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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