Igazi elonyukayo

Ingqwalaselo yexinzelelo yegazi eliphezulu

Uxinzelelo oluphezulu lwegazi luyimeko eneempembelelo zempilo ezichaphazela abantu abangama-80 abantu abadala baseMerika. Xa zifunyenwe kwaye ziphathwa ngokukhawuleza, kunjalo, zinokunciphisa umngcipheko wokuhlaselwa kwentliziyo, ukuphazamiseka, kunye nesifo sesifo.

Yintoni Ixinzelelo Yegazi?

Uxinzelelo lwegazi yi-force yangaphandle eyenziwa yigazi kwiindonga ze-artery. Imirhubhe yimizila yegazi ethwala igazi kunye ne-oksijini kwimiphunga ukuya kuzo zonke izitho kunye nezicubu zomzimba.

Iimitha ze-Arrium ziqukethe imisipha kunye nezimo eziguquguqukayo, izicubu ezixhamlayo ezixubileyo ukuze zisebenzise amandla okuhamba kwegazi eziveliswa yintliziyo. Yaye isenzo sokuphambanisa senhliziyo sivumela ukuba igazi lihambe ngeemithalo.

Uxinzelelo lwegazi luboniswa ngamanani amabini. Inombolo ephezulu, uxinzelelo lwegazi lwe-systolic, ibonisa amandla aveliswa yizithintelo zenhliziyo. Inombolo engezantsi, uxinzelelo lwegazi lwe-diastolic, ibhekisela kwingcinezelo yegazi kwiindonga zemirhobho xa intliziyo iphumla phakathi kokuphambana.

• Ingqwalasela ye-Hypertension (i-High Blood Pressure)

• Kuthetha ukuthini Ukuba Unesifo esiphene?

Amanani

Emva kweminyaka engama-20, bonke abadala kufuneka baqale ukujonga uxinzelelo lwabo lwegazi ekutyelelweni kwabo kwezempilo rhoqo. Ukuba uneminyaka engaphezulu kwama-40 okanye unomngcipheko weengcinezelo zegazi eziphezulu, kufuneka ube neengcinezelo zegazi zakho kwiingalo zombini ubuncinane ngonyaka. Kubalulekile ukusebenzisa ukusetyenziswa kwengcinezelo yegazi echanekileyo, kungenxa yoko kungenako ukukhawuleza ukujonga ingcinezelo yakho yegazi kumatshini ozenzekelayo kwi-pharmacy okanye kwivenkile.

Uxinzelelo lwegazi oluqhelekileyo lubonwa njengengaphantsi kwama-120/80 mm Hg. Ukujonga iliso lamahora angama-24 okanye ukunyamekelwa kweengcinezelo zegazi ekhaya rhoqo, uxinzelelo lwegazi oluqhelekileyo lugxininiswa njengengcinezelo yegazi engaphantsi kwama-135/85 mm Hg.

Ukuba inani lakho liphezulu kuneli, akuthethi ukuba unomfutho ophezulu wegazi. Uxinzelelo lwegazi luyakushintsha ekuphenduleni ukusebenza, uxinzelelo, amayeza, ukugula, kunye nexesha lemihla. Kubalulekile ukuthatha ukufundwa eziliqela emva kwexesha ukwenzela ukuba wenze i-diagnostic efanelekile.

Izizathu

Uninzi lwabantu abadala abanomfutho wegazi ophezulu unomdla wenyango ophezulu, obizwa ngokuba ngu "mfuneko" wegazi. Oku kuthetha nje ukuba ukuphakama kwexinzelelo lwegazi akubangelwa nayiphi na isizathu. Uxinzelelo lwengcinezelo lweprayimari lukhula kancane kancane kwiminyaka emininzi. Ngaphandle kokuba uyibeke iliso, unganakuze uqaphele ukuba unengxaki engakhokelela kumonakalo omkhulu wombutho.

Isondlo sesondlo sesibini kubhekisela kwixinzelelo lwengqondo elibangelwa enye imeko okanye amayeza. Kwiimeko ezininzi, uxinzelelo lwexinzelelo lwangasese lwenzeka ngokukhawuleza kwaye lunokuphakamisa ukuphakama kwegazi ngaphezu kwegazi eliphambili legazi. Izifo ze-Thyroid, izifo zengqondo, ukuphazamiseka kokulala, ukusetyenziswa kakubi kotywala, iziyobisi ezingekho mthethweni, kunye nezicubu ze-adrenal gland zizinye zezizathu zengcinezelo yecala.

Izinto zobungozi

Kukho iintlobo ezahlukeneyo ezinokunyusa umngcipheko wegazi eliphezulu. Ezinye izinto ezinobungozi azikwazi ukuguqulwa kodwa ezinye zingancitshiswa ngeenguqu zokutya kunye nendlela yokuphila. Izingozi ezingenakuguqulwa ziquka ubudala, imbali yentsapho kunye nohlanga. Umzekelo:

• Emva kweminyaka yobudala engama-45, amadoda angaphinda akhule ukunyuka kwengcinezelo yegazi.
• Kubasetyhini , ingozi iyanda emva kweminyaka engama-65.
• Abantu baseMerika basengozini enkulu yokuxinzeleleka kolukhuseleko oluvame ukuphuhlisa kwangaphambili kwaye kubangela iingxaki ezinzulu.

Izinto ezinokuguguleka ziquka:

• Ukugqithisa
• Indlela yokuphila
• Ukusetyenziswa kotywala
• Ukutya okuphezulu kwe-sodium okanye ephantsi kwe-potassium
• Ukusela ngokweqile utywala
• Ukungabi novithamini D
• Ukuxinezeleka kunokunyusa uxinzelelo lwegazi okwethutyana kwaye, ngokugqithiseleyo kwexesha, kunokukhokelela kwingcinezelo engapheliyo.

Nangona abantwana basengozini encinci yokuphucula ingozi, basenokuvelisa uxinzelelo lwegazi ngenxa yezinye iimeko. Ixinzelelo legazi lomntwana kufuneka lilinganiswe kwi-check-up nganye ngonyaka kwaye kuthelekiswe nabanye abantwana beqela elifanayo.

Amanqanaba

Uxinzelelo lwegazi lungawela kwelinye leelwimi ezintlanu:

1. Ukunyuka kwesantya . Ukuba uxinzelelo lwegazi lwe-systolic luphakathi kwe-120-139 mm Hg okanye ukuba uvavanyo lwegazi lwe-diastolic luphakathi ko-80 no-89 mm Hg, unokuba ne-hypertension. Ukunyanzeliswa kwegazi, njengengcinezelo yegazi ephezulu, inomngcipheko ophezulu wentsholongwane yomzimba kwaye ngokugqithiseleyo idlula ixesha. Unyango lubandakanya amanyathelo angaphantsi kwe-aprmacological, njengokunciphisa ubunzima, ukunyuka komzimba, ukuphepha ukunxila ngokweqile, nokunciphisa ityuwa.
2. Isigaba I-hypertension . Oku kubhekisela kwingcinezelo yegazi ye-systolic ye-140 mm Hg ukuya kwi-159 mm Hg okanye uxinzelelo lwegazi lwe-diastolic we-90 ukuya kuma-99 mm Hg. Ukuba kuphela enye yalezi zixabiso iphakanyisiwe, ngoko ke ixabiso eliphakamileyo linquma ubunzima bexinzelelo. Oku kuya kubangela ukuzimisela unyango olufanelekileyo.
3. I-systolic / i-diastolic yomsongela ophezulu . Izigulane ezinexinzelelo lwegazi le-systolic ezingaphezu kwama-140 mm Hg kunye noxinzelelo lwe-diastolic ezingaphantsi kwe-90 mm Hg zibhekwa ukuba zinexinzelelo lwe-systolic. Abo banexinzelelo lwe-diastolic elikhulu kunokuba lilingana no-90 mm Hg kodwa ngoxinzelelo lwe-systolic ngaphantsi kwama-140 mm Hg banokucingwa ukuba banesifo soxinzelelo se-diastolic. Uxinzelelo lwegazi lwe-systolic luyingozi kakhulu kubantu abangaphezu kweminyaka engama-60. Izifundo zibonisa ukuba kukho inzuzo ebalulekileyo ekuphatheni uxinzelelo lwegazi, ngakumbi kwizigulane ezinexinzelelo lwengqondo. Iingcebiso zangoku zibonisa ukuba unyango lwegazi luqaliswe kwizigulane ezineganga lokuxinzeleleka kwengozi, nangona kufuneka kuqalwe ngaphambili kubantu abaneesifo senhliziyo, isifo sikashukela, okanye isifo sesifo esingasasigxina.

• I-Pseudotumor Cerebri Izizathu kunye neempawu

• Ingaba unalo ifuthe eliphezulu?

1. Isigaba II somngcipheko . Oku kubhekisela kwixinzelelo oluphezulu, kunye noxinzelelo lwe-systolic we-160 mm Hg okanye ngaphezulu okanye uxinzelelo lwe-diastolic we-100 mm Hg okanye ngaphezulu. Isigaba II somfutho wegazi ophezulu unokuqala ukufuna amayeza angaphezu kweyodwa unyango.
2. Ingozi ephezulu yengozi . Oku kubhekisela kwiimpembelelo eziphezulu kakhulu zegazi, ngaphezu kwe-180 mm Hg systolic okanye 120 mm Hg diastolic, ekhula ngokukhawuleza kwaye ivelise umonakalo wecala lokugqibela. I-hypertension eyingozi yimeko efuna unonophelo lwangonyango. Le meko iyaziwa nangokunyanzeliswa kokuxinzeleleka komnxeba okanye uxinzelelo oluphezulu lwexinzelelo. Iimpawu zingenzeka ngenxa yokulimala komzimba, kubandakanya ukudideka okanye ukuguquka kwesimo sengqondo, umbono ophazamisayo, ukuxhamla, ukuphefumula okufutshane, ukuvuvukala kunye nentlungu yesifuba ngenxa ye-angina, ukuhlasela kwentliziyo, okanye i-aneurysm.

Ukuxilongwa

I-United States ye-Preventional Services Task Force ikhuthaza ukunciphisa uxinzelelo lwegazi lwe-ambulatory blood pressure ukuze ixilongwe ngokuchanekileyo yomshukela ophezulu. Nangona unokuba uphakamise uxinzelelo lwegazi xa ulinganiswa kwiofisi yakho ugqirha, oku kungaba ngumphumo "wengubo emhlophe yengcinezelo." Ukuhlolwa ngumboneleli wakho wezempilo uya kuphinda ulahleke "ukugxininiswa kwegazi." Iimpembelelo zegazi eziphakathi kwe-12 kunye neye-24 ezisebenzisa ukunyamezela ngenyameko yegazi zihlala zihluke kakhulu kwiimvavanyo ezithathwe kwikliniki okanye kwisibhedlele, kwaye zibangele izigulana ezimbalwa ezifuna unyango, kunye nezigulane ezimbalwa ezifuna unyango ngenxa yoko. Ezinye izigulane zinokuphakamisa umlinganiselo wexinzelelo lwegazi ofumene kunye nokubeka esweni esilungeleleneyo esibabeka esichengeni sokubethelwa kwesifo kunye nesifo senhliziyo nangona ukufundwa kwimeko yokunakekelwa kwezempilo kuqhelekileyo.

Ukuba ufumene unyango lwegazi, ugqirha wakho okanye umboneleli wezempilo unokuyalela iimvavanyo zelabhoratri ukukhetha ukuba okanye akukho nto ibangela isibini, njengobunzima be-thyroid okanye ukungavamile kwintsimbi ye-adrenal. Olunye uvavanyo lwegazi luya kulinganisa amanqanaba e-electrolyte, i-creinine, kunye negazi le-urea nitrogen ukuqinisekisa ukuba iintso zakho zibandakanyeka.

I-urinalysis yinto enye esetyenziswa rhoqo ukuxilonga umonakalo wezintso ngenxa yexinzelelo legazi kunye nokulawula iingxaki zeengtso ezingabangela isizathu sesibini. Iipayili ze-Lipid zilinganisa iqondo lakho le-cholesterol kwaye zisetyenziselwa ukuvavanya umngcipheko wesifo senhliziyo njengesifo senhliziyo kunye nesifo. Uphando lwezifundo lusetyenziselwa ukufumanisa izicubu ezinokuthi zi-grenal adrenal okanye ukulimala kwiintso.

Ukuba ufumanisa ukuba unengcinezelo yenyango, uya kufuneka kwakhona ukuhlolwa kwamehlo. Uviwo kunye ne-ophthalmoscope lunokumisela umphumo wakho wegazi uxinzelelo kwimigodi yegazi kwiso kwaye ingaba i-retina yakho ayizange imenze umonakalo.

Ukongezelela kwi-electrocardiogram (ECG) ukuvavanya umonakalo wenhliziyo, intambo ye-echocardiogram ingasetyenziselwa ukubona ukuba intliziyo yakho ikhulisiwe okanye ukuba unayo nezinye iingxaki zomzimba ezinxulumene nomfutho wexinzelelo, njengemigodi yegazi okanye umonakalo we-valve senhliziyo. Ukuhlolwa kwe-ultrasound ye-Doppler ingasetyenziselwa ukujonga ukuhamba kwegazi kwiimitha zokurhoxisa ukuchonga ukuba zithintele, zenza ukuba kubekho uxinzelelo lwegazi oluphezulu.

Unyango

Uphulo lokuqala loxinzelelo lwengxubevange lubandakanya ukutshintsha kwindlela yokuphila kunye nokutya ukuphelisa okanye ukunciphisa izinto ezinomdla ezifana nokukhuluphala okanye ukutya okuphezulu kwe-sodium. Ukuyeka ukutshaya nokunciphisa ukusetyenziswa kotywala-isiselo esisiselo samabhinqa kunye neziphuzo ezimbini ngosuku kuba ngamadoda-amanyathelo abalulekileyo ekunciphiseni uxinzelelo lwegazi.

Ugqirha wakho mhlawumbi uya kuncomela ukuvuthwa kwe-aerobic rhoqo echaphazela umxhesho wegazi. Ubu bungqina bubonisa ukuba ukuhamba ngokukhawuleza ubuncinane imizuzu engama-30 imihla ngemihla ngeeveki kunenzuzo yokunciphisa uxinzelelo lwegazi.

Kukho nenani leeklasi ezahlukeneyo zamachiza ezifumanekayo kunyango lwexinzelelo. Iingcebiso zeJNC 8 zonyango lwexinzelelo lwegazi zisekelwe kubungqina obuvela kwizifundo ezininzi kwiindawo ezininzi ezahlukeneyo. Abantu abanesigxina soxinzelelo kwi-stage II bangafuna unyango lokuqala kunye neyeza ezimbini okanye inkunkuma edibeneyo.

Ukulandeleka kubalulekile. Ukuba umgomo wakho wexinzelelo lwegazi awuzange uphumelele emva kwenyanga yonyango, umniki-nkonzo wakho unokwandisa umthamo wakho okanye ungeze iklasi elithile leyeza. Emva kokuba ufikelele kwiinjongo zakho zengcinezelo yegazi, kufuneka uqhubeke nokubeka esweni impendulo yakho kwonyango nophuhliso lwalo naziphi na iimeko ukuze ukhusele ukuqhubeka kweengxaki.

Iingxaki

Kukho imiphumo ephawulekayo kwimeko yengozi engapheliyo :

• Ukuhlaselwa yintliziyo
• Stroke
• Aneurysms
• Ukumelwa yintliziyo
• Ukuhluleka kweengso
• Ukulimala kwimithambo yegazi
• Iingxaki zeengcinga kunye neenkumbulo
• Umonakalo wamehlo nokulahleka kombono
• Isifo se-Metabolic syndrome

Umonakalo uqokelelwa ngexesha. Umxinzelelo ophezulu wegazi awunqabile ukuba unxulumene neempawu, ngoko ngokuqhelekileyo ukushiywa kungaphathwa kakubi okanye kukunyanzelwanga kuze kubekho umonakalo osisigxina nesonakalisayo. Xa uxinzelelo lwegazi linyuka, iindonga zeerrixi zingalimala okanye zolule. Ukulimala kwimithambo yegazi kunokudala imimandla ebuthakathaka eyenza i-aneurysms okanye iphule.

Ukulimala kwintliziyo yomzimba kungakhokelela ekufubeni kwe-acrivity over time. I-fibrillation ye-Atrial iyinqanaba lentliziyo engavumelekanga elibeka engozini yokubetha. Umxinzelelo ophezulu wegazi unokudiliza ingqameko yangaphakathi yemithambo, ukuvumela ukuveliswa kwezicubu ezibomvu ezakha umdlalo we-cholesterol kunye neeplatelet (iiseli zegazi ezenza iimbophu). Ukwakhiwa kwe-cholesterol kwimithambo yegazi eyonakalisiweyo kuthiwa yi-plaque. Ezi zifake zibangela ukunciphisa imirhobho, ekhokelela kumsebenzi oninzi ngentliziyo ukupompa igazi elaneleyo ngomzimba.

I-Plaque iyakwazi ukuphuka phantsi kwengcinezelo ephezulu. Oku kubangela ukuba iiplatelets zihambelane kwaye zenze i-clot engakwazi ukuhamba kwaye ihambe ngeenxa zonke kwimizila yegazi, ikhusele igazi le-oksijeni ekubeni lingene kwizicubu ezibalulekileyo. Ukongezelela, la macwecwe angahle ahambe aze ahambe kwezinye iindawo zomzimba, avimbele ukuhamba kwegazi kunye nokubangela ukuhlaselwa yintliziyo okanye ukubetha. Ukwakheka kwe-clot kwanciphisa umthamo, okwenza intliziyo isebenze nzima ukupompa igazi nge-oksijini kuwo wonke umzimba.

Ukulimala kwimithambo ephuma kwixinzelelo eliphezulu yegazi, kubandakanywa ukonakala kunye ne-cholesterol build-up, kubangela ukuqina kobuchopho. Oku kubangela ukuba intliziyo isebenze nzima ukunyusa igazi kuwo wonke umzimba. Inhliziyo iyimisipha, kwaye ngokuhamba kwexesha, iya kuba yonakaliswe kunye ne-floppy ngenxa yokunyuka kwengcinezelo yegazi. Amagumbi entliziyo aya kwandisa kwaye iintambo ze-muscular aziyi kukwazi ukwenza isivumelwano ngokufanelekileyo ukuze zihlawule, ezibangele ukuhluleka kwentliziyo .

ILizwi

Uxinzelelo lwengcinezelo luyisifo esiyingozi esingapheliyo esinokubangela ezininzi iimpembelelo zempilo ngexesha elide. Ukuba uneminyaka engama-20 ubudala, kufuneka ube nengcinezelo yegazi yakho ehlolwe yinkathalo yakho yezempilo ukubonelela ngokutyelela kwezempilo. Ukuba ungaphezu kweminyaka engama-40, kubalulekile ukuba uphezulu lwakho lwegazi luhlolwe rhoqo ngonyaka. Khumbula, ukufunda okufumaneka kumashini omatshini okanye kwi-pharmacy akunakho ukuchaneka.

Ukufumanisa ukunyuswa kwengcinezelo yegazi kusenokuba nako ukwenza utshintsho olusempilweni kwindlela yokutya kunye nendlela yokuphila eya kunciphisa umngcipheko weengxaki ezinzulu ezifana nesifo okanye isifo senhliziyo. Ukuba uwela kwindawo enobungozi obuphezulu, yenza uxinzelelo lwegazi lwakho luhlolwe namhlanje.

> Imithombo:

> Eckel RH, Jakicic JM, Ard JD, et al. 2013 Isikhokelo se-AHA / ACC yokulawulwa kwendlela yokuphila yokunciphisa ingozi yomzimba: ingxelo ye-American College of Cardiology / i-American Heart Association Task Force kwiZikhokelo zokuSebenza. J Am Coll Cardiol . 2014; 63: 2960.

> Hsu CY, McCulloch CE, uDarbinian J, et al. Ukuphakanyiswa kwengcinezelo yegazi kunye nomngcipheko wesifo se-renal esigxina kwizifundo ezingenazo izifo zesifo sezintso. Arch Intern Med . 2005; 165: 923.

> Levy D, uLarson MG, Vasan RS, et al. Inkqubela yokusukela kwixinzelelo lwexinzelelo kwi-heart failure congress. JAMA . 1996; 275: 1557.

> Siu AL. I-US Preventive Services Task Force. Ukuhlolwa kweengcinezelo zegazi eziphezulu kubantu abadala: ISitatimende seNkcazo yokuPhakamisa iMisebenzi ye-Preventive Services. Ann Intern Med . 2015; 163: 778.

> Taylor BC, Wilt TJ, Welch HG. Impembelelo ye-diastolic kunye ne-systolic blood pressure kwi-mortality: impembelelo kwingcaciso "yesiqhelo". J Gen Intern Med 2011; 26: 685 Vakili BA, Okin PM, Devereux RB. Iimpembelelo zesigxina se-ventricular hypertrophy. Inhliziyo J. 2001; 141: 334.