Ngasekupheleni kuka-2017, i-American College of Cardiology (ACC) kanye ne-American Heart Association (AHA), ngokubambisana neminye imikhakha eminingi yezokwelapha ehloniphekile, yakhululwa isethi entsha yeziqondiso zomshuwalense .
Lezi ziqondiso ezintsha zadlulile isikhathi eside. Ngaphambi kokukhululwa, odokotela babezama ukusebenza kusukela okungenani izigaba ezine zeziqondiso, ezivela ezinhlanganweni ezihlukahlukene, ezihlukahlukene komunye nomunye ngezindlela ezibalulekile.
Imikhombandlela ka-2017 ithembisa ukuthola cishe wonke umsebenzi wezokwelapha emuva ekhasini elifanayo mayelana nomfutho wegazi ophezulu.
Imikhombandlela ka-2017 ihluke ngezindlela ezimbalwa ezibalulekile ezivela emibhalweni yangaphambilini ye-hypertension, futhi bobabili odokotela nabantu abahlolwa noma abaphathwa nge-hypertension kufanele baqaphele lezi zincomo ezintsha.
Yini okusha ku-2017 Iziqondiso?
Izici ezintsha zemihlahlandlela ka-2017 ziwela emikhakheni emihlanu ejwayelekile:
- Uhlelo olusha lwesigaba somfutho wegazi ophezulu
- Izincomo ezintsha zokuthola ukuxilongwa kwegazi
- Ukuthatha ingozi yenhliziyo yonke ekubhekiseni izinqumo zokwelashwa
- Ukugcizelela kakhulu ekushintsheni kwendlela yokuphila ekuphatheni umfutho wegazi ophezulu
- Ukubhebhethekisa ukucindezelwa kwegazi ngesikhathi sokwelashwa
Isistimu Yokuhlukaniswa Kusha Ye-Hypertension
Ngaphambi kwemikhombandlela ka-2017, abantu abane-systolic blood pressure ka-120-139 mmHg babhekwa "banesifo sokushisa ngokweqile"; labo abanezimo ezicindezelayo ze-140-159 mmHg babecatshangwa ukuthi banesisindo somfutho we-Stage 1; nalabo abanezinkinga ze-systolic zika-160 mmHg noma ngenhla babecatshangwa ukuthi banesigaba se-2 se-hypertension.
Uhlelo lwesigaba sika-2010, esekelwe emiphumeleni yelingo oluthile olwenziwe ngokungahleliwe, linciphisa imingcele yeSigaba 1 ne-Stage 2 yomshuwalense, kanje:
- Ukushisa ngokweqile manje kuchazwa ngokuthi i-systolic blood pressure ye-120-129 mmHg no-diastolic yegazi ngaphansi kwe-80 mmHg.
- Isigaba 1 somfutho wegazi ophakeme sichazwa ngokuthi i-systolic blood pressure ka 130-139 mmHg KANYE nocingo lwe-diastolic ka-80-89 mmHg.
- Isigaba sesi-2 somfutho wegazi ophakeme sichazwa ngokuthi i-systolic blood pressure ye-140 mm Hg noma ngaphezulu KUNYE ukucindezelwa kwe-diastolic ka-90 mmHg noma ngaphezulu.
Empeleni, imihlahlandlela ka-2017 ihlukanisa isigaba esidlule sokuthi "isandulela-ngculazi" sesigaba ezimbili. Ingxenye engezansi isacatshangelwa ukuthi i-hypertension, kodwa ingxenye engaphezulu (i-systolic blood pressure ka 130-139) manje ibhekwa njengeSigaba 1 somfutho wegazi ophezulu. Lolu shintsho lwenziwa ngoba idatha evela ekuvivinyweni kwamaklinikhi manje ibonisa ukuthi abantu abacindezelwa yigazi kulezi zigaba 130-139 baneengozi enkulu kakhulu yokucindezeleka kwenhliziyo, futhi ukucindezelwa kwegazi okuphakeme kufanele kuqondiswe.
Izincomo Ezintsha Zokuthola I-Hypertension
Imikhombandlela ka-2017 ithatha izinhlungu ukuveza ukuthi indlela yegazi ephindwe kaningi ngayo emahhovisi odokotela, futhi indlela indlela yokucindezeleka isetshenziselwa ngayo, iye yahlushwa izinkinga.
Umfutho wegazi womuntu uguquke ngokuphawulekayo phakathi nenkathi yosuku olujwayelekile, kuye ngokuthi isimo somuntu somsebenzi, ukucindezeleka, i-hydration, i-posture, nezinye izinto eziningi ezingashintsha kusukela ngomzuzu kuya kumzuzu. Ngakho, ukuze ulinganise ngokunembile ukucindezelwa kwegazi, kubalulekile ukwenza kanjalo ngaphansi kwezimo ezilawulwa ngokucophelela.
Nansi indlela iziqondiso ezintsha ezichaza ngayo inqubo efanele yokulinganisa ukucindezelwa kwegazi:
- Isiguli kufanele sikhululeke ngokuphelele, sihlezi esihlalweni (ngezinyawo phansi futhi sisekelwa emuva) okungenani imizuzu engu-5.
- Isiguli kufanele sigweme i-caffeine, ukuvivinya umzimba nokubhema okungenani imizuzu engu-30 ngaphambi kokuba kwenziwe isilinganiso.
- Isiguli kufanele sibe nesigqila esingenalutho.
- Akekho isiguli noma umuntu othatha ukucindezelwa kwegazi kufanele akhulume ngesikhathi sokuphumula, noma ngesikhathi sokulinganisa.
- Zonke izingubo ezithinta indawo ye-cuff yegazi kumele zisuswe. (Akukho ukuthatha ukucindezelwa kwegazi phezu komkhono.)
- Ngokuyinhloko, ukucindezelwa kwegazi akumelwe kulinganiswa ngenkathi isiguli sihlezi noma silele etafuleni lokuhlola.
- Kumelwe kuthathwe okungenani izilinganiso ezimbili noma ezintathu, okungenani izikhathi ezimbili noma ezintathu ezihlukene, futhi isilinganiso salezi zifundo kufanele zisetshenziselwe ukuxilonga ukucindezeleka komfutho wegazi ophezulu.
Noma ubani oye ehhovisi likadokotela eminyakeni yamuva cishe uzoqaphela ukuthi le mihlahlandlela ayilandelwa kaningi. Noma kunjalo, kudingeka ukuthi ilandelwe ukuze ukufundwa kwegazi kufundwe ukuthi kunembile. Lokhu bekuyiqiniso njalo, kodwa kuyiqiniso ikakhulukazi namhlanje ngesistimu yokuhlukaniswa komfutho wegazi ophakanyisiwe ophakanyisiwe emibhalweni ka-2017. Ngaphandle kokuba umfutho wegazi ulinganiswe ngaphansi kwezimo zokuphumula okunethezekile, okunethezekile okuchazwe kule mihlahlandlela, izingqinamba ukuthi ukurekhoda kwegazi kuzonyuswa phezulu.
Ngaphezu kwalokho, imihlahlandlela ka-2017 iphakamisa ukuthi uma ukucindezeleka komzimba kutholakala emtholampilo besebenzisa lezi zinyathelo ezilinganiselwe, umfutho wegazi kufanele ulinganiswe ngesisekelo sokuthungatha ngaphambi kokunquma ukuthi lo mfutho wegazi ophezulu ukhona.
Ukuthatha Ingozi Ephelele Yomphimbo E-Akhawunti
Ngenkathi abantu abano-sysilic blood pressure yabo phakathi kuka-130-139 mmHg manje behlukaniswa njengokuba ne-Stage 1 ye-hypertension esikhundleni se-hypertension, iziqondiso zango-2017 zincoma ukuthi zibheke ingozi yazo yonke inhliziyo ngaphambi kokunquma ukuthi ingabe ingazifaka noma zingabeki yini ukwelashwa okunamandla.
Ekucabangeni ingozi yenhliziyo yonke yabantu abanesifo somfutho we-Stage 1, imihlahlandlela ka-2017 batusa ukusebenzisa i-ACC / AHA Pooled Cohort Equations risk calculator. Lesi sibalo silinganisa iminyaka engu-10 engozini yesifo senhliziyo ngokusebenzisa ubudala, ubuhlanga, ubulili, ama- cholesterol amazinga , i-systolic blood pressure, isifo sikashukela nomlando wokubhema, nanoma yikuphi ukwelashwa kwe-cholesterol nomfutho wegazi. Uma ingozi yeminyaka engu-10 isekelwe kulolu wokubala okubungozi kulinganiselwa ukuthi ingaphezulu kwamaphesenti angu-10, ngakho-ke ukwelashwa kwezidakamizwa zeSigaba 1 somfutho wegazi ophakanyisiwe kunconywa.
Uma ingozi yabo engama-10 ephansi kunamaphesenti angu-10, abantu abane-Stage 1 ye-hypertension kufanele baphathwe nezinguquko zendlela yokuphila, njengalabo abane-hypertension.
Abantu abane-Stage 2 ye-hypertension bazohlale befuna ukwelapha izidakamizwa .
Ukugxila kwizinguquko zokuphila
Noma ubani one-hypertension, noma iSigaba 1 noma isiteleka se-Stage 2, izinguquko zendlela yokuphila zigcizelelwe njengegumbi lesikhambi ngemikhombandlela ka-2017.
Izinguquko zokuphila eziphakanyisiwe zifaka okuningi kokuzivocavoca (okungenani imizuzu engama-30 yokuzivocavoca okungenani kathathu ngesonto), ukudla kwe-DASH-style, ukunciphisa ukuphela kokudla ukubhema , ukulahlekelwa kwesisindo, nokunciphisa utshwala okungaphezu kwesisodwa esisodwa ngosuku abesifazane, neziphuzo ezimbili ngosuku ngamadoda.
Amathegethi aphansi weTherapy Pressure Therapy
Imikhombandlela ka-2017 igcizelela ukuthi isisombululo sokwelapha kwegazi kufanele sibe yinkinga ye-systolic engaphansi kuka 130 mmHg, nokucindezela kwe-diastolic engaphansi kuka-80 mmHg.
Lokhu kuhloswe kuncane kunezinhloso ezihlongozwa yimikhombandlela yangaphambilini, okuyinto ngokuvamile ehlose ukucindezelwa kwegazi systolic engaphansi kuka 140 mm Hg kubantu abaningi. Ezinye iziqondiso ezidlule zancenga ukuqapha okukhulu ezigulini ezikhulile, zincoma umgomo wokwelashwa ka-150 mmHg noma ngaphansi.
Isihluthulelo esisha, sokwelashwa okuphansi kuka 130 mmHg noma ngaphansi, kubantu asebekhulile nakwabanye abantu, sisekelwe emiphumeleni yelingo olusha olulandelwayo olwenziwe ngokungahleliwe oluye lwabonisa imiphumela ephuthumayo yabantu abaneminyaka yonke abaphathwe emigomeni engezansi.
Izwi elivela
Imihlahlandlela ye-hypertension ka-2017 ibonisa ukuhlanganiswa nokubuyekezwa kwezinhlayiyana eziningana zeziqondiso ezivela emaqenjini amaningana ochwepheshe, okuhloselwe ukuthola odokotela abaphatha ukwelashwa komfutho konke ekhasini elifanayo. Kukhona izinguquko emibhalweni ka-2017 ezoyothatha ezinye ukujwayela, kokubili ekuxilongweni kanye nendlela yokwelashwa kwesifo somfutho wegazi ophezulu. Kodwa-ke, zisekelwe ebufakazini obuqinile bempilo, futhi kufanele zamukeleke odokotela abaningi.
Uma unayo noma uhlolisiswa nge-hypertension, kungaba umqondo omuhle ukuxoxa ngalezi ziqondiso ezintsha nodokotela wakho, ukuqinisekisa ukuthi ukuhlolwa kwakho kulungile, futhi uhlelo lwakho lwezokwelapha lungcono kuwe.
> Imithombo:
> Muntner P, Carey RM, Gidding S, et al. Umthelela omkhulu wabantu base-US we-2017 American College of Cardiology / American Heart Association Isiqondiso Esiphezulu Sokucindezelwa Kwegazi. Ukujikeleza 2017; I-DOI: 10.1161 / CIRCULATIONAHA.117.032582.
> Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Isiqondiso se-Prevention, Detection, Assessment, kanye nokuphathwa kwe-High Blood Pressure kubantu abadala: Umbiko we-American College of Cardiology / American I-Heart Association Task Force emithethweni yezokwelapha. I-hypertension 2017; I-DOI: 10.1161 / HYP.0000000000000066.
> Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Isiqondiso se-Prevention, Detection, Assessment, kanye nokuphathwa kwe-High Blood Pressure kubantu abadala: Umbiko we-American College of Cardiology / American I-Heart Association Task Force emithethweni yezokwelapha. J Am Coll Cardiol 2017; I-DOI: 10.1016 / j.jacc.2017.11.005.