Isiteji somfutho wegazi ophezulu ekuxilongweni sizoqondisa ukwelashwa kwakho kokuqala
Abantu abaningi bayamangala ukuthola ukucindezelwa kwegazi eliphezulu njengokufundwa okungaqondakali emsebenzini wokuqokwa kwabadokotela ngenxa yokuthi ukucindezeleka kwegazi akubangelwa izimpawu. Eqinisweni, indlela kuphela yokuthola ukuxilongwa komfutho wegazi ophakeme ukukala ukucindezelwa kwegazi.
I-American Heart Association itusa ukuhlolwa ngokulinganisa kwengcindezi yegazi okungenani njalo eminyakeni emibili uma ingcindezi yegazi isendaweni evamile.
Imihlahlandlela ye-United States Preventive Services Task Force iphakamisa ukuhlola bonke abantu abangaphezu kweminyaka engu-18.
Okungenani, abantu abadala abangaphezu kweminyaka engama-40 kufanele babe nokucindezelwa kwegazi okungenani eyodwa ngonyaka. Abantu abadala abaneminyaka engama-18 no-39 abanesimo sangaphambili sokucindezeleka kwegazi phakathi kuka 130-139 mm Hg systolic kanye / noma 85-89 mm Hg diastolic noma abanezicabangela zengozi ephezulu yegazi, okufaka ukukhuluphala noma ukubhema, kufanele futhi bahlolwe minyaka yonke .
Ukuqinisekisa Ukutholakala Kwakho
Uma ufunda ngokuphakeme, udokotela wakho uyovame ukuphindaphinda ukucindezela kwegazi izikhathi eziningana ngaphambi kokuba uhlolwe. Ukuxilongwa kwe-hypertension nezigaba ze-hypertension zisekelwe kokulinganiselwa kokubili kokucindezelwa kwegazi okungenani okungenani ezimbili, nakuba ukuhlolwa kwengcindezi yengcindezi yegazi kuphakanyiswa ukuqinisekisa ukuphakama kwengcindezi yegazi evezwe ngokuhlolwa kwezikhathi zokuhlola.
Ukuqapha kwengcindezi yekhaya kuyindlela ehlukile yokuqinisekiswa lapho ukuqapha ukucindezeleka kwegazi kungatholakali. Ukuqinisekiswa komfutho wegazi ophezulu ukufundwa ehhovisi likadokotela kunconywa ngoba ezinye iziguli zingase zithole "ukugcoba okukhulu kwegazi".
Izitebhisi ze-Hypertension zichazwe
Izigaba ezahlukene ze-hypertension zachazwa yiKomiti YoMkhandlu Kazwelonke Yokuvimbela, Ukutholakala, Ukuhlolwa Nokuphathwa Kwezinga Eliphakeme Lokucindezeleka Kwegazi (JNC7) ngo-2003.
Ngaphezu kokuchaza izigaba ezimbili zokushisa komfutho wegazi, i-JNC7 nayo ichaza ukuguqulwa kwesidumbu. Ukwelashwa ngokweqile kuhlotshaniswa nenengozi yomzimba, kuhlanganise nengozi eyengeziwe yokwelashwa kwe-coronary.
Izigaba ze-hypertension zisebenza kubantu abadala abangaphathwa ngemithi ye-blood pressure futhi abangakabi khona njengamanje. Zichazwa yi-JNC7 kanje:
- Umfutho wegazi ovamile: i-systolic blood pressure ngaphansi kuka-120 mm Hg no-diastolic wegazi [80 mm Hg].
- Ukwelashwa ngokweqile: i-systolic blood pressure kusuka ku-120 kuya ku-139 mm Hg noma i-diastolic yegazi ukusuka ku-80 ukuya ku-89 mm Hg.
- Isitezi I-hypertension: i-systolic yegazi ye-140 kuya ku-159 mm HG KANYE no-diastolic wegazi okwe-90 kuya kuma-99 mm Hg.
- Isinyathelo sesi-2 somfutho wegazi: isisindo segazi se-systolic esingaphezu kuka-160 mm Hg noma i-diastolic yegazi ye-100 mm Hg noma ngaphezulu.
Uma usebenzisa i-ambulatory blood pressure yokuqapha noma ukufundwa kwegazi kwegazi, i-hypertension ngokuvamile ichazwa ngokuthi isilinganiso samahora angu-24 ka-130/80 mm Hg noma ngaphezulu; isilinganiso semini ka 135/85 noma ngaphezulu; noma isilinganiso sebusuku sika 120/70 noma ngaphezulu.
Ukuguqulwa kwesisu
Cishe amaphesenti angu-30 abantu abadala ase-United States bane-hypertension. Abantu abane-hypertension bangenengozi enkulu yesifo senhliziyo, nakuba kungenakuphakama njengoba kunabantu abanomfutho wegazi ophezulu.
Uma ungaphenduliwe, i-hypertension ye-hypertension ivame ukuqhubekela phambili e- hypertension , okubhekisela ekucindezeni kwegazi ka-140/90 nangaphezulu.
Ukuphefumula ngokweqile kuvame ukuphathwa ngokuguqula indlela yokuphila. Ngaphezu kokudla nokuzivocavoca, ukuyeka ukubhema , ukubheka utshwala nokugcina isisindo esinempilo kuzo zonke izinyathelo ezibalulekile okufanele uziphathe ukuze ulawule ukucindezeleka kwegazi.
Isiteji sokuqala se-Hypertension
Ngezinye izikhathi, isiteji I-hypertension ibizwa ngokuthi "mncane" wegazi, okuyinto ngeshwa engakwazi ukuveza izingozi ezihambisana nalesi simo. Ngaphezu kokuguquka kwendlela yokuphila eyenzelwe bonke abagulayo abane-hypertension ne-hypertension, isigaba se-1 se-hypertension sifaka ukusetshenziswa komuthi ohlukahlukene we-antihypertensive ukunciphisa ukucindezelwa kwegazi kanye nengozi yokushaya isifo nesifo senhliziyo.
Izinketho eziphakanyiswa yi-JNC 8 zihlanganisa i-thiazide diuretics , i-ACE inhibitors, i-block block receptor blockers, noma i-calcium channel blockers. Ikhethelo elihle kunazo zonke iziguli zase-Afrika i-thiazide diuretics noma i-calcium channel blocker.
Imikhombandlela kazwelonke eyakhiwe yi-JNC8 incoma ukuthi iziguli zase-Afrika zaseMelika ezicindezelekile ze-systolic 145 mm Hg noma ngaphezulu ziqala ukwelashwa ngokushesha kanye nemithi emibili. Uma umgomo wakho wegazi ungakutholakali kungakapheli inyanga yokuqala ukwelashwa ngemithi ye-hypertension, umthamo wemithi kufanele ukhuliswe noma enye imithi ingeziwe.
Isiteji sesi-2 Sengcindezi
Iziguli ezinesigaba se-hypertension zesigaba 2 kufanele ziphathwe ngokuguqula indlela yokuphila nokuqala kwezidakamizwa ezimbili ezihlukene zamakilasi ahlukene, ezikhethwe ezigabeni ezinhlanu ezahlukene zemishanguzo yegazi ezifakiwe ezincomo ze-JNC. Uma izinombolo zakho ze-blood pressure zingena ezigabeni ezahlukene, inombolo ephakeme izosetshenziselwa ukunquma isiteji sakho.
I-Hypertension ephikisayo
Abantu abaningi bayodinga imithi engaphezu kweyodwa noma emibili ukulawula ukucindezeleka kwegazi. Ukucindezeleka okunamandla yigama elisetshenziselwa ukuchaza ukucindezelwa kwegazi eliphezulu kubantu ababesenomfutho wegazi ophezulu naphezu kokuthatha okungenani izinhlobo ezintathu zemithi. Uma unesifo somfutho wegazi ophakeme, udokotela wakho uzosesha isimo esingaphansi noma isizathu. Imithi yakho ingadinga ukulungiswa ukuze kutholakale ukulawula.
Imithi
Ngaphandle kwamakilasi emithi ahlanganiswe nezincomo ze-JNC, kunezinye izinhlobo eziningi zemithi yokwelapha ukucindezelwa kwegazi eliphezulu. Lezi zihlanganisa abavimba be-beta nezidakamizwa ; ama-vasodilator, okuvimbela imisipha ejikeleze imithwalo yegazi ekungeneni; ama-alpha blockers, okuvimbela imithwalo yegazi emithanjeni yegazi; kanye nama-agent agent-central abamba ukuvimbela ukudluliselwa kwamasignali wesistimu wezinzwa kusuka ebuchosheni obangela ukunciphisa imithwalo yegazi. Abantu abaningi bayodinga imithi engaphezu kweyodwa ukulawula ukucindezeleka kwegazi.
Imigomo Yokucindezela Igazi
Ukwelashwa okuphakanyisiwe kokushisa komfutho kuhlanganisa kokubili imithi kanye nezinguquko ezibalulekile zokuphila, njengokudla nokuzivocavoca. Umgomo wakho wegazi wegazi uzokuxhomeka kuneminyaka yakho nokuthi ngabe unayo yini ezinye izimo zezokwelapha noma cha. Abantu abadala abanempilo abaneminyaka engama-60 noma ngaphezulu kufanele bazame ukuthola ukucindezelwa kwegazi ngaphansi kuka-150/90 mm Hg. Abantu abadala asebephila kahle nabantu abanesifo sikashukela, isifo se-artery coronary, noma isifo esingenasifo sezinso kufanele bahlose ukucindezelwa kwegazi ngaphansi kuka-140/90 mm Hg.
Kubalulekile ukuqhubeka nokuqapha izinombolo zakho nokulandela zonke izincomo, ngoba ukwelashwa kokweqile kwegazi kunganciphisa kakhulu ingozi yezinkinga.
> Imithombo:
> Brown, M. M. (2003). Umbiko weSikhombisa weKomiti Kazwelonke Yohlangene Yokuvimbela, Ukutholakala, Ukuhlolwa Nokuphathwa Kwe-High Blood Pressure. Umbiko we-JNC 7. Ukunakekelwa Kwamehlo Okusekelwe Ebufakazi , 4 (3), 179-181. i-doi: 10.1097 / 00132578-200307000
> Egan, B. M., Bandyopadhyay, D., Shaftman, S. R., Wagner, C. S., Zhao, Y., & Yu-Isenberg, K. S. (2012). I-Initial Monotherapy kanye neTherapy yokwelapha kanye ne-Hypertension Lawula Unyaka Wokuqala. I-hypertension , 59 (6), 1124-1131. doi: 10.1161 / hypertensionaha.112.194167
> James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... Ortiz, E. (2014). Umhlahlandlela osuselwa ngo-2014 wokuphatha ukucindezelwa kwegazi eliphezulu kubantu abadala. I-JAMA , 311 (5), 507. i-doi: 10.1001 / jama.2013.284427
> Ukuhlolwa kwe-High Blood Pressure kubantu abadala: Isitatimende Sokuncoma Sezinsizakusebenza Ze-US Preventive Services. (2015). Ama-Annal of Medicine Internal , 163 (10), I-32. i-doi: 10.7326 / p15-9036
> Wald, D. S., uMthetho, M., Morris, J. K., Bestwick, J. P., & Wald, N. J. (2009). Ukwelashwa Kokuhlanganiswa Ne-Monotherapy ekunciphiseni Ukucindezelwa Kwegazi: Ukuhlaziywa kwezibalo kwabangu-11 000 Abahlanganyeli abavela ezilingweni ezingu-42. I-American Journal of Medicine , 122 (3), 290-300. doi: 10.1016 / j.amjmed.2008.09.038