Prof Djoko

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    I was born …

    July 25th 1949

    Semarang, Central Java, Indonesia

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    I am basically …

    A Cardiologist

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    Studied in …

    Faculty of Medicine, Airlangga University

    Surabaya, East Java, Indonesia

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    …..

    IRM Fellow in Cardiology

    Philippine Heart Center for Asia, Manila

    PhD in Health Science

    Airlangga University, Surabaya

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    Resident of Cardiology and Vascular Medicine, Faculty of Medicine,

    Airlangga University, Surabaya, Indonesia(1976 – 1980)

    Head of Cardiology & Vascular Medicine Outpatient Clinic, Dr. Soetomo General Hospital - Airlangga University, Surabaya, Indonesia

    (1981 – present)

    Head of Exercise Stress Test Division of Dr. Soetomo General Hospital - Airlangga University, Surabaya, Indonesia

    (1983 – present)

    Staff of Cardiology & Vascular Medicine Department, Faculty of

    Medicine, Airlangga University, Surabaya, Indonesia (1976 – present)

    Members of Surabaya Heart Center, Dr. Soetomo General Hospital – Airlangga University, Surabaya, Indonesia

    (1979 – present)

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    Member of 

    Indonesian Medical Association

    The Indonesian Society of Internal Medicine

    Indonesian Heart Association

    Asia Pacific Society of Cardiology

    Asean Federation of Cardiology

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    Scientific Publication & Research

     Writer

     145 Papers

    • Co-Writer  – 100 Papers

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    Nice to meet you …

    Let’s begin …

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    Prof.DR.dr.Djoko Soemantri,SpJP, (K) FIHA,FASCCFaculty of Medicine, Airlangga University / Dr. Soetomo General Hospital

    Surabaya Indonesia

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    Rationalist

    Empirist Pragmatist

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    The JNC 7 Key Messages 1. In persons > 50 years SBP of > 140 mmHg is a much

    more important CVD risk factor than DBP. 2. CVD risk, beginning at 115/75 mmHg, doubles with  20/10 mmHg. Normotensive at 55 years have 90% risk for HPN.

    3. SBP of 120-139 mmHg or DBP of 80-89mmHg require life style modifications to prevent CVD.

    4. Thiazides should be used, either alone or in combina- tion.

    5. Goad BP < 140/90 mmHg, < 130/80 mmHg for DM or

    chronic Kidney disease. 6. Initiating Tx with 2 agents should be considered

    7. The responsible physician’s judgement remains para- mount.

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    Preface

    “… if a man declares to you that he has found

    facts that he has observed and confirmed

    with his own experience, be cauotius in

    accepting what he says. Rather , investigate and weigh this opinion or hypothesis

    according to requirements of pure logic,

    without paying attention to this contention

    that affirms empirically.” ( Moses Maimonides, 1195 )

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    How to make an appropriate decision?

    External Evidence

    Clinical

    Expertise

    Cardiovascular

    Pathophysiology

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    And What Is Not?

    External clinical Evidence can inform but

    can never replace, individual clinical

    expertise

    EB cardiology is not restricted to randomized clinical trials and meta-analyses

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    The Practice of Evidence Based

    Cardiology

    Individual

    clinical

    expertise

    Best Available External

    Clinical

    Evidence

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    User’s guides

    “ Are The Study Results Valid ?”

    “What are the study result ?”

    “ How will the study results help me care for my patients ?”

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    Good Doctors Use both Individual Clinical Expertise and The Best

    Available External Evidence, and

    Neither Alone is Enough

    Allan ritchnic, David Sacket, salim Yusuf.

    Evidence Based Cardiology, 1999.

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    Excelent External Evidence May Be

    Inapplicable To or Inappropiate for

    an Individual Patient

    Allan ritchnic, David Sacket, salim Yusuf.

    Evidence Based Cardiology, 1999.

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    How to Manage

    the Patient

    Institution : Physician : Patient :

    1. Evident Base 1. Way of Thinking 1. Individual

    2. Guideline 2. Rationale 2. Wholistic

    Proper Treatment

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    Thank You 

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