Okwenza odokotela bangase bangabi indawo engcono kakhulu yokukala ukucindezelwa kwegazi.
Kubonakala sengathi ukuxilongwa komfutho wegazi ophezulu kungagcina kukhishwe ehhovisi likadokotela, futhi kungena ekhaya, okungenani uma i-United States Preventive Services Task Force (USPSTF) inendlela yayo.
NgoDisemba, 2014, i-USPSTF ikhishwe izincomo ezintsha zokubheka ukucindezeleka, okukhuthaza odokotela ukuba basebenzise ukuqapha kwengcindezi yegazi (ABPM) ngaphambi kokuba benze iziguli baye empilweni yokuphilisa i-antihypertensive.
Ngokuyinhloko, i-USPSTF yenza umphakathi ube yimfihlo encane engcolile - okungukuthi, ukuthi izilinganiso zegazi ezitholakale ehhovisi likadokotela ngokuvamile zikhona nje ezingenembile ngokwanele. I-ABPM iyindlela enembile kakhulu yokunquma ukuthi umuntu unayo yini noma ayinayo isifo somfutho wegazi ophezulu , futhi ukusetshenziswa kwayo kuzovimbela amacala amaningi okwelapha ngokweqile futhi (okungavamile) ngaphansi kokuphathwa.
Kubonakala sengathi okungenani odokotela abathile (kanye nabakhokhela cishe) bazophikisana nalezi ziqondiso ezintsha, nokuthi okungenani ukucindezelwa kuzobe kuthwalwe ukuze uthole i-USPSTF ukuthi iguqule izincomo ezihlongozwayo ngaphambi kokuba ziqedelwe. Inkinga yodokotela ukuthi i-ABPM ibhekene nobunzima bokuhlinzeka, ngokuvamile ayitholakali kalula, futhi isidingo sokuyisebenzisa isongela ukuqhubeka nokucindezela ukuphila komsebenzi odokotela kakade kunzima. Inkinga yabakhokhi ukuthi i-ABPM iyabiza, futhi ngeke ifande ukukhokhela amakhulu ezinkulungwane ze-ABPM ukuhlolwa ngonyaka.
Ububunzima bokuphikisana okunjalo ukuthi i-USPSTF iqondakala ngokuyisisekelo kulokhu. Izilinganiso zegazi ezitholakala ehhovisi likadokotela zivame ukudukisa, futhi zingaholela ekunakekelweni kwezempilo okungalungile.
Okwenza ukuthi iHhovisi leHhovisi Lokucindezela Ngegazi Liyinkinga
Uma une-blood pressure yakho elinganiselwe ehhovisi likadokotela, isilinganiso esibhaliwe ngokushesha siba ngumfutho wegazi "osemthethweni" - njengokungathi ukucindezelwa kwegazi kuyinani le-static, njengesisindo sakho noma ukuphakama kwakho.
Kodwa ukucindezelwa kwegazi akuyona inani le-static. Lishintsha kancane kancane ngomzuzu kuya ngomzuzu , kuye ngezidingo eziphuthumayo zesistimu yakho yezinhliziyo. Ngaphandle kokuba kwenziwe ngaphansi kwezimo ezichazwe ngokucophelela, isilinganiso esisodwa se-blood pressure singase sibe ngcono kangcono kunesampula esingavamile kulezi zindinganiso eziguquguqukayo.
Ukuze uzame ukuzungeza le nkinga, isilinganiso se-"standard" segazi sichazwa njengokwenzeka ngaphansi kwesimo "sokuphumula okuthulile," futhi izifundo ezibonisa izinzuzo zokuxilonga nokuphatha umfutho wegazi ophezulu zisekelwe kulezi zindinganiso.
Nazi izidingo zesilinganiso "sejwayelekile" segazi:
- Isiguli kufanele sibekwe endaweni ekhululekile, efudumele, futhi ethule.
- Isiguli akufanele sibe ne-caffeine noma imikhiqizo kagwayi okungenani imizuzu engama-30.
- Isiguli kufanele sihlale phansi, ngemuva kwawo sisekelwa futhi siqondile, futhi ngezinyawo zombili zisekelwa phansi.
- Isiguli kufanele sihlale siphumule kule ndawo okungenani imizuzu engu-5.
- Ngemuva kokuthi lezi zimo zifinyeleleke, udokotela noma unesi kufanele athathe ngokuthula ukucindezela kwegazi isiguli okungenani kabili, mhlawumbe ngehora lesigamu elingu-5 phakathi kokufundwa.
- Uma lezi zilinganiso ezimbili zihluka ngaphezu kuka-5 mm Hg, ukufundwa okuningi kufanele kwenziwe, ngezikhathi ezifanayo phakathi kokurekhoda, kuze kube yilokho okuqoshiwe kuvuma.
Sonke siyazi ukuthi kwenzekani empeleni. Iziguli zifika ngesikhathi sokuqokwa kwakhe, kodwa ziphelelwa yisikhathi ekamelweni elilindile elinabantu abaningi. Ekugcineni, isiguli sigijimela ekamelweni lokubanda elibandayo, futhi liyalwe ukuba lihlubule phansi futhi ligqoke izingubo zokuhlolwa ezibucayi ngokuzibopha. Khona-ke, bonke kodwa behamba zezingxenye, isiguli sihlala njengoba siyalwe etafuleni lokuhlola elibandayo, singenaso ukwesekwa emuva futhi imilenze idangalisa. Udokotela oshaywayo noma umhlengikazi ekugcineni ugijimela ngaphakathi, ahlabe umfutho wegazi, kanti ngenkathi ethatha ingcindezi yegazi ngesikhathi esisodwa efaka isiguli ku-Q & A, noma uqala ukwenza izinto ezimbili noma ezintathu ezisekhokha "lokukhokha ukusebenza" .
Futhi akukho cishe ithuba lokuthola umfutho wegazi wesibili ufunda imizuzu emihlanu kamuva.
Ngakho-ke, ezimweni eziningi (uma kungenjalo), lokho okungena ehhovisi likadokotela kufana nesampula okungahleliwe komshini wegazi oguqukayo, ezimweni ezihluke kakhulu "kokuphumula okuthulile." Ngencazelo, isilinganiso esinjalo akufanele sisetshenziswe ukuxilonga isigaba 1 somfutho wegazi ophezulu.
Naphezu kwalokhu okushiwo, uma umfutho wegazi olinganiselwe kahle ngaphakathi kohlobo olujwayelekile (ngaphansi kuka-120 mm Hg systolic nangaphansi kuka-80 mm Hg diastolic), akukho umonakalo owenziwa. Futhi uma ingcindezi yegazi iphakeme ngokwanele (160 mm Hg systolic), kungacatshangwa ngokuphepha ukuthi umfutho wegazi ophezulu ungokoqobo, futhi ukwelashwa kungasungulwa. Inkinga ivela lapho ukucindezelwa kwegazi ehhovisi kusezingeni elibi kakhulu, isigaba 1 somfutho wegazi ophezulu. Ingabe lokhu kube yingozi kakhulu? Noma ingabe yindlela nje yokwenza isampula?
Odokotela, yebo, abazishayi icala. Iziguli ezithintekayo ehhovisi likadokotela, futhi ezijwayelekile ekhaya, kuthiwa zine " ingubo emhlophe yokugcoba ngokweqile ." Futhi nakuba kungenzeka ukuthi i-white coat hypertension ikhona ngempela, kubonakala sengathi odokotela abaningi bayaziqhenya sungula isifo esisha, futhi sinikeze iziguli zabo, lapho ezimweni eziningi behluleka ukukala ukucindezelwa kwegazi njengoba kufanele kulinganiswe.
Inzuzo ye-ABPM (no-HBPM)
Inzuzo ye-ABPM ukuthi ayithembeli ekufundeni kwegazi elilodwa noma amabili ngaphansi kwezimo ezilawulwa ukuthi zilawulwa. Esikhundleni salokho, i-ABPM isampula ukucindezelwa kwegazi ngezikhathi eziphindaphindiwe ngaphezu kwehora eli-24 - kuzo zonke ukushintshashintsha okuvamile ngosuku. Ukuba khona noma ukungabikho komfutho wegazi ophezulu kunqunywa ukucindezelwa kwegazi phakathi nsuku lonke. Ukuxilongwa kwe-hypertension ne-ABPM sekuqinisekisiwe kahle, futhi kunembile kakhulu kunokuthola ukuthi isifo somfutho esiphezulu se-stage 1 senziwe ehhovisi likadokotela.
Okunye okunye ku-ABPM ukuqapha ukucindezelwa kwegazi kwekhaya (HBPM). Kunezinzuzo eziningana ze-HBPM ezenza zikhange kakhulu kune-ABPM yokuxilonga nokulawula umfutho wegazi ophezulu, futhi odokotela abaningi bakholelwa ukuthi kuyinto ehlukile. Idokhumende yomqulu we-USPSTF ibonisa ngokucacile okuthandayo kwe-HBPM phezu kwehhovisi likadokotela ukuze kutholakale ukucindezeleka komfutho wegazi ophezulu.
Konke Okukushoyo Kuwe
Kungenzeka ukuthi kuyoba khona impi ephuthumayo ngaphambi kokuba odokotela nabakhokhi bavumelane ne-USPSTF ukuthi isigaba 1 somfutho wegazi ophezulu kufanele sitholwe kuphela ngemva kokuba i-ABPM (noma i-HBPM) iqinisekisa ukuxilongwa. Okufanele ukwazi, uma utshelwe ukuthi unesisindo somfutho wegazi ophezulu (noma isifo sofuba ), kanti udokotela wakho ukhuthaza ukwelashwa kwansuku zonke, ukuthi lezi zivivinyo zokuqinisekisa ziyatholakala namhlanje, futhi kuwukuhlakanipha ukuzicela. Funda nge-ABPM ne-HBPM, bese ubuza udokotela wakho uma kungakufanelekile ukusebenzisa ukuhlolwa okunjalo ukuqinisekisa ukuthi empeleni unomfutho wegazi ophezulu ngaphambi kokuqala ukwelashwa.
Imithombo:
Isitatimende Sokunconywa Okubhaliwe: Ukucindezelwa Kwegazi Eliphezulu Kwabadala: Ukuhlola. "I-US Preventive Services Task Force. Disemba 2014. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/hypertension-in-adults-screening-and-home- ukuqapha (kufinyelelwe ngoJanuwari, 2015).
U-Pickering TG, uMiller NH, u-Ogedegbe G, et al. Ukwenza isenzo ekusetshenzisweni nasekubuyiselweni kokuqapha kwengcindezi yegazi ekhaya: isifingqo esiphezulu: Isitatimende esivumelwaneni sesayensi esivela ku-American Heart Association, i-American Society Of Hypertension, ne-Preventive Cardiovascular Nurses Association. I-Hypertension 2008; 52: 1.