Kuchiza Kupanikizika Kwambiri kwa Magazi
Ngati mwapezeka kuti muli ndi matenda oopsa , kapena kuthamanga kwa magazi, nkofunika kuti inu ndi dokotala mukhale ndi cholinga chochiritsira, ndiyeno mutenge zofunikira kuti mukwanitse cholinga chimenecho.
Kumbukirani kuti, nthawi zambiri, kukwaniritsa cholinga chanu chokhazikitsa magazi chidzakwaniritsidwa pambuyo pa masitepe - sitepe imodzi panthawi imodzi.
Pambuyo pa sitepe iliyonse, inu ndi dokotala wanu mutha kudziwa ngati cholinga chanu - chimakwaniritsa "kuthamanga" kwa magazi popanda zotsatira zoopsa - zakwaniritsidwa.
Kukhazikitsa Zolinga za Chithandizo
Zolinga zamankhwala zothandizira kuthamanga kwa magazi zakhala zikusintha pakapita nthawi, ndipo zakhala zikutsutsana kwambiri. Koma mu 2017, magulu akuluakulu azachipatala adagawana mfundo zovomerezeka zokhudzana ndi matenda komanso matenda oopsa. Kawirikawiri, madokotala tsopano ali patsamba limodzi.
Cholinga cha kuchiza matenda oopsa ndi kuchepetsa kupatsirana kwa magazi mpaka 130 mmHg, komanso kuthamanga kwa diastolic kupitirira 80 mmHg. Cholinga chimakhala chimodzimodzi kwa aliyense amene ali ndi matenda oopsa, mosasamala za msinkhu.
Komabe, zolinga za mankhwala nthawi zina zimayenera kukhala payekha. Mwachitsanzo, anthu ena okalamba omwe ali ndi matenda a hypertension angakhale ndi mutu wathanzi wochizira kwambiri.
Ndipotu, isanafike chaka cha 2017 cholinga cha chithandizo cha anthu oterowo chinali kukakamiza kuchepetsa mphamvu ya systolic ya pansi pa 140, kapena 150, mmHg. Deta yaposachedwapa kuchokera ku mayesero a zachipatala imasonyeza kuti cholinga chachepera 130 mmHg chimabala zotsatira zabwino ngakhale anthu achikulire, ndipo ndondomeko ya 2017 inasinthidwa kuti asonyeze mfundo zatsopanozi.
Komabe, kwa anthu ena achikulire cholinga chochepa chikhonza kukhalabe chokwiya kwambiri, kotero anthu ena akhoza kukhala ndi zovuta zosiyanasiyana.
- Kodi n'zotheka kuchepetsa kuthamanga kwa magazi kwambiri?
- Werengani za kuchiza matenda oopsa kwambiri okalamba.
Kodi Muli ndi Choponderezeka Kwambiri Kapena Chachiwiri?
Chithandizo chanu choyambitsa matenda oopsa kwambiri, choyamba, chidzatsimikizika ngati kuthamanga kwanu kwa magazi kukuyambitsidwa ndi matenda enaake (omwe ali odwala matenda oopsa kwambiri), kapena ngati muli odwala ambiri omwe ali ndi matenda oopsa palibe chifukwa chenichenicho).
Ngati muli ndi vuto lachiwopsezo, njira yowonjezereka ya chithandizo iyenera kukhala yothetsera vuto.
Kotero, pa zokambirana zonsezi tidzakhala ngati mukudwala kwambiri.
Njira Zochiritsira Zophiphiritsira Zowonjezera Kuthamanga Kwambiri kwa Mthupi
Chithandizo choyamba cha matenda oopsa kwambiri chimadalira "siteji" ya matenda anu oopsa, omwe amatsimikiziridwa ndi systolic yanu ndi diastolic ya magazi .
• Gawo 1 lachiwopsezo : systolic 130 - 139 mmHg, OR diastolic 80 - 89 mmHg
• Gawo lachiwopsezo cha 2 : systolic wamkulu kuposa 140 mmHg, kapena diastolic wamkulu kuposa 89 mmHg
Kuphatikiza apo, kuthamanga magazi kwa 120 mmHg kapena kupitirira (koma osachepera 130 mmHg) kumaonedwa kuti ndikuthamanga kwa magazi . Kuchepa kwa thupi kumasonyeza kuti pangakhale ngozi yowonjezera mtima, koma sikumayesedwa kuti ndi chikhalidwe chomwe chimaletsa mankhwala ochepetsa mankhwala osokoneza bongo. Mmalo mwake, kusintha kwa moyo kumalimbikitsidwa kuti kuchepetsa chiopsezo.
Kusintha kwa Moyo
Ngati matenda anu oopsa kwambiri ndi ofatsa (Gawo 1 lachiwopsezo chachikulu), dokotala wanu angayambe mwa kulangiza kusintha kwa moyo. Kusintha kwa moyo wanu komwe kungakuthandizeni kuchepetsa kuthamanga kwanu kwa magazi kumaphatikizapo:
• Kukulandira chakudya cha matenda oopsa
• Kukhazikitsa lamulo loletsa mchere
• Kukonzekera pulogalamu yowonetsera nthawi zonse
• Kusiya kusuta
Ngati mukupeza bwino kusintha kwa moyo wanu koma kusintha kwanu kwa magazi sikunakwaniritse cholinga chanu (kapena ngati muli munthu wambiri, ndipo kuyesetsa kwanu pa zakudya ndi masewero olimbitsa thupi kumapitirirabe pang'ono ndi zomwe akatswiri amalangiza) dokotala wanu angakulimbikitseni mankhwala osokoneza bongo.
Mankhwala Osokoneza Bongo
Mipingo ikuluikulu isanu ya mankhwala amagwiritsidwa ntchito pochizira matenda:
• ACE inhibitors
• Angiotensin receptor blockers, ARBs
Mankhwala ena osiyanasiyana adagulitsidwa chifukwa cha matenda oopsa kwambiri m'magulu onsewa, ndipo mankhwala ena owonjezera amakhala ndi mankhwala osakaniza. Pano pali mndandanda wokwanira wa mankhwala ambiri omwe alipo tsopano omwe akupezeka kuti athe kuchiza matenda oopsa.
Ngati muli ndi Stage I , ndikukumana ndibwino kuti mphamvu yanu ya magazi ikhoza kubweretsedwera pamagulu ndi mankhwala osakaniza. Ngati muli ndi Gawo 2 lachiwopsezo chachikulu, mankhwala osakaniza amodzi omwe sangakhale oyenera, ndipo adokotala angayambe nthawi yomweyo ndi mankhwala osakaniza.
Ngati mankhwala osakanizidwa (kapena monotherapy) amasankhidwa, zikuwoneka bwino kuyamba ndi thiazide diuretic (kawirikawiri chlorthalidone kapena hydrochlorothiazide), kaccium blocker, kapena ACE inhibitor. (ARBs angagwiritsidwe ntchito m'malo mwa ACE inhibitor ngati ACE inhibitor sakulekerera). Odwala achichepere kawirikawiri amayankha bwino ACE inhibitors; Odwala wakuda ndi okalamba akudwala bwino ndi thiazide diuretics kapena calcium channel blockers. Anthu oteteza Beta nthawi zambiri amakhala osasankha bwino pa monotherapy.
Ngati kuyesa koyamba pa monotherapy sikokwanira kapena sikulekerera, kusinthasintha kwa mankhwala osakaniza, kenaka kuchitatu ngati kuli kofunikira, kawirikawiri amalangizidwa ngati sitepe yotsatira.
Ngati mayesero atatu kapena ochulukirapo pa monotherapy sakugwira ntchito bwino, chotsatira ndicho kuyesa mankhwala osakaniza ndi mankhwala awiri kapena kuposa. Ngakhale kusakanikirana kwambiri kuli kotheka, umboni watsopano umasonyeza kuti kugwiritsa ntchito calcium blocker pamodzi ndi ACE inhibitor kapena ARB akhoza kukhala ogwira mtima kwambiri ndi ovomerezeka kuphatikiza. Madokotala ambiri tsopano ayesera kuphatikiza izi, ngakhale monotherapy inali ndi thiazide diuretic.
Pogwiritsa ntchito njira zowonongeka, ambiri mwa odwala omwe ali ndi matenda oopsa kwambiri amafika pofuna kuwopsa kwa magazi ndi zotsatira zochepa. Kumbukirani kuti kupeza mankhwala opatsirana odwala matendawa kumafuna masabata angapo kapena miyezi ingapo, komanso mayesero angapo a mankhwala. Koma ndi kofunikira kuti mumamatire pulogalamuyi. Kupeza mphamvu ya magazi kuti ifike pamagulu, ndikusunga kumeneko, kukupatsani malipiro aakulu kwambiri chifukwa cha khama lanu - kuchepa kwa mtima kwambiri komanso kupwetekedwa mtima.
> Zotsatira:
> Law, MR, Morris, JK, Wald, NJ. Gwiritsani Ntchito Kupsyinjika kwa Magazi Kuchepetsa Mankhwala Osokoneza Bongo Mu Kupewa Matenda a Mitsempha: Meta-Analysis Of 147 Mayesero Osinthika Mu Mtheradi Wa Zomwe Zimayambira Kuchokera Kufufuza Kwambiri Epidemiological. BMJ 2009; 338: b1665.
> Staessen, JA, Wang, JG, Thijs, L. Kupewa Kwambiri Kulimbana ndi Kuthamanga kwa Magazi: Zowonjezereka Zachidule Zosinthidwa Mpaka 1 March 2003. J Hypertens 2003; 21: 1055.