Matenda a "Standard" a hypertension angasinthe
Kuwonjezera pa kukhala ndi chiopsezo chachikulu cha matenda a mtima, zilonda, ndi zina, kuthamanga kwa magazi kungathenso kumayambitsa matenda a impso . Osati kokha, odwala omwe ali ndi matenda a impso (CKD) omwe alipo kale, amakhala pachiopsezo chachikulu cha matenda opatsirana pogonana (pamene amafunikira dialyse kapena kupatsirana kwa impso), ngati magazi awo atha kukhala otetezeka kwambiri.
Pambuyo pa matenda a shuga, kuthamanga kwa magazi ndi chifukwa chofala kwambiri chakuti anthu amayamba kugwidwa ndi impso .
Kusiyanitsa Pakati pa Complete Impso Kulephera ndi Kufooka Maganizo
Pambuyo pake, kukwaniritsa ndi kusunga "kuthamanga kwa magazi" ndi chimodzi mwa zinthu zofunika kwambiri zothandizira kupititsa patsogolo CKD. Zingakulepheretseni kuti musafike pofika pomwe mukukhala odalira pa dialyse. Koma kodi ndi chiyani chomwe chimatchedwa kukakamizidwa kwa magazi?
Njira Yomwe Tikumvera Kuthamanga kwa Magazi Si Nkhani ya Lingaliro Limodzi lachigulu
Chabwino, si nthawi zonse! Icho chimatsimikiziridwa ndi madokotala ambiri omwe amakhala mozungulira tebulo, ayang'anani pa umboni wamakono, ndipo atiuze ife tonse momwe tingachitire izo! Ndi gulu lotchedwa Joint National Committee (JNC) ndipo limakhazikitsidwa ndi National Institutes of Health (NIH). Malingaliro awo atsopano anabwera mu February 2014, ndipo nthawi zambiri amatchedwa "JNC 8." Ndi JNC yemwe nthawi zambiri amakhala ndi mawu omaliza osati mankhwala omwe tiyenera kugwiritsa ntchito kuti tipeze kuthamanga kwambiri kwa magazi, komanso zomwe cholinga chathu cha magazi chiyenera kukhala.
Chifukwa Chake Mavuto Omwe Amayambitsa Magazi Amasintha
Kawirikawiri, pamaso pa JNC 8, ife tinkakonda kukhala okwiya kwambiri pa zolinga zamankhwala zothandizira magazi, nthawi zambiri timachiza odwala ku zida zoposa 130/80. Komabe, kuti ndikupangitse zinthu zisokoneze, ndiloleni ndiwuze kuti JNC siyomwe yokhayikitsa malingaliro a thupi pankhani ya kukakamizidwa kwa magazi.
Yang'anani pa Table 6 apa.
Mutha kuona kuti malangizo oyambirira ochokera kumapeto kwa 2010-2011 ndi asanakhale akuwoneka kuti amalimbikitsa kuopsa koopsa kwa magazi kuti achepetse zolinga. Kuti, makamaka, anali choonadi chovomerezeka chowonadi kwa madokotala ambiri, akatswiri a cardiologists, ndi a nephrologists, mpaka mochedwa kwambiri. Komabe, mu 2010 tinaphunzira kwakukulu pa kuthamanga kwambiri kwa magazi komwe kunanenedwa m'magawo opatulika a New England Journal of Medicine (NEJM). Kafukufukuyu wotchedwa ACCORD trial inasonyeza kuti panalibe phindu pochiza kuthamanga kwa magazi kwa masentimita 120 mm systolic wotsutsana ndi malingaliro otetezeka a 140 mm. Izi zinkangowonongeka ndi nzeru za "adalandira" kuchipatala, zomwe zimakhulupirira kuti kutsika kwa magazi nthawi zonse kumakhala bwino komanso koipa kwambiri! Mayeserowa analibe phokoso mu poto, kuyambira poyamba, tawona phunziro lina lomwe limatchedwa kuyesedwa kwa INVEST komwe kunanenanso kuti palibe phindu lokhalitsa magazi.
(Ndikufuna kufotokozera ngakhale kuti monga mankhwala ena aliwonse, mankhwala opatsirana kwambiri ndi omwe amatsutsana kwambiri ndipo zinthu zimasintha. Palibe malangizo awiri omwe amavomerezana ndipo ngakhale JNC yalandira gawo labwino ).
Zolinga zamakono zamakono
JNC yakhala ikulimbikitsa malingaliro malinga ndi zaka za anthu ambiri:
- Ukalamba <60 yrs: cholinga chake ndi kuwasunga pansi pa 140/90
- Zaka> 60 Zaka: cholinga chake ndi kuwasunga pansi pa 150/90
Zolinga Zimasiyana Kwa Anthu Amene Ali ndi Matenda a Impso
Mavuto a magazi omwe amagwiritsidwa ntchito kwa munthu wodwala matenda oopsa kwambiri sangagwiritsidwe ntchito kwa wodwalayo amene ali ndi matenda a impso . Ndipotu, tili ndi mabungwe ambiri omwe amakhudzidwa kwambiri ndi matenda a impso monga Matenda a Impso Kupititsa patsogolo Zotsatira za Padziko Lonse (KDIGO) zomwe zalimbikitsa zolinga zapansi. Koma malinga ndi momwe JNC 8 imayendera, cholinga chake ndikuteteza aliyense ali ndi matenda a impso, mosasamala kanthu za msinkhu woperekedwa ndi mphamvu ya magazi <140/90.
Ndipo simukusowa chithandizo chamankhwala ngati mumakonda kukhala pansi pa msinkhu umenewu. Ngati muli pafupi ndi chiwerengero ichi, mungakhale kutali ndi zakudya / kusintha kwa moyo nokha.
Ndizonso za Mmene Muchichitira
Zimene ndalongosola pamwambapa ndi zomwe mumapangitsa BP kutero. Koma dokotala wodzakalipira adzakumbukiranso mankhwala omwe angagwiritsidwe ntchito kuti akufikitse ku cholinga. Mapeto sikuti nthawi zonse amatsutsa njira zothandizira matenda . Sindingalowe m'mawu ake apa koma mungathe kudutsa mu JNC 8 ngati mukufuna kudziwa.
Nthawi zambiri timakhalanso ndi zina zotchedwa "zizindikiro zovuta" pankhani ya chithandizo chamagulu. Mwachitsanzo, munthu yemwe ali ndi mapuloteni owonjezera mu mkodzo akhoza kuikidwa pa lisinopril (piritsi la magazi), ngakhale kuthamanga kwa magazi kuli pansi pa cholinga ichi. Pachifukwa ichi, piritsi la magazi limagwiritsidwa ntchito pazinthu zina.
Kuti afotokoze mwachidule, kwa odwala ambiri okhala ndi matenda a impso, cholinga chenicheni cholimbikitsidwa kuti athe kukwaniritsa ntchito ya impso ndi kuchepetsa mwayi wawo wopita ku matenda a impso adzatha <140/90. Zomwezo ndi pamene ife timayima mpaka JNC 9!