmmHg).3<\/sup>.<\/p>\n\n\n\n

With a variety of\ndiseases that will be felt for people with obesity, such as high cholesterol,\nlow HDL, and high blood pressure, as we know, various types of traditional\nmedicines will give good effects and little risk for the body if consumed,\nusing herbal medicines will provide a slight risk because it uses natural raw\nmaterials based on products made by Prof. Dr. Nurhaedar jafar, Apt, M.Kes.\nrelated to breadfruit leaf extract.<\/p>\n\n\n\n

Materials and Methods<\/strong><\/p>\n\n\n\n

Ethics<\/strong><\/p>\n\n\n\n

This study was\napproved by the Health Research Ethics Committee of Hasanuddin University with\na recommendation for ethical approval number 3004\/UN4.14.1\/TP.01.02\/2023.\nRespondents’ participation in this study was voluntary, and respondents who\nagreed to participate had filled out informed consent.<\/p>\n\n\n\n

Study Design and Respondents<\/strong><\/p>\n\n\n\n

The design of this\nresearch study is an experiment with a double-blind design, Randomized\ncontrolled trial, pre and post-on obese patients conducted from May 2023-June\n2023 at  Makkasau Health Centre Makassar\nCity. The population in this study were people in the Makassau Health Centre\narea with obese nutritional status ranging in age from 25-60 years. The sample\nof this study was 36 people, with 18 people in the intervention group and 18 in\nthe control group.<\/p>\n\n\n\n

Preparation of Breadfruit Extract<\/strong><\/p>\n\n\n\n

The prepared\nmaterial was then placed in a drying room with a cooling system set at 180\u00b0C\nfor three cycles of 24 hours each. The finely chopped product was then\nprocessed in a crusher to create a substance known as simplicia, resulting in a\nyield of 9 kg. The simplicial was deposited into a container and combined with\na water solvent (reverse osmosis) at a ratio of 1:10, incorporating 500 liters\nof water. The mixture was left to macerate for three hours, stirring intervals\nof every 28 minutes.<\/p>\n\n\n\n

Subsequently, the\nmacerated material underwent separation using a spinner\/separator at a speed of\n2800 revolutions per minute for 10 minutes. This process effectively distinguished\nbetween the residue and the filtrate. The residue was discarded, and the\nfiltrate underwent drying using a HaiCuan freeze dryer. The drying process\nemployed a temperature of -60 \u00baC through the sublimation method and lasted for\n36 hours, producing 1000 grams of solid extract.<\/p>\n\n\n\n

The obtained dry\nextract was carefully weighed using a digital scale measuring 500 mg. The\ninternal quality control team from Ismut Fitomedica Indonesia Corps. (PT IFI)\nthen encapsulated the dry extract.<\/p>\n\n\n\n

Data Collection<\/strong><\/p>\n\n\n\n

This study used\nanthropometry measurement tools such as BA digital scales to measure body\nweight and fat percent and Microtoice to measure height. Dietary measurement\ntools used were the Food Recall 24 hours and questionnaires. They were\nmeasuring high blood pressure using a digital tensimeter. The intervention\ngroup was given breadfruit leaf extract capsules, and the control group was\ngiven a placebo. The placebo for the control group is filled with lactose.\nDuring the data collection phase, respondents in the intervention group\nconsumed two capsules of breadfruit leaf extract per day for 21 days (42\ncapsules per respondent), while the control group consumed one placebo capsule\ndaily for the same duration, totaling 21 capsules per respondent.<\/p>\n\n\n\n

Blood Pressure Measurement<\/strong><\/p>\n\n\n\n

Blood pressure\nmeasurements were taken by health workers using a digital tension device and\ntaken in a sitting position two times. Prehypertension 130\/80 – 139\/80 and\nhypertension >140\/80. <\/p>\n\n\n\n

Statistical Analysis<\/strong><\/p>\n\n\n\n

In this research,\ndata analysis is done using SPSS software version 13 by IBM corporate. The\nconfidence level in this study is 95%, and the significance level is 0.5. The\nfirst analysis is the normality test of data using the Kolmogorov-Smirnov test.\nIf the data is normal, the paired t-test is carried out, and the independent\nt-test, if the data is not normal, then uses the Wilcoxon and Mann-Witney\ntests.<\/p>\n\n\n\n

Results<\/strong><\/p>\n\n\n\n

Respondent\nCharacteristics<\/strong><\/p>\n\n\n\n

Table 1: Characteristics of Respondents <\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Variables<\/strong><\/p>\n<\/td>\n

\n

Intervention<\/strong><\/p>\n<\/td>\n

\n

 <\/strong><\/p>\n<\/td>\n

\n

Control<\/strong><\/p>\n<\/td>\n

\n

 <\/strong><\/p>\n<\/td>\n

\n

p*<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

 <\/strong><\/p>\n<\/td>\n

\n

N<\/strong><\/p>\n<\/td>\n

\n

%<\/strong><\/p>\n<\/td>\n

\n

N<\/strong><\/p>\n<\/td>\n

\n

%<\/strong><\/p>\n<\/td>\n

\n

 <\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Age (Years)<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

26-35<\/p>\n<\/td>\n

\n

7<\/p>\n<\/td>\n

\n

38.9<\/p>\n<\/td>\n

\n

8<\/p>\n<\/td>\n

\n

44.4<\/p>\n<\/td>\n

\n

0.185<\/p>\n<\/td>\n<\/tr>\n

\n

36-45<\/p>\n<\/td>\n

\n

2<\/p>\n<\/td>\n

\n

11.1<\/p>\n<\/td>\n

\n

4<\/p>\n<\/td>\n

\n

22.2<\/p>\n<\/td>\n<\/tr>\n

\n

46-55<\/p>\n<\/td>\n

\n

5<\/p>\n<\/td>\n

\n

27.8<\/p>\n<\/td>\n

\n

6<\/p>\n<\/td>\n

\n

33.3<\/p>\n<\/td>\n<\/tr>\n

\n

56-60<\/p>\n<\/td>\n

\n

4<\/p>\n<\/td>\n

\n

22.2<\/p>\n<\/td>\n

\n

0<\/p>\n<\/td>\n

\n

0<\/p>\n<\/td>\n<\/tr>\n

\n

Gender<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

Male<\/p>\n<\/td>\n

\n

9<\/p>\n<\/td>\n

\n

50<\/p>\n<\/td>\n

\n

7<\/p>\n<\/td>\n

\n

38.9<\/p>\n<\/td>\n

\n

0.502<\/p>\n<\/td>\n<\/tr>\n

\n

Famale<\/p>\n<\/td>\n

\n

9<\/p>\n<\/td>\n

\n

50<\/p>\n<\/td>\n

\n

11<\/p>\n<\/td>\n

\n

61.1<\/p>\n<\/td>\n<\/tr>\n

\n

Education<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

Finished Primary School<\/p>\n<\/td>\n

\n

2<\/p>\n<\/td>\n

\n

11.1<\/p>\n<\/td>\n

\n

3<\/p>\n<\/td>\n

\n

16.7<\/p>\n<\/td>\n

\n

0.403<\/p>\n<\/td>\n<\/tr>\n

\n

Completed Junior School<\/p>\n<\/td>\n

\n

2<\/p>\n<\/td>\n

\n

11.1<\/p>\n<\/td>\n

\n

4<\/p>\n<\/td>\n

\n

22.2<\/p>\n<\/td>\n<\/tr>\n

\n

Completed High School<\/p>\n<\/td>\n

\n

6<\/p>\n<\/td>\n

\n

33.3<\/p>\n<\/td>\n

\n

2<\/p>\n<\/td>\n

\n

11.1<\/p>\n<\/td>\n<\/tr>\n

\n

Higher Education<\/p>\n<\/td>\n

\n

1<\/p>\n<\/td>\n

\n

44.4<\/p>\n<\/td>\n

\n

3<\/p>\n<\/td>\n

\n

50.0<\/p>\n<\/td>\n<\/tr>\n

\n

Jobs<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

Work<\/p>\n<\/td>\n

\n

14<\/p>\n<\/td>\n

\n

77.8<\/p>\n<\/td>\n

\n

14<\/p>\n<\/td>\n

\n

77.8<\/p>\n<\/td>\n

\n

1.000<\/p>\n<\/td>\n<\/tr>\n

\n

Not Working<\/p>\n<\/td>\n

\n

4<\/p>\n<\/td>\n

\n

22.2<\/p>\n<\/td>\n

\n

4<\/p>\n<\/td>\n

\n

22.2<\/p>\n<\/td>\n<\/tr>\n

\n

Abnominal<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

\u226590 Male<\/strong><\/p>\n<\/td>\n

\n

9<\/p>\n<\/td>\n

\n

50.0<\/p>\n<\/td>\n

\n

7<\/p>\n<\/td>\n

\n

38.9<\/p>\n<\/td>\n

\n

0.502<\/p>\n<\/td>\n<\/tr>\n

\n

\u226580 Famale<\/strong><\/p>\n<\/td>\n

\n

9<\/p>\n<\/td>\n

\n

50.0<\/p>\n<\/td>\n

\n

11<\/p>\n<\/td>\n

\n

61.1<\/p>\n<\/td>\n<\/tr>\n

\n

IMT<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

Overweight<\/p>\n<\/td>\n

\n

5<\/p>\n<\/td>\n

\n

27.8<\/p>\n<\/td>\n

\n

3<\/p>\n<\/td>\n

\n

16.7<\/p>\n<\/td>\n

\n

0.423<\/p>\n<\/td>\n<\/tr>\n

\n

O<\/em>besity<\/p>\n<\/td>\n

\n

13<\/p>\n<\/td>\n

\n

72.2<\/p>\n<\/td>\n

\n

15<\/p>\n<\/td>\n

\n

83.3<\/p>\n<\/td>\n<\/tr>\n

\n

Source: Primary Data, 2023               <\/p>\n<\/td>\n

 <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n

The\ncharacteristics of the respondents are shown in Table 1. This study involved 36\nrespondents, evenly split between the intervention and control groups, each\nwith 18 respondents. The majority of the intervention group (38.9%) and control\ngroup (44.4%) respondents were between 26 and 35 years old. In the intervention\ngroup, there was an equal gender distribution (50% male, 50% female), while the\ncontrol group had a higher proportion of females (61.1%). In terms of\neducation, the intervention group had mostly high school graduates (33.3%),\nwhereas the control group consisted mainly of junior high school graduates\n(22.2%). The majority of both groups were employed (77.8% in each). Abdominal\ncircumference analysis revealed that 50% of the intervention group had\nmeasurements \u226590 for males and \u226580 for females, while 61.1% of the control\ngroup had measurements \u226580 for females. As for BMI, 72.2% of the intervention\ngroup and 83.3% of the control group were classified as obese.<\/p>\n\n\n\n

Overview\nof Respondents’ Examination<\/strong><\/p>\n\n\n\n

Table 2: Overview of Blood Pressure Respondents in each group before and after the intervention<\/strong>.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Control group<\/strong><\/p>\n<\/td>\n

\n

Intervention group<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Variable<\/strong><\/p>\n<\/td>\n

\n

pre-test<\/strong><\/p>\n<\/td>\n

\n

post-test<\/strong><\/p>\n<\/td>\n

\n

pre-test<\/strong><\/p>\n<\/td>\n

\n

post-test<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

N<\/strong><\/p>\n<\/td>\n

\n

%<\/strong><\/p>\n<\/td>\n

\n

N<\/strong><\/p>\n<\/td>\n

\n

%<\/strong><\/p>\n<\/td>\n

\n

N<\/strong><\/p>\n<\/td>\n

\n

%<\/strong><\/p>\n<\/td>\n

\n

N<\/strong><\/p>\n<\/td>\n

\n

%<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

High Blood Pressure<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Pre-hypertension<\/p>\n<\/td>\n

\n

5<\/p>\n<\/td>\n

\n

27,8<\/p>\n<\/td>\n

\n

3<\/p>\n<\/td>\n

\n

16,7<\/p>\n<\/td>\n

\n

8<\/p>\n<\/td>\n

\n

44,4<\/p>\n<\/td>\n

\n

7<\/p>\n<\/td>\n

\n

38,9<\/p>\n<\/td>\n<\/tr>\n

\n

Hypertension<\/p>\n<\/td>\n

\n

13<\/p>\n<\/td>\n

\n

55,5<\/p>\n<\/td>\n

\n

10<\/p>\n<\/td>\n

\n

55,6<\/p>\n<\/td>\n

\n

10<\/p>\n<\/td>\n

\n

55,5<\/p>\n<\/td>\n

\n

10<\/p>\n<\/td>\n

\n

55,5<\/p>\n<\/td>\n<\/tr>\n

\n

Normal<\/p>\n<\/td>\n

 <\/td>\n <\/td>\n\n

5<\/p>\n<\/td>\n

\n

27,8<\/p>\n<\/td>\n

 <\/td>\n <\/td>\n\n

1<\/p>\n<\/td>\n

\n

5,6<\/p>\n<\/td>\n<\/tr>\n

\n

Source: Primary Data, 2023<\/p>\n<\/td>\n

\n

 <\/p>\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n

Table 2, shows the\nBlood Pressure variable most respondents have Hypertension Blood Pressure\nlevels, in the control group as much as 55.5% to 55.6%, and 5 normal 22.8%.\nWhile in the intervention group 55.5% became 56.5%, and 1 normal 5.6% after the\nintervention.<\/p>\n\n\n\n

Analysis of Mean Before and After Blood Pressure Intervention and Change in Each Group<\/strong><\/p>\n\n\n\n

Table 3: Comparison of Mean (Before-After) Triglyceride Levels Between Intervention and Control Groups<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

 <\/p>\n

Variable<\/strong><\/p>\n<\/td>\n

\n

Before<\/strong><\/p>\n<\/td>\n

\n

After<\/strong><\/p>\n<\/td>\n

\n

p value<\/strong><\/p>\n<\/td>\n

\n

Difference<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

(mean \u00b1 SD)<\/strong><\/p>\n<\/td>\n

\n

(mean \u00b1 SD)<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Blood Pressure <\/strong><\/p>\n<\/td>\n

 <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n
\n

Systole<\/strong><\/p>\n<\/td>\n

 <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n
 <\/td>\n\n

Intervention<\/p>\n<\/td>\n

\n

146,05\u00b112,41<\/p>\n<\/td>\n

\n

142,61\u00b111,63<\/p>\n<\/td>\n

\n

0,015<\/p>\n<\/td>\n

\n

-3,44\u00b1-8,44<\/p>\n<\/td>\n<\/tr>\n

\n

Control<\/p>\n<\/td>\n

\n

147,72\u00b115,72<\/p>\n<\/td>\n

\n

139,33\u00b113,71<\/p>\n<\/td>\n

\n

0,007<\/p>\n<\/td>\n

\n

-8,39 \u00b1 -3,83<\/p>\n<\/td>\n<\/tr>\n

\n

 <\/p>\n<\/td>\n

\n

p value =0.628<\/p>\n<\/td>\n

\n

p value =0.371<\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

p value=0.105<\/p>\n<\/td>\n<\/tr>\n

\n

Blood Pressure<\/strong><\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

 <\/td>\n<\/tr>\n
\n

Diastole<\/p>\n<\/td>\n

 <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n
\n

 <\/p>\n<\/td>\n

\n

Intervention<\/p>\n<\/td>\n

\n

90,11\u00b17,56<\/p>\n<\/td>\n

\n

86,61\u00b17,57<\/p>\n<\/td>\n

\n

0,018<\/p>\n<\/td>\n

\n

-3,5\u00b13,38<\/p>\n<\/td>\n<\/tr>\n

\n

Control<\/p>\n<\/td>\n

\n

89,44\u00b15,46<\/p>\n<\/td>\n

\n

86,22\u00b15,68<\/p>\n<\/td>\n

\n

0,003<\/p>\n<\/td>\n

\n

-3,22\u00b1-3,36<\/p>\n<\/td>\n<\/tr>\n

\n

 <\/p>\n<\/td>\n

\n

p value =0.083<\/p>\n<\/td>\n

\n

p value=0.057<\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

 <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n

Table 3 presents the pre-intervention mean analysis for both the intervention and control groups in systolic blood pressure, revealing a p-value of 0.628, signifying no significant difference between the groups (p>0.05). In the post-intervention phase, the p-value remains above 0.05 at 0.371, indicating no significant disparity between the groups. Similarly, for diastolic blood pressure, the pre-intervention analysis yields a p-value of 0.083, while the post-intervention analysis results in a p-value of 0.057, both exceeding the significance threshold (p>0.05). In summary, there is no substantial distinction between the intervention and control groups regarding diastolic blood pressure in both the pretest and posttest phases.<\/p>\n\n\n\n

Regarding\nsystolic blood pressure, the intervention group exhibited a mean of 146.05 \u00b1\n12.41 before the intervention, which decreased to 142.61 \u00b1 11.63 after,\nresulting in a statistically significant p-value of 0.015 (p<0.05). In\ncontrast, the control group’s pre-post measurements indicated a shift from 147.72\n\u00b1 15.72 to 139.33 \u00b1 13.71, with a p-value of 0.007 (p<0.05). The calculated\nchange (\u2206) in systolic blood pressure showed a decrease of -3.44 \u00b1 8.44 in the\nintervention group and -8.39 \u00b1 3.83 in the control group, but the p-value was\n0.105 (p>0.05), suggesting no significant difference between the two groups.<\/p>\n\n\n\n

For diastolic\nblood pressure in the intervention group, the mean values shifted from 90.11 \u00b1\n7.56 before the intervention to 86.61 \u00b1 5.7 after, with a p-value of 0.018\n(p<0.05). The corresponding \u2206 diastolic blood pressure was -3.5 \u00b1 3.38. In\nthe control group, the diastolic values went from -3.22 \u00b1 3.66 before to after,\nwith a p-value of 0.271 (p>0.05). These results indicate that diastolic\nblood pressure changes were similar in both groups, with no significant\ndifference observed.<\/strong><\/p>\n\n\n\n

Discussion<\/strong><\/p>\n\n\n\n

The sample consisted of obesity and\nhypertension blood pressure measurements in this study were carried out 2x\nrepeatedly to ascertain whether the blood pressure results were by the\nmeasurement standards in 21 days in the morning using a digital device carried\nout directly by the general Makassau puskesmas officer in charge of this study\nto measure the respondent’s blood pressure before the intervention, during the\nintervention, and after the intervention. Therefore, it is guaranteed that the\nimplementation is by the SOP in measuring blood pressure. <\/p>\n\n\n\n

The results of this study proved that\nthe respondents’ blood pressure decreased after giving breadfruit leaf extract\ncapsules, and systole blood pressure was -3.44 mmHg. There was a slight\ndecrease in blood pressure in the intervention group before the intervention,\nwhile the control group decreased by -8.39 mmHg. While in diastole, the control\ngroup was -3.22, and the test group was -.3.5. The control group that experienced\na decrease was also caused by respondents who were still taking hypertension\nmedication. Seven respondents were still taking hypertension medication, which\nallowed the control group respondents to experience a decrease in hypertension\nof 8.39 mmH. There is in accordance by research conducted in America showing\nthat intravenous administration of breadfruit leaf water extracts at 1 mg\/ml at\nan infusion rate of 1 ml\/hour for 45 minutes was shown to reduce mean arterial\npressure (20-30 mmHg), which was significant.3<\/sup>. Research conducted\nin India also showed that breadfruit can reduce blood pressure.5<\/sup>.\nResearch conducted in Indonesia shows that breadfruit root decoction can\nregulate high blood pressure.6<\/sup>. Research at the University of the\nWest Indies uses breadfruit leaves as an antihypertensive drug.7<\/sup>.<\/p>\n\n\n\n

Regarding medication adherence,\nseveral samples took anti-hypertension medication in both the intervention and\ncontrol groups. Two people in the intervention group took medication, while in\nthe control group, there were 11 people, which could lead to more significant\nresults in the control group. Experienced a decrease compared to the\nintervention group, based on the journal, which stated that there was an\ninfluence of medication adherence on reducing the incidence of hypertension<\/p>\n\n\n\n

The breadfruit leaf extract in this\nstudy is young breadfruit leaves that are dried, then processed in the form of\nextracts and encapsulated by the freeze dryer process (HaiCuan brand) using a\ntemperature of -60 \u00baC (sublimation method) for 36 hours to obtain a\ncapsule-shaped solid extract.8<\/sup>.<\/p>\n\n\n\n

Extraction is withdrawing a desired\nactive substance from a raw material using a specific solvent chosen where the\ndesired substance can dissolve. Raw materials come from plants or animals that\nare collected, cleaned, washed, dried, and powdered. The result of extraction\nis called an extract. Extracts contain not only one element but various\nelements, depending on what raw materials are extracted and the extraction\nconditions.9<\/sup><\/p>\n\n\n\n

Alkaloids, flavonoids, essential\noils, and other groups are active compounds in different simplisia. Choosing\nthe best solvent and extraction technique will be easier if you are aware of\nthe active compounds that simplisia contains. Rhizomes and leaves of soft\nsimplisia, easily absorbed by solvents, do not need to be powdered until smooth\nbefore the extraction process. Hard-dried natural ingredients such as seeds,\nbark, and root bark are challenging to absorb by solvents, so they must be\npowdered until smooth.10<\/sup><\/p>\n\n\n\n

One of the fruits commonly processed\ninto fried snacks known as ‘breadfruit chips’ in Indonesia, breadfruit\nArtocarpus altilis, is also utilized in traditional medicine. Breadfruit leaves\ntreat various conditions, including diabetes, high blood pressure, kidney\ndisease, enlarged spleen, liver disease, and hepatitis. Additionally, the\nflavonoid content in breadfruit leaves helps prevent increased blood\ncholesterol levels.11<\/sup><\/p>\n\n\n\n

Breadfruit has many benefits, from\nfruit leaves, and can be used as traditional medicine either processed in\ncapsules or naturally, such as boiled. Breadfruit contains Artocarpus and\npapain enzymes; its leaves contain quercetin, camphor phenols, and\ngamma-aminobutyric acid, which can lower blood pressure.12<\/sup><\/p>\n\n\n\n

So, breadfruit leaf extract was\ntested to reduce blood pressure in obese adults. The results of the above study\nshowed the management of blood pressure. Caps given to control group\nrespondents and intervention groups were expected to lower blood pressure, and\nit was proven that it could reduce blood pressure for 21 days, given\nintervention or treatment. Then breadfruit leaves (Artocarpus altilis) are one\nof the traditional medicines widely known to the Indonesian people. Flavonoids,\nhydrocyanic acid, acetylcholine, tannin, riboflavin, saponin, phenol, quercetin,\nkaempferol, and potassium are the chemical content of breadfruit leaves that\nare efficacious as a medicine for diseases such as kidney, heart, high blood\npressure, liver, enlarged spleen, diabetes, asthma, and cancer.13<\/sup><\/p>\n\n\n\n

Several theories underlie the\npotential anticancer mechanisms of flavonoids. One theory suggests that\nflavonoids serve as oxidants, initiating cancer cell apoptosis by triggering\nDNA fragmentation, starting with releasing a DNA chain due to reactive oxygen\ncompounds like hydroxyl radicals formed through Cu(II) redox reactions.\nFlavonoids are known to mobilize these copper compounds from intra- and\nextracellular sources, focusing on chromatin.14,15<\/sup><\/p>\n\n\n\n

Another theory highlights flavonoids’\nantioxidant properties, mainly shielding against Reactive Oxygen Species (ROS).\nIn a third theory, flavonoids are thought to hinder cancer cell proliferation\nby inhibiting protein kinase activity, disrupting the signal transmission\npathway from the cell membrane to the nucleus.16,17<\/sup><\/p>\n\n\n\n

A fourth theory suggests that\nflavonoids can inhibit receptor tyrosine kinase activity, which is crucial in\nthe growth of malignancies. Quercetin, a flavonoid derivative, is utilized as a\ndietary supplement and has been promoted by the American Cancer Society for its\npotential in disease prevention, including cancer. However, concrete clinical\nevidence for its effectiveness in cancer prevention or treatment in humans\nremains scarce, and at normal dietary levels, quercetin is generally considered\nsafe.13,18<\/sup><\/p>\n\n\n\n

Traditional medicines as an\nalternative to medicine are considered safer regarding side effects and\ntoxicity.19,20<\/sup>. The results of research by Fita Dwi Amira from the\nDepartment of Pharmacy, Faculty of Mathematics and Natural Sciences, University\nof Indonesia, show that breadfruit leaf extract, which consists of 30%\nflavonoid compounds, does not cause poisoning in the body. The parts of the\nbreadfruit plant that are commonly used as medicine are the fruit and leaves.\nHowever, what is most often used as herbal medicine is the leaves.19<\/p>\n\n\n\n

Breadfruit leaves are made into a\ndrink to cure high blood pressure, heart disease, and diabetes because they\ncontain quercetin and potassium.21<\/sup>. In India, breadfruit leaves can\nreduce high blood pressure and relieve asthma.19<\/sup>. Currently, part of\nthe breadfruit plant that is most widely used for medicine is the leaves.\nQuercetin, a derivative of flavonoids, has antihypertensive properties, namely\nwidening the narrowed blood vessel channels and improving blood circulation.22<\/sup>.<\/p>\n\n\n\n

Conclusions and Recommendations<\/strong><\/p>\n\n\n\n

Giving breadfruit leaf extract capsules to the intervention group with obese respondents and high blood pressure showed a decrease in blood pressure after giving breadfruit leaf extract capsules. People who have high blood pressure can consume breadfruit leaf decoction or breadfruit leaf extract. Artocarpus altilis is a herbal plant that is high in flavonoids and is able to cure various types of other diseases including lowering high blood pressure, with herbal treatment it will not give side effects, previous research has carried out toxicity tests which say that breadfruit leaves do not have bad effects if consumed even though routinely.<\/p>\n\n\n\n

Limitations of the Study<\/strong><\/p>\n\n\n\n

The number of\nrespondents in this study was still small so that the comparison between the\nintervention group and the control group was not too large. Monitoring of\nrespondents in taking the breadfruit leaf extract capsules was not done every\nday and the respondents’ diet was also not monitored. Breadfruit leaf extract\nis not yet licensed for over-the-counter sale, so breadfruit leaf water\ndecoction can be a more applicable recommendation in everyday life.<\/p>\n\n\n\n

Acknowledgement<\/strong><\/p>\n\n\n\n

Thanks to all person who have\ncontributions to completing this research.<\/p>\n\n\n\n

Conflict of Interest<\/strong><\/p>\n\n\n\n

No conflict of interest. <\/p>\n\n\n\n

Funding Sources<\/strong><\/p>\n\n\n\n

There is no funding, for this research<\/p>\n\n\n\n

References<\/strong><\/p>\n\n\n\n

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