Ukwelapha Ukucindezelwa Kwegazi Eliphakeme
Uma ngabe uthola ukuthi une-high blood pressure, noma umfutho wegazi ophezulu, kubalulekile kuwe nodokotela wakho ukuthi umise umgomo ofanele wokwelashwa, bese uthatha izinyathelo ezidingekayo ukuze ufeze lowo mgomo.
Khumbula ukuthi, kaningi, ukufeza umgomo wakho wegazi wegazi kuyokwenziwa kuphela emva kochungechunge lwezinyathelo - isinyathelo esisodwa ngesikhathi.
Ngemuva kwesinyathelo ngasinye, wena nodokotela wakho uzoqaphela ukuthi ngabe umgomo - ufinyelela yini "umgomo" wegazi wegazi ngaphandle kwemiphumela emibi kakhulu - ifinyelelwe.
Ukubeka Imigomo Yokwelapha
Izinjongo zokwelashwa zokwelapha umfutho wegazi ophakeme zishintshile ngokuhamba kwesikhathi, kanti empeleni ziye zaba yingxabano encane. Kodwa ngonyaka wezi-2017, izinhlangano ezinkulu zezokwelapha zazishicilela izinkombandlela zokuvumelana mayelana nokuhlonza nokuphatha umfutho wegazi ophezulu. Ngokuyinhloko, odokotela manje basekhasini elifanayo.
Umgomo wokwelapha umfutho wegazi wegazi ukunciphisa ukucindezeleka kwegazi le-systolic ibe ngaphansi kuka-130 mmHg, nokucindezela kwe-diastolic okungaphansi kuka-80 mmHg. Umgomo uhlala ufana nanoma ubani onomshukela ophezulu, kungakhathaliseki ubudala.
Noma kunjalo, izinhloso zokwelashwa ngezinye izikhathi kufanele zizimele ngabanye. Ngokwesibonelo, abanye abantu asebekhulile abane-hypertension ye-systolic ngokuyinhloko bangase babe nekhanda elinomuthi onamandla wokulwa ne-antihypertensive.
Eqinisweni, ngaphambi kuka-2017 umgomo wokwelashwa wabantu abanjalo kwakuhlose ukucindezela kwe-systolic engaphansi kuka-140, noma ngisho no-150, mmHg. Idatha yamuva yakamuva evela ezivivinyweni zomtholampilo ibonisa ukuthi umgomo ongaphansi kuka 130 mmHg uveza imiphumela engcono nakubantu asebekhulile, futhi iziqondiso zango-2017 zashintshwa ukuze zibonise lolo lwazi olusha.
Noma kunjalo, kubantu abathile asebekhulile umgomo ophansi ungase uhlale unonya, ngakho abanye abantu bangase babe nezinhloso ezahlukene zokwelapha.
- Kungenzeka yini ukwehlisa ukucindezeleka kwegazi kakhulu?
- Funda mayelana nokwelapha umfutho wegazi ophezulu asebekhulile.
Ingabe Unesifo Sokucindezela Okusemqoka Noma Sesibili?
Ukwelashwa kwakho kwegazi, kuqala, kuzokwenziwa ukuthi ngabe ukucindezela kwegazi lakho kubangelwa isimo esithile sokugula (okungukuthi, isifo somfutho wegazi ophezulu), noma ngabe useziningi zeziguli ezinegazi eliphakeme (lapho ayikho isizathu esiqondile esiyimbangela).
Uma une-hypertension yesibili, indlela eyinhloko yokwelapha cishe kuyoba ukuphatha imbangela eyimbangela.
Ngakho-ke, kulo lonke lolu cwaningo sizocabangela ukuthi une-high blood pressure ejwayelekile kakhulu.
Izinyathelo Zokwelapha Ezijwayelekile Ze-Essential Hypertension
Ukwelapha kokuqala kwe-hypertension ngokuvamile kuxhomeke "esigabeni" se-hypertension yakho, esinqunywe yi- systolic yakho ne-diastolic yegazi .
• I- Stage 1 yomshuwalense : i-systolic 130 - 139 mmHg, noma i-diastolic 80 - 89 mmHg
• Isigaba 2 somfutho wegazi ophezulu : i-systolic enkulu kune-140 mmHg, noma i-diastolic inkulu kune-89 mmHg
Ngaphezu kwalokho, umfutho wegazi we-symicol we-120 mmHg noma ngaphezulu (kodwa ngaphansi kuka-130 mmHg) ubhekwa njengengcindezelo ye- hypertension . Ukwelashwa ngokweqile kubonisa ukuthi kunengozi encane yenhliziyo, kodwa akubhekwa njengesimo esivumela ukuba ukwelapha izidakamizwa ezingasebenzi. Kunalokho, izinguquko zendlela yokuphila zinconywa ukunciphisa ingozi.
Izinguquko zokuphila
Uma isifo somfutho wegazi ophezulu usuke sibe mnene (Isinyathelo 1 somfutho wegazi ophezulu), udokotela wakho angase aqale ngokucebisa izinguquko zokuphila. Izinguquko zokuphila ezingasiza ekunciphiseni ukucindezeleka kwegazi zihlanganisa:
• Ukwamukela ukudla kokucindezeleka
• Ukwamukela umkhawulo wesikasawoti
• Ukwamukela uhlelo lokuzivocavoca njalo
• Ukuyeka ukubhema
Uma uphumelele ekutholeni lezi zinguquko zokuphila kodwa ukucindezelwa kwegazi okwamanje akukafinyelelanga umgomo wakho (noma uma ungumuntu ojwayelekile, futhi imizamo yakho ekudleni nokuzivocavoca isalokhu ifinyelela kancane kulokho ochwepheshe batusa ngakho) udokotela wakho uzokutusa ukwelashwa kwezidakamizwa ze-hypertension.
Ukwelashwa Kwezidakamizwa
Amakilasi amahlanu amakhulu emithi asetshenziselwa ukwelapha umfutho wegazi ophezulu:
• I-ACE inhibitors
• Abavimba be-Angiotensin receptor, ama-ARB
Izidakamizwa eziningana ezithile ziye zathengiswa nge-hypertension ngaphakathi kwalezi zigaba, futhi imishanguzo eminingi yemithi iqukethe inhlanganisela yale mithi. Nasi uhlu oluphelele oluphelele lwemithi eminingi kadokotela ekhona manje etholakalayo yokwelapha umfutho wegazi ophezulu.
Uma unesiteji I-hypertension , izinkinga ezinhle ukuthi umfutho wegazi lakho ungalethwa emazingeni ahlose ngomuthi owodwa. Uma une-Stage 2 ye-hypertension, ukwelashwa okulodwa okudakamizwa okungeyodwa kungasebenza kahle, kanti udokotela wakho angase afune ukuqala ngokushesha ngokuhlanganiswa kwezidakamizwa.
Uma ukwelashwa komuthi owodwa (noma i-monotherapy) kukhethiwe, kubonakala kungcono ukuqala noma i-thiazide diuretic (ngokuvamile i-chlorthalidone noma i-hydrochlorothiazide), i-calcium blocker ende ende, noma i-ACE inhibitor. (Ama-ARB angasetshenziswa esikhundleni se-ACE inhibitor uma i-ACE inhibitor engavumi ukubekezelela). Iziguli ezincane ngokuvamile ziphendula kahle kuma-ACE inhibitors; Iziguli ezimnyama neziguli asebekhulile zivame ukwenza kangcono nge-thiazide diuretics noma i-calcium channel blockers. Abavimbela i-Beta ngokuvamile bayisinqumo esibi sokuthi i-monotherapy.
Uma ukuzama kokuqala ku-monotherapy kungasebenzi kahle noma kubekezelelwe kahle, ukushintshela kwesinye isidakamizwa esisodwa, bese kuthi kwesithathu uma kunesidingo, ngokuvamile kunconywa njengesinyathelo esilandelayo.
Uma imizamo emithathu noma ngaphezulu e-monotherapy engazange isebenze kahle, isinyathelo esilandelayo ukuzama ukwelashwa okuhlangene ngemithi emibili noma ngaphezulu. Nakuba inhlanganisela eminingi ingenzeka, ubufakazi bamuva bubonisa ukuthi ukusebenzisa i-calcium blocker kanye ne-ACE inhibitor noma i-ARB ingaba inhlanganisela ephumelelayo kakhulu futhi ebekezeleleke kakhulu. Odokotela abaningi manje bazozama le nhlanganisela kuqala, noma ngabe i-monotherapy yayine-thiazide diuretic.
Ngalokhu kuhamba ngokuhlakanipha, iningi leziguli ezinesifo somfutho wegazi ophakeme lizofinyelela ezingeni labo lokucindezela igazi elibhekene nemiphumela emibi kakhulu. Khumbula ukuthi ukuthola ukwelashwa okuphumelelayo kwe-hypertension ngokuvamile kudinga amasonto ambalwa noma izinyanga, kanti nokuhlolwa kwezidakamizwa eziningana. Kodwa kubalulekile ukuthi unamathele ohlelweni. Ukuthola ukucindezeleka kwegazi ukukhomba amazinga, futhi ukuwugcina lapho, kuzokunika inkokhelo enkulu kakhulu emizamweni yakho - ingozi enciphise kakhulu yokuhlasela kwenhliziyo nokushaya isifo.
> Imithombo:
> Law, MR, Morris, JK, Wald, NJ. Ukusetshenziswa Kokucindezelwa Kwegazi Ngezivimbela Ukuvimbela Izifo Zezinhliziyo: I-Meta-Ukuhlaziywa Kwezingu-147 Zemibuzo Engahleliwe Emibhalweni Yenkulindweni Evela Ezifundweni Ze-Epidemiological Ezingavamile. BMJ 2009; 338: b1665.
> Staessen, JA, Wang, JG, Thijs, L. Ukuvimbela Amagciwane Nokunciphisa Ukucindezelwa Kwegazi: Ukubukeza Okulinganiselwe Kubuyekezwe Kusukela ku-1 Mashi 2003. J Hypertens 2003; 21: 1055.