Ekupheleni konyaka we-2017, i-American College of Cardiology (ACC) kunye ne-American Heart Association (AHA), ngokubambisana nezinye iindidi zonyango ezihloniphekileyo, zakhupha isicwangciso esitsha sesikhokelo somfutho wegazi ophezulu .
Ezi zikhokelo zitsha zide zide. Ngaphambi kokukhululwa kwabo, oogqirha babezama ukusebenzela ukususela kwiinqununu ezine zezikhokelo ezihlukeneyo, kwimibutho eyahlukeneyo, eyahlukahluka komnye ngeendlela ezibalulekileyo.
Izikhokelo zonyaka we-2017 zithembisa ukufumana lonke uphando lwezokwelapha emva kwiphepha elifanayo malunga nokuxinzeleleka kwengozi.
Izikhokelo ze-2017 zahluke ngeendlela ezimbalwa ezibalulekileyo ezivela kwizikhokelo zengxowankulu zengxowankulu, kwaye boogqirha nabantu abavavanywa okanye baphathwa ngexinzelelo lwegazi kufuneka baqonde ezi ngcebiso.
Yintoni entsha kwiikhokelo ze-2017?
Imiba emitsha ye-2017 izikhokelo ziwela kwiintlobo ezi-5 eziqhelekileyo:
- Inkqubo entsha yokuhlengahlengiswa kwegazi
- Iinqununu ezintsha zokufumanisa ukunyuka kwegazi
- Ukuthabatha ingozi yomzimba wonke xa usenza izigqibo zonyango
- Ukugxininiswa ngakumbi kwiinguqulelo zendlela yokuphila ekuphatheni umfutho wegazi ophezulu
- Iinjongo zengcinezelo yegazi ngexesha lokunyanga
Inkqubo entsha yokuHlulwa kweNgcinyi
Ngaphambi kwezikhokelo zango-2017, abantu abanexinzelelo lwegazi le-120-139 mmHg babecingelwa ukuba bane-"hypertension"; abo baxinzelelo lwe-syndrome ka-140-159 mmHg babecingelwa ukuba baneSigaba 1 somfutho wegazi ophezulu kunye nalabo abaneempembelelo ze-sympress of 160 mmHg okanye ngasentla zacatshangwa zibe neSigaba 2 somfutho wegazi ophezulu.
Inkqubo yesigaba se-2010, esekelwe kwiziphumo zoluvavanyo olutshanje oluthile, linciphisa iminyango yeSigaba 1 kunye neSigaba 2 somfutho wexinzelelo, njengolu hlobo lulandelayo:
- I-prehypertension ngoku ichazwe njengesixinzelelo segazi se-120-129 mmHg kunye noxinzelelo lwegazi lwe-diastolic ngaphantsi kwe-80 mmHg.
- Isigaba 1 somfutho wexinzelelo luchazwa njenge-systolic blood pressure ye-130-139 mmHg OKANYE noxinzelelo lwe-diastolic ka-80-89 mmHg.
- Isigaba sesi-2 somfutho wexinzelelo sichazwa njengengcinezelo yegazi ye-systolic ye-140 mm Hg okanye ngaphezulu KUNYE uxinzelelo lwe-diastolic lwe-90 mmHg okanye ngaphezulu.
Enyanisweni, izikhokelo ze-2017 zahlula "uhlobo lokudlulela kwangaphambili" kwiindidi ezimbini. Isiqingatha esingaphantsi sisacingwa ukuba sisifo sokunyuka kwesantya, kodwa isigxina esiphezulu (uxinzelelo lwegazi lwama-130-139) ngoku sithathwa njengeSigaba 1 segazi. Olu tshintsho lwenziwe kuba idatha evela kwizilingo zamaklinikhi ngoku ibonisa ngokucacileyo ukuba abantu abaneengcinezelo zegazi ziloluhlu lwe-130-139 banomngcipheko ophezulu kakhulu weengxaki zentliziyo, kwaye iimpembelelo zabo zegazi ziphakanyisiwe.
Iziphakamiso ezintsha zokuqaphela ukunyuka kwegazi
Izikhokelo ze-2017 zithatha ubuhlungu ukubonisa ukuba ingcinezelo yegazi isoloko ilinganiselwe kwiiofisi zonyango, kwaye indlela yokuxinezeleka kwengqondo eye yafunyaniswa ngayo, iye yahlaselwa iingxaki.
Uxinzelelo lwegazi lomntu luyaguquka ngokukhawuleza ngexesha lexesha eliqhelekileyo, kuxhomekeka kwimeko yomntu, ukuxinezeleka, ukunyanzeliswa, ukunyamezela, kunye nezinye izinto ezinokutshintsha ukususela ngomzuzu ukuya kumzuzu. Ngoko, ukuze uchane ngokuchanekileyo uxinzelelo lwegazi, kubalulekile ukwenza njalo phantsi kweemeko ezilawulwa ngokucophelela.
Nantsi indlela izikhokelo ezintsha ezichaza ngayo inkqubo echanekileyo yokulinganisa uxinzelelo lwegazi:
- Isigulane sifanele sikhululeke ngokupheleleyo, sihleli esihlalweni (kunye neenyawo kumgangatho kunye nasemva kuxhaswa) ubuncinane imizuzu emi-5.
- Isigulane sifanele sigweme i-caffeine, ukuzivocavoca kunye nokubhema okungenani imizuzu engama-30 ngaphambi kokuba kwenziwe umlinganiselo.
- Isigulane kufuneka sibe nesinya esingenanto.
- Isigulane okanye umntu othabatha uxinzelelo lwegazi kufuneka akhulume ngexesha lokuphumla, okanye ngexesha lokulinganisa.
- Zonke izambatho ezifihla indawo yecufom yegazi kufuneka zisuswe. (Akukho kuthatha uxinzelelo lwegazi phezu komkhono.)
- Ngokukodwa, uxinzelelo lwegazi akufanele lilinganiswe xa isigulane sihleli okanye silele kwitafile yeemviwo.
- Kufuneka kuthathelwe imilinganiselo engama-2 okanye-3, okungenani ama-2 okanye ama-3 amaxesha ahlukeneyo, kwaye umyinge waloo mvavanyo kufuneka usetyenziswe ukuxilonga i-hypertension.
Nabani oye kwiofisi yegqirha kwiminyaka yamuva uya kuqonda ukuba ezi zikhokelo azilandelekanga. Sekunjalo, kufuneka ukuba ilandelwe ukuze uvavanyo lwegazi lube luchanekile. Oku bekuhlala kuyinyaniso, kodwa kunjalo ngokwenene namhlanje kunye nenkqubo yokuhlengahlengiswa komfutho wexinzelelo ophakanyisiweyo kwizikhokelo ze-2017. Ngaphandle kokuba uxinzelelo lwegazi lugqalwa phantsi kweemeko zokuphumla okuphumlileyo, ukukhululeka okuchazwe kwezi zikhokelo, iingxaki kukuba ukunyanzelelwa kwengcinezelo yegazi kuya kuphakanyiswa.
Ukongezelela, izikhokelo ze-2017 zincoma ukuba ukuba ingozi yexinzelelo ifunyenwe kwiklinikhi ngokusebenzisa ezi nyathelo zokunyamekela, uxinzelelo lwegazi kufuneka lilinganiswe kwisigxina ngaphambi kokuba kuqinisekiswe ukuba i-hypertension ikhona.
Ukuthabatha ingozi ye-Cardiovascular Risk kwi-Akhawunti
Nangona abantu abanomfutho wegazi we-systolic ophakathi kwe-130-139 mmHg bahlulwa njengokuba babe ne-Stage 1 yempembelelo yecandelo endaweni yokuxhatshazelwa kwegazi, izikhokelo zango-2017 zincoma ukuthatha ingozi yabo yonke yempilo yengozi ngaphambi kokuthatha isigqibo sokuba ingabafaki kwi-antihypertensive treatment.
Ekuqikeleleni ingozi yomzimba wonke yabantu abaneSigaba 1 segazi, izikhokelo ze-2017 zincoma ukusebenzisa i-ACC / AHA Pooled Cohort Equation risk calculator. Le calculator iqikelela umngcipheko we-10 weminyaka yesifo senhliziyo usebenzisa ubudala, ubuhlanga, isondo, i- cholesterol , i-systolic blood pressure, isifo sikashukela kunye nembali yokutshaya, kunye nayiphi na unyango lwe-cholesterol kunye negazi. Ukuba umngcipheko weminyaka engama-10 esekelwe kule calculator yomngcipheko uqikelelwa ukuba ungaphezu kweepesenti ezili-10, ngoko unyango lweziyobisi lweSigaba 1 lwexinzelelo lwengqondo luyacetyiswa.
Ukuba umngcipheko we-10 weminyaka ungaphantsi kwama-10 ekhulwini, abantu abaneSigaba 1 soxinzelelo lwegazi kufuneka baphathwe ngeenguqu zendlela yokuphila, njengabo abanesifo sengqondo sokunyuka kwengqondo.
Abantu abaneSigaba 2 soxinzelelo lwe-hypertension baya kufuna ukuba bahlale befuna unyango lweziyobisi .
Ukugxininiswa kwiinguqu zokuphila
Kuba nabani na abane-hypertension, okanye iSigaba se-1 okanye iSigaba 2 somngcipheko, ukuguquka kwendlela yokuphila kugxininiswa njengelona lembombo leyeza kunyango ka-2017.
Ukutshintshwa kwendlela yokuphila ephakanyisiweyo kubandakanya ukusetyenziswa okuninzi (ubuncinane imizuzu engama-30 yokuzivocavoca ubuncinane kathathu ngeveki), ukutya okutshintshwa kweDASH, ukunciphisa ukutya kokuyeka ukutshaya , ukulahleka kwesisindo, nokunciphisa utywala ngaphandle kokusela olunye ngosuku amabhinqa, kunye neziphuzo ezimbini ngosuku ngamadoda.
Iithagethi ezingaphantsi kweCandelo loXinzelelo lweGazi
Izikhokelo ze-2017 zigxininisa ukuba ithagethi yonyango lwexinzelelo lwegazi kufuneka libe yinyxinxu ye-systolic engaphantsi kwe-130 mmHg, kunye noxinzelelo lwe-diastolic ngaphantsi kwe-80 mmHg.
Olu joliso lusezantsi kuneenjongo ezicetywayo zikhokelo zangaphambili, ezona zijoliswe kakhulu kwi-systolic blood pressure ezingaphantsi kwama-140 mm Hg kubantu abaninzi. Ezinye izikhokelo zangaphambili zancongo ngakumbi izigulane ezigugile, zicebisa injongo yonyango ye-150 mmHg okanye ngaphantsi.
Injongo entsha, unyango olungaphantsi kwe-130 mmHg okanye ngaphantsi, kubantu asebekhulile nakumntu wonke, isekelwe kwimiphumo entsha, iziphumo ezinkulu zonyango ezibonakalisiweyo ezibonisa iziphumo eziphuculiweyo zabantu bonke ubudala abaphathwe kwiinjongo eziphantsi.
ILizwi
Izikhokelo zengxowankulu ye-2017 zimela ukuhlanganiswa kunye nokuhlaziywa kweeseti eziliqela zezikhokelo ezivela kumaqela amacandelo amaninzi, okujoliswe ekutholeni oogqirha abaphethe unyango lwegazi eliphezulu kwiphepha elifanayo. Kukho utshintsho kwizikhokelo ze-2017 eziza kuthatha ukusetyenziswa, kokubili ekuxilongweni kunye nendlela yokunyanga kwengozi yomshukela ophezulu. Nangona kunjalo, zisekelwe kubungqina obuqinileyo bekliniki, kwaye kufuneka zenziwe ngamagqirha amaninzi.
Ukuba unayo okanye uphononongwa ngophezulu lwengqondo, kuya kuba yinto efanelekileyo ukuxoxa ngezi khokelo ezintsha kunye noogqirha wakho, ukuqinisekisa ukuba ukuxilongwa kwakho kuchanekile, kwaye isicwangciso sakho sokonyango sigqibelele kuwe.
> Imithombo:
> Muntner P, Carey RM, Gidding S, et al. Impembelelo yabemi be-US ye-2017 yase-American College of Cardiology / i-American Heart Association I-High Blood Guidure Guideline. Uhambo 2017; INGXELO: 10.1161 / ICIRCULATIONAHA.117.032582.
> Whelton PK, Carey RM, Aronow WS, et al. 2017 I-ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / I-PCNA Isikhokelo soKhusela, ukuThengwa, ukuVavanywa, nokuPhathwa koPhulo oluphezulu lwegazi kwiNgxelo ye-American College of Cardiology / yaseMerika. IQumrhu loMbutho Weqela Lentliziyo kwiZikhokelo zoLwazi lweZikliniki. Uxinzelelo lwengqondo 2017; INGXELO: 10.1161 / HYP.0000000000000066.
> Whelton PK, Carey RM, Aronow WS, et al. 2017 I-ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / I-PCNA Isikhokelo soKhusela, ukuThengwa, ukuVavanywa, nokuPhathwa koPhulo oluphezulu lwegazi kwiNgxelo ye-American College of Cardiology / yaseMerika. IQumrhu loMbutho Weqela Lentliziyo kwiZikhokelo zoLwazi lweZikliniki. J Am Coll Cardiol 2017; INGXELO: 10.1016 / j.jacc.2017.11.005.