Uxinzelelo oluphezulu, okanye uxinzelelo lwegazi oluphezulu, lunye lweengxaki zonyango eziqhelekileyo. Ngelishwa, ingozi yexinzelelo kudla ngokungaqhelekanga. Okugqithisileyo, xa kufunyaniswa ukuba, kudlalwa ngokungafanelekanga nangona kunjalo ukuba kaninzi kunzima ukunyanga. Ngoko ke, nangona wonke umntu "eyazi" malunga negazi legazi, ihlala ibangela phambili yokuhlaselwa intliziyo , isifo , isifo , isifo sesifo kunye nezinye iingxaki zempilo.
Ngenxa yokuba uxinzelelo lwexinzelelo luqhelekile kwaye luncedo, kubalulekile ukuba wonke umntu abe neengcinezelo zegazi ahlolwe rhoqo. Yaye ukuba unengcinezelo, kubalulekile ukuba usebenze ngokusondeleyo kunye nogqirha wakho ukufumana unyango osebenzayo oya kukuvumela ukuba ugweme imiphumo emibi kwaye uphile ubomi obude, obuphilileyo.
Iyintoni Ingxinzelelo yegazi kunye Nokuba Kutheni Kubaluleke Kangako?
Uxinzelelo lwengcinezelo yimeko apho uxinzelelo kwimibhobho ephakamileyo ngokwaneleyo ekugqibeleni livelise umonakalo kwimithambo yegazi, kwaye ekugqibeleni iilungu apho lihambisa igazi.
Njengoko intliziyo ibetha, iqhubela igazi ngeemithambo kunye nezitho zomzimba. Ingcinezelo eyenziwe yintliziyo yokubetha iqhubela phambili igazi kwaye ilula iindonga ezixakile zeemitha. Phakathi kweentliziyo zentliziyo, njengoko intliziyo ye-muscle idibanisa, iindonga zengqungquthela ziyabuyela kwisimo sazo sokuqala, ngaloo ndlela igcina igazi liqhubela phambili kumathishini omzimba. (Ukwandiswa kwemibhobho kunye nentlone yentliziyo nganye kukuvumela ukuba sizive "ngepulse.")
Ngoko ke, uxinzelelo lwegazi ngaphakathi kwemithambo-eyenziwa yintliziyo yokubetha kunye nemithambo ye-elastic esebenza kunye-egcina igazi lijikeleza.
Ukuba uxinzelelo lwegazi luphantsi kakhulu (imeko ebizwa ngokuba yi- hypotension ), izitho zomzimba zihlupheka ngenxa yokuba azifumani ukuhamba kwegazi okwaneleyo. Kodwa uxinzelelo lwegazi olusenyuka kakhulu (uxinzelelo lwegazi) lubangela iingxaki zalo. Uxinzelelo lwe-hypertension luyakwazi ukukhawuleza i- atherosclerosis , ekhokelela kwi- coronary disease kunye neentliziyo , ukuhluleka kwentliziyo , ukubetha kweentso, ukuhluleka kwezintso , isifo se-artery kunye ne- aortic aneurysms .
Yingakho uxinzelelo lwengcinezelo luyingozi enkulu yokukhubazeka kwangaphambili kunye nokufa, kwaye kutheni ukuxilonga nokunyanga kubaluleke kakhulu kwimpilo enobomi kunye nobomi obude.
Ziziphi Iimpawu Zogxininiso?
Uxinzelelo olusisigxina sisifo esibangelisayo. Uninzi lwabantu abanesifo soxinzelelo aluzange luhlakulele naluphi na iimpawu ezivela kwingcinezelo ephezulu yegazi, kwaye kaninzi lubonakala kwaye luziva luphilile ngokupheleleyo kwiminyaka emininzi-de kube yenze umonakalo ongenakuguquka kwiqumrhu elibalulekileyo. Ngoko okokuqala uphawu lwexinzelelo lwengcinezelo, ngelishwa, ngokuqhelekileyo ukuhlaselwa kwintliziyo ngokukhawuleza okanye ukubetha-ngokubonakalayo ngaphandle kwebala. Yingakho i-hypertension ivame ukubizwa ngokuthi "umbulali ongenangqondo."
Uxilongo lweZifo?
Uxinzelelo lwexinzelelo luyafunyanwa xa uxinzelelo lwegazi lwakho luphumla lufunyaniswa luhlala luphakanyisiwe.
Kubalulekile ukulinganisa uxinzelelo lwegazi ngokuchanekileyo ukuze ugweme ukuxilonga okanye ukuhlolisisa ukunyanga kwegazi. Kwiofisi yezokwelapha yanamhlanje, iimeko ezichanekileyo zokulinganisa ngokuchanekileyo uxinzelelo lwegazi zihlala zinganakwa. Ekubeni nguwe omele aphile kunye nokuxilongwa (okanye ngemiphumo yokuxilongwa okuphosakeleyo), kufuneka ufumane ingcamango ethile yokufumana uxinzelelo lwegazi.
Umlinganiselo wexinzelelo lwegazi ubonakaliswa njengamanani amabini- i-systolic ne-diastolic yexinzelelo yegazi- njengale: 120mmHg / 80mmHg, okanye ngaphezulu, 120/80 ("inamashumi amabini anamashumi angamashumi asibhozo.") Inani eliphakamileyo, uxinzelelo lwe-systolic, limele uxinzelelo ngaphakathi komthamo ngelixa intliziyo isenza isivumelwano. Inombolo engezantsi, uxinzelelo lwe-diastolic, ibonisa uxinzelelo lobungozi phakathi kwentsimbi yeentliziyo, ngelixa intliziyo ikhululekile.
Isikhokelo esisemthethweni sokulinganisa uxinzelelo lwegazi sichaza ukuba imilinganiselo kufuneka yenziwe kwindawo ekhulileyo, efudumalayo emva kokuba uhlezi ngokuphumla ubuncinane imizuzu emihlanu. Akufanele ube nekhofi okanye usebenzise iteksi ubuncinane imizuzu engama-30. Ubuncinane ubuncinci begazi lwegazi ezimbini kufuneka kuthathwe phantsi kwezi meko, ubuncinane imizuzu emihlanu, kwaye kufuneka iphindwe ngokuphindaphindiweyo kangangoko kufuneka ukuba imilinganiselo ivume ngaphakathi kwe-5 mmHg.
Nabani oye kwiofisi yegqirha kwiminyaka embalwa edlulileyo uyazi ukuba akunakwenzeka ukuba zonke ezi zihambelane nazo. Sekunjalo, phambi kokuba ugqirha akunike ukuxilongwa ngokusisigxina komfutho wexinzelelo, kufuneka ukuba azive ebophekile ukuba enze ukuxilongwa ngokuchanekileyo. Kwaye kufuneka ufune ukuba enze njalo.
Enye into eyinkxalabo ekuxilongweni komfutho wegazi ophezulu kwiofisi yoogqirha yinto ebonakalayo " yengubo emhlophe yengozi yokugxininisa" -thi kuthetha ukuba izinga lexinzelelo legazi liphakanyisiwe kwiofisi yegqirha, kodwa ziqhelekileyo malunga naluphi na ixesha. Uninzi lweengcali zivakalelwa kukuba iingubo ezimhlophe zengcinezelo ayifuni unyango.
Ngenxa yobunzima obuyiyo ekubandakanyeni ukuxilongwa ngokufanelekileyo kwexinzelelo lwengqondo kwiofisi yegqirha, iingcali zengxangxuthongo ziza zijikeleze ngombono wokuthi indlela echanekileyo yokufumanisa i-hypertension ayikho kwiofisi yegqirha, kodwa kunokuba ixinzelelo lwegazi iliso . Ubungqina bokuqokelela ubungqina obucetyiswayo kwindlela kwaye ezinye izikhokelo zonyango zangoku zikhankanya ukuba ukubeka iliso kwi-ambulatory kukhethwa ukuba kuhlolwe ukunyuka kwegazi.
Ziziphi izinto ezibeka ingozi kwi-Hypertension?
Uxinzelelo lwexinzelelo luyinto eqhelekileyo phakathi kwamaqela aseNtshona. Nangona kunjalo, abanye abantu basemngciphekweni omkhulu wokuhlakulela umfutho wegazi ophezulu.
Uxinzelelo lwentliziyo luqhelekileyo kwaye lukhulu nakakhulu kubantu abamnyama nakubantu abanomdla wentsapho yengozi yecindezelo. Ukunyuka kweetyuwa ngaphezu kweyona nto ibalulekileyo ekuphuculeni ingcinezelo yabantu abaninzi. Ukutya ngokugqithiseleyo kotywala (ikhulu kuneziphuzo ezimbini ngosuku) kudibene nomxinzelelo ophezulu. Amanqanaba e-blood-lipid ephakamileyo (i- cholesterol kunye ne-triglycerides egazini lakho) zidibaniswa neemeko ezandisiweyo zengcinezelo. Kwaye, ke, kukho into ebalulekileyo yengozi-yokugqithisa okanye ukugqithisa.
Ziziphi Iingxaki Zogxininiso?
Iimbangela zexinzelelo zengxowankulu zihlala zihlukeneyo kwiindidi eziqhelekileyo: i-hypertension eyona nto ephambili ("ibalulekileyo yengozi yecembelelo") kunye nomfutho wegazi ophezulu unesibini kwiinkalo zonyango.
Uninzi lwabantu abanexinzelelo lwengcinezelo lubaluleke kakhulu , olubhekiselele kukuba, akukho nto ebangela ukuba kubonakale-kubangelwa kungekho sizathu esicacileyo. Nangona uphando oluninzi luyenziwe ukuzama ukuphawula isizathu esiyintloko (okanye kubangele) yongcinezelo olubalulekileyo, ngoku kubekho iimeko ezihlala zingekho.
Ngokuqhelekanga ukuba ingozi yexinzelelo yecala kunezinye ezibonakalayo-kwaye zihlala ziguqulwa kunye / okanye ziguqulwa. Iimeko ezinokuvelisa i-hypertension yesibini ziquka izifo zengqondo, i- apnea yokulala , ubumbano lwe-aorta, izifo zeemithwalo yegazi ezibonelela iizintso, iintlungu ezahlukeneyo ze-endocrine, kunye nokusetyenziswa kwemithi yokukhulelwa komlomo , ukusela utywala, ukusetyenziswa kakubi kwe -anti-steroidal anti- izidakamizwa ezivuthayo (i-NSAID) , okanye izidakamizwa zokuxhatshazwa.
Imbali yonyango ngokucophelela, uvavanyo lomzimba, kunye nokuvavanywa komsebenzi wegazi ngokuqhelekileyo kufuneka uxhobise ugqirha wakho ukuba ngaba kuya kuthathwa amanyathelo athile ukuba afune iinjongo ezinokubangela ingozi yesondlo .
Ziziphi iiNqanaba zoPhulo lwengqondo?
Xa i-hypertension ifunyaniswa, "isigaba" somfutho wexinzelelo luyinto ebalulekileyo ekuqaliseni ukuba luhlobo luni lweyonyango olusetyenziswa ekuqaleni. Isigaba somntu ophezulu somfutho wexinzelelo luyodwa enye indlela yokuthetha ukuba kunzima kangakanani-ngamanye amazwi, ukuphakama kwengcinezelo yegazi kukuphakame kangakanani.
Izigaba zengcinezelo yokhuseleko:
- Isigaba 1 somfutho wegazi ophezulu: uxinzelelo lwe-systolic 140-159mmHg OKANYE uxinzelelo lwe-diastolic 90-99mmHg
- Isigaba sesi-2 somfutho wexinzelelo: uxinzelelo lwe-systolic olungaphezu kwe-159mmHg OKANYE ingcinezelo ye-diastolic ingaphezu kwe-99mmHg
Ukongezelela kwezi zigaba zimbini, "oogqirha baya kuxoxa ngesigaba esingacwangciswanga esibizwa ngokuba yi- hypertension, apho ixinzelelo legazi liphezulu kunelohlu olufunayo , kodwa alukho okwaneleyo (okanti) ukuba ibhalwe ngegazi eliphezulu.
Kuthetha ukuba i-prehypertension ifumaneka ukuba uxinzelelo lwe-systolic luwela phakathi kwe-120-139mmHg okanye uxinzelelo lwe-diastolic luphakathi kwama-80-89mmHg. Ngenxa yokuba abantu abane-hypertension abanomngcipheko ophezulu kakhulu wokuba baxineke ngokunyanisekileyo, kufuneka babe neengcinezelo zegazi zabo ubuncinci kwiinyanga ezi-6-12. Abanye oogqirha bakholelwa ukuba kufuneka baphathwe ngegazi eliphezulu. Okona kuncinci, kufuneka bafumane utshintsho lokuphila oluya kunciphisa umngcipheko wokuba nomfutho wegazi ophezulu kunye nesifo senhliziyo.
Ukongeza kwi-hypertension ne-stage 1 kunye nesigaba se-2 somfutho wokhuseleko lwegazi, kukho uhlobo olunqabileyo lwe-high blood pressure olubizwa ngokuba yingozi yengozi. I-hypertension eyingozi ifumaneka xa uxinzelelo lwegazi luphezulu kakhulu kwaye luhamba kunye nobungqina obunobungozi obukhulu kwiimpawu ezibangelwa ukuphuka kwemithambo yegazi ezibonakaliswe ngokukhawuleza kwimixinzelelo yegazi.
Umonakalo wequmrhu elibi kakhulu libonakaliswa ngokuphuma kwi-retina yamehlo, ukuphuma kwizintso, ukulimala komzimba, okanye ukubetha. Izimpawu ezibangelwa ngabantu abaneengozi zengcinezelo ezinxulumene nomzimba zihlobene nequmrhu okanye izitho zonakaliswe. Uxinzelelo olubi lwexilongwane luhlala lugxininiso lwezonyango kwaye ngokubanzi lufuna unyango olunzulu, olunzulu lonyango.
Kutshanje Kufunyaniswe Ngokuxinzeleleka Kwengcinezelo? Ukufumana unyango olufanelekileyo
Ukuba uye wafumanisa ukuba unengcinezelo yenyango, iindaba ezilungileyo kukuba kukho uluhlu oluninzi lwezonyango ezifanelekileyo zokukhetha. Iindaba ezimbi kukuba kukho ezininzi iindlela zokwelapha ezichanekileyo zokukhetha ukususela apho-ngamanye amaxesha kunokukwenza ukhethe "unyango" oluncinane luyinkimbinkimbi.
Unyango lwengcinezelo luqala rhoqo ngokutya, ukuvivinya umzimba, ukulawula ubunzima, kunye nokunqandwa kwe-sodium . Kwezinye iimeko (ikakhulukazi kubantu abane-hypertension okanye isigaba 1 somfutho wegazi ophezulu) ezi ntlobo zendlela yokuphila zanele, kwaye unyango lweziyobisi lungafaneleki.
Nangona kunjalo, kuninzi lwabantu abaneganga loxinzelelo lwegazi, kunye nabani na onqanaba lesibini lokuxinzelela, uxhatshazo lweziyobisi ludingeka ukuba kunciphise ngokwaneleyo uxinzelelo lwegazi.
Ngenxa yokuba ininzi imithi yonyango isavunyelwe ukonyango lwexinzelelo, ukukhetha izilwanyana "ezilungileyo" (okanye ukudibanisa iziyobisi) kunoma yimuphi umntu onikezelwe ngumfutho wegazi ophezulu unokuqala ukubonakala kunzima. Nangona kunjalo, izikhokelo ziye zaphuhliswa ukuze kuncede oogqirha bafumane ngokukhawuleza, ukunyamezeleka kakuhle (kwaye ngokuqhelekileyo kufikeleleka) irejimeni yonyango malunga nabani na abanegazi eliphezulu.
Ngoko ke, ukuba wena kunye nodokotela wakho uthatha indlela enengqiqo, isinyathelo-silumko, kukho ithuba elihle lokuba uza kulungela ngokukhawuleza kunyango olufanelekileyo.
Ukuba uneminyaka engama-65 okanye ngaphezulu, kungenzeka ukuba i-hypertension yakho ingundoqo ye-hystotension-systolic-oko kukuthi, iscinezelo segazi se-systolic siphezulu, ngelixa uxinzelelo lwegazi lwe-diastolic luhlala luhlu oluqhelekileyo. Ukuba kunjalo, wena kunye nogqirha wakho kufuneka uthathe amanyathelo athile okuqapha njengoko uqala unyango lwegazi lakho.
Ukuphila Ngexinzelelo Loxinzelelo
Xa ufumanisa ukuba unesixinzelelo segazi, unokulindela ukuba kubekho ixesha apho uya kubona ugqirha wakho ngokuphindaphindiweyo kunokuqhelekileyo. Uzakufuna uvavanyo olusisiseko lokubangela isisiseko sogxininiso lwakho lwegazi, kwaye mhlawumbi uya kufuneka udwendwe oluninzi lwezonyango ngaphambi kokuba ufumane i-regimen yonyango efanelekileyo.
Kodwa xa eli qela liphelile, ungalindela ukubuyela kwimpilo eqhelekileyo. Ngokuqinisekileyo, kunokubakho ulungiso oluthile lokuphila oluya kulufuna ukuba ufunde, kodwa mhlawumbi luya kutshintsha utshintsho omele ulwenze ixesha elidlulileyo.
Iindaba ezilungileyo-ngoku ukuba ugxininiso lwakho lwengxakeko lugcinwe ngokwaneleyo-ukuba "ubomi obuqhelekileyo" kunokuhlala ixesha elide kwaye libe nempilo ngakumbi kunokuba kwakungenjalo.
ILizwi
Uxinzelelo lwengcinezelo yintlupheko yonyango eqhelekileyo esoloko ineempembelelo ezinzima. Ngokufunda konke onako malunga negazi, ungasebenza kunye nogqirha wakho ukwenza uvavanyo olufanelekileyo ngexesha elifanelekileyo kwaye ufike ngokukhawuleza kwiloni efanelekileyo oyifunayo.
> Imithombo:
> Chobanian, AV, Bakris, GL, Black, HR, Cushman, WC. Ingxelo Yesixhenxe yeKomiti yeSizwe yoNxibelelwano yokuThusela, ukuThengwa, ukuVavanywa nokuPhathwa koPhulo oluPhezulu lweGesi: I-JNC 7 Report. JAMA 2003; 289: 2560.
> Hamba AS, Bauman M, Coleman King SM, et al. Indlela esebenzayo yokulawula uxinzelelo lwegazi: Isiluleko sezesayensi esivela kwi-American Heart Association, i-American College of Cardiology, kunye namaziko okuLawula nokuLawulwa kwezifo. Uxinzelelo lwe-2013; maneka kwi http://hyper.ahajournals.org.
> James PA, Oparil S, uCarter BL, et al. 2014 Isikhokelo esisekelwe kwiingqinisiso zokulawula uxinzelelo lwegazi kubantu abadala: Ingxelo evela kwamalungu eepaneli aqeshwe kwiKomiti yeSizwe yeSizwe yoLwesine (JNC 8). JAMA 2014; INGXELO: 10.1001 / jama.2013.284427. Iyatholakala kwi: http://jama.jamanetwork.com/journal.aspx.
> Kaplan NM, uVictor RG. Isahluko 8: Iingxaki ze-Hypertensive. Ku: Kaplan's Clinical Hypertension, 10 Ed, Lippincott, Williams & Wilkins, Philadelphia 2010. iphe.
> Mancia G, Bombelli M, Brambilla G, et al. Ixabiso lexesha elide lokuxela ingubo ephezulu emhlophe yengubo: ingqiqo evela > ukuxilonga > ukusebenzisa zombini ukunyanzeliswa kwegazi kunye nemilinganiselo yegazi. Uxinzelelo lwe-2013; 62: 168.
> Myers, MG. Ukuqwalaselwa kweengcinezelo zegazi eziqhelekileyo eziqhelekileyo. Uxinzelelo lwe-2005; 45: 483.
> I-Pierdomenico SD, iCuccurullo F. Ixabiso leprognostic ye-white-coat ne-masked hypertension efunyenwe ngamehlo okuqhelanisa nezifundo kwizifundo ezingaqalekanga: i-updated > meta analysis >. Am J Hypertens 2011; 24:52.