Ukucindezelwa Kwegazi Eliphakeme

Okubalulekile nge-High Blood Pressure

Umfutho wegazi ophakeme yisimo esinemiphumela emibi yempilo esithinta abantu abadala baseMelika abangaba yizigidi ezingu-80. Uma kutholakala futhi kuphathwa ngokushesha, kunganciphisa ingozi yokushaya inhliziyo, isifo sohlangothi, nesifo sezinso.

Kuyini Ukucindezelwa Kwegazi?

Umfutho wegazi yiwona amandla angaphandle asebenzisa igazi ezindongeni ze-artery. Imishanguzo iyimithwalo yegazi ethwala igazi ne-oxygen emaphashini kuya kuzo zonke izitho nezicubu zomzimba.

Imishanguzo iqukethe imisipha futhi iguquguquke, izicubu ezixhunyiwe ezigxilwe ukuze zithole amandla okugeleza kwegazi okwenziwa yinhliziyo. Futhi isenzo sokumosha senhliziyo yilokho okuvumela igazi ukuba lihambe ngalezi zindlela zomzimba.

Ukucindezelwa kwegazi kuboniswa ngezinombolo ezimbili. Inombolo ephezulu, i-systolic blood pressure, ibonisa amandla aphethwe izinhlangothi zenhliziyo. Inombolo ephansi, i-diastolic blood pressure, ibhekisela ekucindezelweni kwegazi emagcekeni we-arteries lapho inhliziyo iphumula phakathi kwezingqinamba.

• Uhlolojikelele lwe-Hypertension (High Press Press)

• Kusho ukuthini Uma Unesifo Sokucindezeleka?

Izinombolo

Ngemuva kweminyaka engama-20, bonke abantu abadala kufanele baqale ukuqapha umfutho wegazi labo ekuvakasheni kwabo njalo. Uma uneminyaka engaphezu kwengu-40 noma unengozi yokucindezela kwegazi, kufanele ube nokucindezelwa kwegazi lakho kuzo zonke izingalo okungenani ngonyaka. Kubalulekile ukusebenzisa isisindo somshini wegazi wezinga elifanele, yingakho kungenakwanele ukuhlola ukucindezelwa kwegazi lakho kumshini othomathikhi ekhemisi noma esitolo.

Ukucindezeleka kwegazi okuvamile kubhekwa ukuthi kungaphansi kuka-120/80 mm Hg. Ukuqapha kwehora lamahora angu-24 noma ukuqapha kwengcindezi yengcindezi yekhaya ekhaya, ukucindezelwa kwegazi okuvamile kwansuku zonke kuchazwa ngokuthi ingcindezi yegazi engaphansi kuka-135/85 mm Hg.

Uma izinombolo zakho ziphakeme kunalokhu, akusho ukuthi une-high blood pressure. Ukucindezeleka kwegazi kungashintsha ekuphenduleni umzimba, ukucindezeleka, imithi, ukugula, ngisho nesikhathi sosuku. Kubalulekile ukuthatha ukufunda izikhathi eziningana ngokuhamba kwesikhathi ukuze wenze ukuxilongwa okufanelekile.

Izimbangela

Iningi labantu abadala abanomfutho wegazi ophezulu banomfutho wegazi ophezulu, owabizwa ngokuthi "ubalulekile" wegazi. Lokhu kusho ukuthi ukuphakama kwengcindezi yegazi akusona ngenxa yenye imbangela. Ukucindezeleka okuyisisekelo kancane kancane kukhula iminyaka eminingana. Ngaphandle kokuba uyiqaphele, kungenzeka ukuthi ungalokothi uqaphele ukuthi ubhekene nenkinga engabangela ukulimala komzimba obalulekile.

I-high blood pressure ibhekisela emfuthweni wegazi ophakeme obangelwa omunye umuthi noma imithi. Ezimweni eziningi, ukushisa komfutho wesibili kwenzeka ngokuzumayo futhi kungabangela ukuphakama okukhulu kwegazi kune-primary blood pressure. Izifo ze-thyroid, isifo sezinso, ukuphefumula okuphazamisayo kokulala, ukusetshenziswa kabi kotshwala, izidakamizwa ezingekho emthethweni, nezicubu ze-adrenal gland ezinye zezimbangela zomshuwalense wesibili.

Izingozi Zezingozi

Kunezici ezihlukahlukene ezingakwandisa ingozi yegazi eliphezulu. Ezinye izinto eziyingozi azikwazi ukuguqulwa kodwa ezinye zingancishiswa ngezinguquko zokudla nokuphila. Izingozi ezingenakuguqulwa zihlanganisa iminyaka, umlando womndeni, nohlanga. Ngokwesibonelo:

• Ngemuva kweminyaka engu-45, amadoda angase ahlakulele ukucindezelwa kwegazi eliphezulu.
• Kwabesifazane , ingozi ikhula ngemva kweminyaka engama-65.
• AbaseMelika baseMelika basengozini enkulu yokucindezeleka okukhulu okuvame ukuthuthukisa ekuqaleni futhi kubangele ukucindezeleka okukhulu.

Izimo eziyingozi ezingaguquleka zihlanganisa:

• Ukuba ngokweqile
• Indlela yokuphila yangasese
• Ukusetshenziswa kotshwala
• Ukudla okuphezulu kwe-sodium noma ephansi ye-potassium
• Ukudla ngokweqile kotshwala
• Ukungabi nevithamini D
• Ukucindezeleka kungaphinde kwandise umfutho wegazi okwesikhashana futhi, ngokuhamba kwesikhathi, kubangele ukucindezeleka okungapheli.

Nakuba izingane zisengozini encane yokuba nengcindezi ebalulekile yegazi, zingaba nomfutho wegazi ophezulu ngenxa yezimo ezithile. Umfutho wegazi wengane kufanele ulinganiselwe ekuhloleni njalo ngonyaka futhi uqhathaniswe nezinye izingane zeqembu elifanayo.

Izigaba

Ukucindezelwa kwegazi kufundwe kungawela kwesinye sezigaba ezinhlanu:

1. Ukuguqulwa kwesisu . Uma ingcindezi yegazi ye-systolic iphakathi kuka-120-139 mm Hg noma uma i-diastolic yegazi yakho ifundwa iphakathi kuka-80 no-89 mm Hg, ungase ube nesifo sofuba. Ukwelashwa ngokweqile, njengengcindezi ephakeme yegazi, kuthatha ingozi eyengeziwe yokugula kwesifo senhliziyo futhi ngokuvamile ibuhlungu ngokuhamba kwesikhathi. Ukwelashwa kuhlanganisa izinyathelo ezingezansi, njengokuncipha kwesisindo, ukukhula komzimba, ukugwema ukuphuza ngokweqile nokuvimbela uketshezi.
2. Isigaba I-hypertension . Lokhu kubhekisela kumfutho wegazi we-systolic we-140 mm Hg kuya ku-159 mm Hg noma ukucindezelwa kwegazi kwe-diastolic ka-90 kuya ku-99 mm Hg. Uma kuphela eyodwa yalezi zindinganiso ziphakanyisiwe, khona-ke inani eliphakeme likhomba ubunzima be-hypertension. Lokhu kuzoholela ekunqumeni ukwelashwa okufanele.
3. I-systolic / i-diastolic yomshuwalense omkhulu . Iziguli ezine-systolic blood pressure ezingaphezu kwama-140 mm Hg kanye nokucindezela kwe-diastolic ezingaphansi kuka-90 mm Hg kubhekwa ukuthi zine-hypertension eyimvelo ehlukile. Labo abanesisindo se-diastolic esingaphezu kuka-90 mm Hg kodwa abanesisindo se-systolic ngaphansi kuka-140 mm Hg kubhekwa ukuthi banesifo somfutho ophezulu we-diastolic. Umfutho wegazi we-systolic uyingozi kakhulu kubantu abangaphezu kweminyaka engama-60. Ucwaningo lubonisa ukuthi kunezinzuzo eziphawulekayo zokwelapha umfutho wegazi, ikakhulukazi ezigulini ezinomfutho wegazi ophansi. Izincomo zamanje ziphakamisa ukuthi imithi yomshuwalense wegazi iqaliswe ezigulini ezinesiteji somfutho wegazi ophezulu, nakuba kufanele ziqalwe ngaphambili kubantu abanesifo senhliziyo, isifo sikashukela, noma isifo esingenasifo sezinso.

• I-Pseudotumor Cerebri Causes and Symptoms

• Ingabe unaso isifo somfutho wegazi ophakeme?

1. Isinyathelo II somfutho wegazi ophezulu . Lokhu kubhekisela emgodini wegazi ophakeme, ngesisindo se-systolic se-160 mm Hg noma ngaphezulu noma ukucindezelwa kwe-diastolic ka-100 mm Hg noma ngaphezulu. Isiteleka se-II segazi singase sidinge imithi engaphezu kweyodwa yokwelapha.
2. I-hypertension engalungile . Lokhu kubhekisela ekucindezelekeni kwegazi okwedlulele, ngaphezu kuka 180 mm Hg systolic noma 120 mm Hg diastolic, ekhula ngokushesha futhi ikhiqize umonakalo wendikimba yokuphela. I-hypertension engalungile yinkinga edinga ukunakekelwa kwezempilo ngokushesha. Lesi simo siyaziwa ngokuthi ukuphuthumayo komfutho wegazi noma isimo esibucayi se-hypertensive. Izimpawu zingase zivele ngenxa yengozi yomzimba, kufaka phakathi ukudideka noma izinguquko zesimo sengqondo, umbono obonakalayo, ukugabuka, ukuphefumula, ukuvuvukala nokuhlunguphazwa kwesifuba ngenxa ye-angina, isifo senhliziyo, noma i-aneurysm.

Ukuxilongwa

I-United States Preventive Services Task Force ikhuthaza ukulinganiswa kwengcindezi yegazi ukuze ihlolwe kahle ngomshuwalense. Nakuba kungenzeka ukuthi uphakamise ukucindezelwa kwegazi uma kulinganiswa ehhovisi likadokotela wakho, lokhu kungaba umphumela we "white coat hypertension." Ukuhlolwa ngumphathi wakho wezempilo kungase kuphinde kuphuthelwe "umfutho wegazi ophakeme". Ukucindezeleka kwegazi le-12-nehora lama-24 ukusebenzisa ukuqapha kwengcindezi yengcindezi yegazi ngokuvamile kuvame kakhulu ukufundwa okwenziwe emtholampilo noma esibhedlela, futhi kubangele iziguli ezimbalwa ezidinga ukwelashwa, neziguli ezimbalwa ezidinga ukwelashwa ngenxa yalokho. Ezinye iziguli kungenzeka ukuthi zaphakamisa izinga lokucindezela kwegazi elitholakalayo ngokuqapha okuvame ukubeka engozini yokushaywa isifo nesifo senhliziyo ngisho nalapho ukufunda okutholakala endaweni yokunakekelwa kwezempilo kuyinto evamile.

Uma uthola ukuthi une-high blood pressure, udokotela wakho noma umhlinzeki wezempilo uyokwazi ukuyala ukuvivinya kwe-laboratory ukucacisa noma ngabe kukhona yini imbangela yesibili, njengokungavamile kwegciwane noma ukungavamile kwesikhumba se-adrenal. Ezinye izivivinyo zegazi zizokala amazinga e-electrolyte, i-creinine, negazi le-urea nitrogen ukuze ubone ukuthi izinso zakho zihilelekile yini.

Ukuhlaziywa kwe-urinal yisinye isilingo esivame ukusetshenziselwa ukuxilonga ukulimala kwezinso ngenxa yomsindo wegazi nokulawula ukuphazamiseka kwezinso okungaba imbangela yesibili. Amaphrofayili ka-Lipid alinganisa amazinga akho e-cholesterol futhi asetshenziselwa ukuhlola ingozi yakho yesifo senhliziyo njenge-heart attack and stroke. Ucwaningo lokucubungula lusetshenziselwa ukukhomba izicubu ezinokwenzeka zezinhlayiya zomzimba noma ukulimala izinso.

Uma uthola ukuthi une-high blood pressure, uzodinga futhi ukuhlolwa kweso. Ukuhlolwa nge-ophthalmoscope kunganquma ukuthi umfutho wegazi lakho unomthelela kangakanani emithanjeni yegazi emehlweni futhi ngabe noma yini i-retina yakho iyenzile umonakalo.

Ngaphandle kwe-electrocardiogram (ECG) ukuhlola ukulimala kwenhliziyo okungenzeka, i-echocardiogram ingasetshenziselwa ukubona ukuthi inhliziyo yakho ikhulisiwe noma ngabe unezinye izinkinga zenhliziyo ezihlobene nomfutho wegazi ophakeme, njengezindwangu zegazi noma umonakalo we-valve senhliziyo. Ukuhlolwa kwe-ultrasound ye-Doppler ingasetshenziselwa ukuhlola ukugeleza kwegazi phakathi kwemithambo yegazi ukuze kutholakale ukuthi ngabe kuncane kangakanani, ngaleyo ndlela kubangele ukucindezela kwegazi eliphezulu.

Ukwelapha

Ukwelashwa kokuqala kwe-hypertension kufaka izinguquko endleleni yokuphila nokudla ukuze kuqedwe noma kuncishiswe izici ezithintekayo ezifana nokukhuluphala noma ukudla okuphezulu kwe-sodium. Ukuyeka ukubhema nokunciphisa ukuphuza utshwala-okuphuza usuku nosuku neziphuzo ezimbili ngosuku ngamadoda-yizinyathelo ezibalulekile zokunciphisa ukucindezeleka kwegazi.

Udokotela wakho cishe uzotusa ukuvivinya umzimba okuvamile okwenza kube nomphumela omuhle ekucindezeni kwegazi. Ubufakazi bubonisa ukuthi ukuhamba okusheshayo okungenani imizuzu engama-30 nsuku zonke izikhathi eziningana ngesonto kunenzuzo yokunciphisa ukucindezelwa kwegazi.

Kukhona namakilasi amaningi ahlukene emithi atholakala ekwelapheni umfutho wegazi ophezulu. Izincomo ze- JNC 8 zokwelashwa kwengcindezi yegazi zisekelwe ebufakazini obuvela ezifundweni eziningi ezindaweni eziningi ezahlukene. Abantu abanesifo somfutho wegazi wesigaba 2 bangadinga ukwelashwa kokuqala ngemithi emibili noma imithi ehlanganisiwe.

Ukulandelwa kubalulekile. Uma umgomo wakho wegazi wegazi ungakutholakali emva kwenyanga yokwelashwa, umhlinzeki wakho wezempilo uyokwandisa umthamo wakho noma wengeze iklasi elihlukile lemithi. Ngemuva kokuthi ufinyelele umgomo wakho wokucindezela igazi, kufanele uqhubeke uqapha impendulo yakho ekwelapheni nasekuthuthukiseni kwanoma yiziphi ezinye izimo ukuze uvimbele ukuqhubeka kwezinkinga.

Izinkinga

Kunemiphumela ephawulekayo ekwenzeni umfutho wegazi ophezulu :

• Isifo senhliziyo
• Isibungu
• Aneurysms
• Ukuhluleka kwenhliziyo
• Ukuhluleka kwezinso
• Ukulimala kwemithwalo yegazi
• Izinkinga zokuqonda nokukhumbula
• Umonakalo wamehlo nokulahlekelwa kombono
• I-metabolic syndrome

Umonakalo uhlanganisa isikhathi. Umfutho wegazi ophezulu awuvamile ukuhlotshaniswa nezimpawu, ngakho-ke kuvame ukushiywa kungaphathwa kabi noma kunganakiwe kuze kube yilapho kwenzeka umonakalo wensimbi unomphela futhi owonakalayo. Lapho ukwanda kwengcindezi yegazi, izindonga ze-arteries zingalimala noma zihanjiswe. Ukulimala emithanjeni yegazi kungenza izifunda ezibuthakathaka ezenza kube ne-aneurysms noma ukuhlukana.

Ukulimala emisipha yenhliziyo nakho kungabangela ukufucula kwe-atrial ngokuhamba kwesikhathi. I-fibrillation ye-atrial iyinani lezinhliziyo elingavamile elikubeka engozini yokushaywa yisifo. Umfutho wegazi ophezulu ungaphinda uqede ungqimba lwangaphakathi lwe-arteries, okuvumela ukwakhiwa kwezicubu ezibomvu eziheha ama-cholesterol ama-distillate nama-platelet (amangqamuzana egazi akha ama-clots). Ukwakhiwa kwe-cholesterol emithanjeni yegazi ewonakele kuthiwa yi-plaque. Lezi zimpawu zenza ukunciphisa kwemithanguzo, okuholela emsebenzini omningi wenhliziyo ukupompa igazi elanele emzimbeni.

I-plaque ingaqhekeka ngaphansi kwengcindezi ephezulu. Lokhu kubangela amaplatelets ukunamathela futhi awenze i-clot engakwazi ukuhamba futhi ihambisane nokujikeleza kwegazi, ivimbela igazi elenziwe nge-oksijeni ukuba lingangeni kuzicubu ezibucayi. Ukwengeza, lawa macwecwe angahle ahambe aye kwezinye izingxenye zomzimba, avimbele ukugeleza kwegazi futhi akhiphe ukuhlasela kwenhliziyo noma isifo sohlangothi. Ukwakheka kwe-clot kwanciphisa umthambo, okwenza inhliziyo isebenze kanzima ukupompa igazi nge-oxygen kuwo wonke umzimba.

Ukulimala emithanjeni ephuma ephezulu yegazi, okufaka ukukhwabanisa kanye ne-cholesterol build-up, kubangela ukuqina kobuchopho. Lokhu kubangela inhliziyo ukuba isebenze kanzima ukushaya igazi emzimbeni wonke. Inhliziyo iyisiphako, futhi ngokuhamba kwesikhathi, iyolimaza futhi i-floppy ngenxa yomfutho wegazi ophezulu. Amagumbi enhliziyo azokwandisa futhi imicu ye-muscular ngeke ikwazi ukuthenga ngokugcwele ukukhokhela, okuholela ekuhlulekeni kwenhliziyo .

Izwi elivela

Ukucindezeleka komzimba kuyisifo esiyingozi esingapheli esingabangela imiphumela eminingi engozini yempilo ngokuhamba kwesikhathi. Uma ungumuntu omdala ngaphezu kweminyaka engu-20, kufanele ube nomfutho wegazi lakho uhlolwe ukuhlinzeka ngempilo yakho ekuhlinzekeni kwempilo yakho evamile. Uma ungaphezu kweminyaka engama-40, kubalulekile ukuba uhlolwe ngegazi lakho njalo ngonyaka. Khumbula, ukufundwa kwakho okuvela emshinini wemishini noma ekhemisi kungenzeka ukuthi akulungile.

Ukubona ukucindezeleka kwegazi kusenesikhathi kungakusiza wenze izinguquko ezinempilo ekudleni kwakho nasekuziphatheni kwakho okuzokwenza ukuthi kunciphise ingozi yezifo ezinzima ezifana nesifo sokushaya noma isifo senhliziyo. Uma uhlaselwa esigabeni esingozi kakhulu, sebenzisa ukucindezelwa kwegazi lakho namuhla.

> Imithombo:

> Eckel RH, Jakicic JM, Ard JD, et al. Isiqondiso se-AHA / ACC sika-2013 mayelana nokuphathwa kwendlela yokuphila ukunciphisa ingozi yemvelo: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol . 2014; 63: 2960.

> Hsu CY, McCulloch CE, uDarbinian J, et al. Ukuphakama kwengcindezi yegazi kanye nesifo se-end-stal disease of renal ezifundweni ezingenaso isifo sezinso esiphezulu. I-Arch Intern Med . 2005; 165: 923.

> Levy D, uLarson MG, Vasan RS, et al. Ukuqhubekela phambili kokuguliswa kokweqile kwegazi kuya ekuhlulekeni kwenhliziyo. I-JAMA . 1996; 275: 1557.

> Siu AL. I-US Preventive Services Task Force. Ukuhlolwa kwe-high blood pressure kubantu abadala: Isitatimende sokuncoma se-US Preventive Services Task Force. U-Ann Intern Med . 2015; 163: 778.

> Taylor BC, Wilt TJ, Welch HG. Impact ye-diastolic ne-systolic blood pressure on mortality: impendulo yencazelo "evamile". UJ Gen Intern Med 2011; 26: 685 Vakili BA, Okin PM, Devereux RB. Izimpendulo zokubikezelwa kwe-hypertrophy ye-ventricular ye-ventricular. Am Heart J. 2001; 141: 334.