Hypertension is a rise in blood pressure above 140/90 mmHg, or a disease that occurs due to an increase in systolic and diastolic blood pressure above 140/90 mmHg with consistency [1, 2], Hypertension is a major factor in various diseases such as: stroke, kidney disease, coronary heart disease and retinopathy. Hypertension is the most significant cause of cardiovascular and generally occur anyway and is a major problem in both developed and developing countries and the cause of death number one in the world each year [2],

Hypertension or high blood pressure often also dubbed the silent killer-stationary (the silent killer). In general, people do not know if he suffered from hypertension and is usually detected when there is a previous examination because they reason other diseases. And unconsciously patients already have serious complications in organs-the vital organs such as the heart, kidneys and brain. The most important thing is to know the causes or risk factors for the prevention of hypertension and hypertension management potent in reducing the risk of cardiovascular disease [3, 4],

According to the WHO about 972 million people or 26,4% of people worldwide suffer from hypertension, numbers this possibility will rise to 29,2% in 2025. Of the 972 million people with hypertension, 333 million are in the developed countries and the remaining 639 are in developing countries, including Indonesia [5], Basic Health Research (Riskesdas) mentions the year 2018, the prevalence of hypertension in Indonesia reached 34,1% by age≥18 years. There is an increased prevalence of hypertension based on interviews (if ever in the diagnosis of health workers and taking antihypertensive medication) of 9,5 in 2013 and decreased by 8,8 in 2018, The prevalence of hypertension in NTT Province, according Riskesdas 2018 reached 23,3%. While the prevalence of hypertension for Rote Ndao regency in 2018 reached 20,7%. [6], Factors that influence the occurrence of hypertension include genetic factors, age, sex, obesity and the consumption of salt and alcohol. Increased blood pressure usually affects the blood vessels of the heart. When this longstanding heart failure were preceded by shortness of breath, over time will be a stroke and death because they do not the blood flow smoothly, so that the supply of oxygen below the red blood cells become obstructed. Hypertension is more common in men compared to women, more women because they tend to creaka hypertension after menopause. This is caused by the hormone estrogen drop significantly as a result of endothelial cell damage that triggers plaque in blood vessels, causing various diseases such as cardiovascular disease (CVD) and even stroke.

Men at higher risk to suffer from hypertension than women up to the age of 55 years. Of course this should not be a problem for men. For decrease in the hormone testosterone has little impact on the risk of hypertension, unless accompanied by an unhealthy lifestyle, obesity and smoking. Hypertension on leave without handling lead to complications and health problems, such as coronary heart disease, stroke and retinopathy. Hypertension is affected by the blockage and narrowing of caused by lipid that accumulates below the deepest layer (endothelium) blood vessel walls [7]. The main cause of atherosclerosis is a lipid which resulted in the emergence of a disease such as kidney failure, stroke and heart attack.

The development of people's behavior more freely along with the lifestyle and economic status increases, it makes people more oblivious to a healthy lifestyle including diet. Now diet, contain cholesterol and eat more often with the intensity of the portion of food is increasing, stress is difficult to control, smoking, obesity and physical activities like sports much less enjoy doing [8],

Starting from the complex problems of hypertension and the presence of barriers to treatment are pharmacologically due to purchasing power has declined and has a fairly expensive, so the anticipation of these problems need to be given a new innovation to the community that treatment of non-pharmacological very suitable (gymnastics prolanis and acupressure extremities) can be a good alternative choice, both in terms of the economy and its impact. As already explained that acupressure extremity and gymnastics prolanis can lower blood pressure in hypertensive patients, Which is expected to perform in non-pharmacological treatment of hypertension in patients with blood pressure can be decreased⁹, Non-pharmacological treatment, weight loss, exercise and activities that are organized and carried out with a healthy lifestyle one of which is a complementary therapy that uses natural ingredients, such as acupressure, meditation, aromatherapy, herbal and nutritional therapy[4, 9],

Physical activity or sport (gymnastics) causes major changes to the system circulation and breathing in which both take place simultaneously as a homeostatic response. Exercise is often used in patients with hypertension is aerobic exercise. Many forms of aerobic exercise that can be taken by patients with hypertension include jogging and aerobic gymnastics. Regular exercise can lower systolic and diastolic pressure in people with mild hypertension [10,11], Physical exercise is very influential for persons with hypertension in improving the body's immunity after regular exercise, preventing obesity, normalizes blood pressure and improve employability. Aerobic exercise can help improve hemostatic system and blood pressure [10]. One of the government's program of gymnastics Prolanis (Management for Chronic Disease Program) is a form of aerobic physical exercise. Gymnastics is also included government programs run by the organization of the Social Security Agency (BPJS). Prolanis a health care system and a proactive approach are implemented in an integrated manner involving participants, health facilities and BPJS (Agency for the Implementation of Social Security) Health within the framework of the maintenance of health for participants who bears a chronic disease in order to achieve optimal quality of life with health care costs effectively and efficient [10], Prolanis this program can improve the quality of life for people with chronic diseases such as hypertension.

Gymnastics or exercise increases the need for oxygen in the cell energy formation process, resulting in increased heart rate, cardiac output and stroke volume increases. Thus the increase in blood pressure. After rest dilated or stretched blood vessels and blood flow down temporarily, about 30-120 minutes. Then back on the blood pressure before exercise. If you exercise regularly and continuously, the blood pressure reduction lasts longer and is more elastic blood vessels. Mechanism drop in blood pressure after exercise can relax the vessels-arteries. So with the widening of blood vessels drop in blood pressure [12],

The first-level health facilities (FKTP) in this case the end of the health centers spear implementation of chronic disease prevention and management of hypertension. Prolanis activities include: medical consultation, gymnastics prolanis or education club Prolanis, monitoring the health status of the form of checks every month (GDP/GDPP), routine examination of 3 to 6 months (HbA1c), routine examination 6 monthly blood chemistry (micro albuminuria, urea, creatinine, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), then there is a home visit activity, drug services, mentoring specialist, and a reminder (via SMS gate way).

In dealing with chronic diseases such as hypertension need to use complementary therapies such as gymnastics prolanis, acupressure, yoga and cupping. acupressure is a simple therapy, no side effects because they do not perform invasive techniques and easily done [13], Acupressure is derived from the science of acupuncture in which one form of physiotherapy or massage at specific points of the body surface that able to provide the healing process [14],

Acupressure benefits include help in managing stress, calm the nervous tension and promote relaxation of the body. This therapy uses acupressure technique conducted finger at the point associated with hypertension. Massage-massage on a certain point in acupressure therapy may stimulate nerve impulses so as to expedite the flow of blood, relaxes spasms, and lower blood pressure [14], Pharmacologic treatment of hypertension by using a diuretic, beta bloker, vasodilators, angiotensin potassium, converting enzyme inhibitors and angiotensin II receptor blocker angiotensin [15],

Research that has been tested and has emperik evidence regarding prolanis gymnastics and acupressure performed by Saktia (2014) with title the effect of acupressure therapy in hypertensive patients in mind health clinic in Surakarta synergy "The results of this study concluded that acupressure therapy effect on hypertension with the results of analysis Wilcoxon test showed p-value =0.008 to p-value of <0.05 [4]. Other studies say about prolanis exercise influence on blood pressure with a sample of 22 respondents, divided into two intervention and control groups before and after the acupressure therapy. The results showed there is a significant difference between the systolic blood pressure at the beginning and end of the exercise 2 times/week (p = 0, 003<α = 0, 001); between diastolic blood pressure at the beginning and end of the exercise 2 times/week (p =0, 002<α =0, 001) [10],

Based on the description above, the researchers wanted to examine more about "complementary intervention prolanis gymnastics and acupressure are effective against systolic and diastolic blood pressure in hypertensive patients."

This type of research is quasi experiment with using a pretest-posttest control group design. Pretest conducted in the intervention group and the control group. Was given treatment in the intervention group and the control group was given three times a week for 1 month (12 times) then do the posttest.

Tabel.1 shows the distribution of respondents by sex of male respondents were 7 respondents (33.3%) and 14 female respondents (47.6%) in the intervention group, while the control group of 10 male respondents (47.6 %) and women as much as 11 respondents (52.4%), the majority of respondents education is at the level of high schools in the intervention group of 10 respondents (47.6%), and the control group were 12 respondents (57.1%), whereas respondents work mostly farmers in the intervention group were 11 respondents (52.4%) in the control group of farmers and civil servants respectively 8 respondents (38.1%). Coffee drinking habits in the intervention group were 13 people (61.9), while the control group 15 (71.4). habit smoking intervention group 6 (28).

Based on the average characteristics of respondents Table 4.1 above can be seen that the average age of the respondents in the intervention group was 52, 05 years with a standard deviation of 6,644. Whereas in the control group the average age of respondents was 50.58 with a standard deviation of 7,425.

Table 2. Anova test results reapead measure systolic blood pressure showed that the p-value is 0.0001 intervention group (p<0.05) means gymnastics prolanis and acupressure effectively lower extremity systolic blood pressure. P-value is 0.0001 the control group (p<0.05) prolanis gymnastics effective means against the systolic blood pressure, but viewed from the mean between intervention and control groups at week 4 effective intervention group with a mean of 157.62

The test results showed that systolic data discrepancies p-value was 0.0001 (p<0.05) means There is a difference in the intervention group exercises and acupressure extremity prolanis effectively lower blood pressure than the control group.

Graph. 1 Average systolic blood pressure before and after treatment in the intervention group.

The graph above shows the average systolic blood pressure in both groups experienced a decline noble in the first week and continued to decline in the second week, third and fourth week.

The results of calculation of the mean difference in measurement results indicate different exercises and acupressure prolanis extremities as well as the drug can lower systolic blood pressure in the intervention group at Δ mean -11.09, while the control group experienced a change of Δ mean -8.76.

Table 3. Reapeted measure anova test results diastolic blood pressure showed that the intervention group p-value was 0.0001 (p<0.05) means extremity exercises and acupressure prolanis effectively lower diastolic blood pressure. p-value is 0.0001 the control group (p<0.05) prolanis gymnastics effective means to lower diastolic blood pressure, whereas seen from the mean value of the more significant intervention group (101.29)

The test results showed that diastolic data discrepancies p-value was 0.030 (p<0.05) means that there is a difference in the intervention group exercises and acupressure extremity prolanis effectively lower blood pressure than the control group.

Graph 2 Average systolic blood pressure before and after treatment in the intervention group.

Graph 2 above shows the average diastolic blood pressure in both groups experienced a decline noble in the first week and continued to decline in the second week, third and fourth week.

The results of calculation of the average difference in results, showed differences prolanis exercises and acupressure extremities as well as the drug can lower systolic blood pressure in the intervention group of Δ mean -9.61, while the control group experienced a mean change of Δ -9.7 .