Uxinzelelo lwengcinezelo yinto ekhuselekayo kwizifo nokufa eUnited States egalela ukuphazamiseka, isifo sesifo, kunye nokuhlaselwa kwentliziyo. Kubalulekile ukuyijonga ngokukhawuleza kwaye uyiphathe, ukwenzela ukukhusela iingxaki ezinzulu. IKomishoni kaZwelonke yokuBambisana, ukuThengwa, ukuVavanywa, kunye noPhando lwePhepha lokuPhepha kweGazi eliPhakamileyo likhuphe iziphakamiso ezisekelwe kubungqina besayensi.
Yintoni i-JNC 8?
Usenokuba uvile ukuba kukho izikhokelo zolawulo lwegazi eliphezulu kubantu abadala. Ezi khokelo zishicilelwe yiKomiti yeSizwe yeSizwe ye-8 yokuLungisa, ukuThengwa, ukuVavanywa kunye nokuPhathwa koPhulo oluPhezulu lweGazi, obizwa ngokuba ngu-JNC 8. Izikhokelo zenziwe emva kokuba ikomidi leengcali liququzelele ubungqina bobunzululwazi obukhoyo kwaye bahlaziywa ukuze banikeze izikhokelo oogqirha ngolawulo loxinzelelo lwegazi. I-JNC 8 incoma imingcele yokunyanga kwengcinezelo yegazi ephezulu, iinjongo zengcinezelo yegazi, kunye neyeza zonyango olusisiseko.
Iimpawu zokuPhepha kweGazi kunye neNjongo
Izifundo zibonisa ukuba ukunciphisa uxinzelelo lwegazi kubantu abadala abanomfutho wegazi ophezulu nge-10 mm Hg kunokunciphisa umngcipheko wokufa kwisifo senhliziyo kunye nokubetha ngo-25% ukuya kwi-40%. Ubungqina bubonisa ukuba abantu abadala abaneminyaka engama-60 ubudala kufuneka baqale unyango xa i-systolic blood pressure ukufunda (inombolo ephezulu) ngu-140 mm Hg okanye ngaphezulu okanye xa i-diastolic yegazi ifundwa ngu-90 mm Hg okanye ngaphezulu.
Kubantu abadala abaneminyaka engama-60 ubudala, unyango kufuneka luqale ukuba uxinzelelo lwe-systolic luyi 150 mm Hg okanye ngaphezulu kwaye ukuba uxinzelelo lwe-diastolic lungama-90 mm Hg okanye ngaphezulu. Izigulane eziqala unyango kufuneka zisebenzise la manani njengenjongo yazo. Abantu abanesifo sikashukela okanye izifo ezingapheliyo kufuneka basebenzise ezi njongo njengoko i-JNC 8 ayifumananga ubungqina bokuba ukugcina uxinzelelo lwegazi oluphantsi luphucula iziphumo zempilo kula maqela amabini.
Iingcebiso zoMilatho kwiNyango yokuqala
I-JNC 8 yatshintsha iingcebiso zonyango malunga nokunyanga koxinzelelo lwegazi, ukusuka kwiiklasi ezi-5 zezidakamizwa ukuya kwiiklasi ezi-4 ezicetyiswayo. I-JNC 8 iingcebiso zonyango ezilungisiweyo kwiiklasi ezine zamachiza:
- I-Angiotensin iguqula i-enzyme inhibitors (ACEI)
- I-Angiotensin receptor blockers (ARB)
- Diuretics
- I-block blockers yeCalcium (CCB)
I-JNC 8 iphinde iphinde ihlaziye ubungqina ngokucophelela ukwenza iziphakamiso ezithile zonyango ngamaqela aphantsi kobuhlanga kunye nobukho besifo sikashukela okanye isifo sesifo esingasigxina. Kukho ubungqina obuninzi bokuba kukho ukungafani ngokobuhlanga ekuphenduleni kwizigaba ezithile eziqhelekileyo zonyango lwegazi. Iziphakamiso zokugqibela zi:
- Umntu jikelele ongekho nxweme (kunye okanye onesifo sikashukela) kufuneka aqale unyango nge-ACEI, ARB, CCB, okanye uhlobo lwe-thiaude-diuretic (oko kukuthi, i-hydrochlorothiazide)
- Abantu abanzi abamnyama (kunye okanye abanesifo sikashukela) kufuneka basebenzise iCCB okanye uhlobo lwe-thiazide-diuretic yolawulo lokuqala loxinzelelo lwengqondo.
- Izigulane ezinezifo zesifo esingasigxina ezingaphezu kweminyaka eyi-18 kufuneka zisebenzise i-ACEI okanye i-ARB njengonyango lokuqala okanye unyango olongezelelweyo kuba oku kuboniswe ukuphucula iziphumo zeentso. Oku kusebenza kubantu abamnyama nabangabamnyama.
Nini ukunyusa iDose okanye udibanise iMithi entsha
I-JNC 8 icebisa ukwanda kwenzalo yokuqala yezilwanyana okanye ukongezwa kwesibini kwisilwanyana kwisinye seziklasi zonyango ezicetywayo ukuba ungenakukwazi ukufikelela ekujoliswe kuyo kwiphepha lexinzelelo lwegazi ngaphakathi kwenyanga. Ukuba ukwanda kwe dose okanye ukongezwa kwesilwanyana esitsha akunciphisi uxinzelelo lwegazi kwiinjongo zakho, ngoko ugqirha wakho kufuneka afake isilwanyana sesithathu kwenye yeeklasi ezicetywayo. Nangona kunjalo, ii-ACEIs nee-ARB akufanele zisetyenziswe kunye. Ezinye izigulane zingadinga ukongezwa kwesilwanyana esivela kwelinye iklasi.
Ezinye iiKlasi ze-Antihypertension Izidakamizwa
Kukho amaxesha apho izigulane zinesizathu esinye sokuthatha isicatshulwa kwiklasi engakhankanywe ngokuthe ngqo kwiingcebiso ze-JNC 8.
Ngokomzekelo, i-beta-blockers iboniswe ukuphucula ukusinda kwizigulane ezinokukhubazeka kwentliziyo, ngoko zikhethekileyo zokunciphisa uxinzelelo lwegazi kwizigulane ezinokukhubazeka kwentliziyo. Izigulane ezine-prostatic hypertrophy zihlala zifumana iklasi yezilwanyana ezibizwa ngokuba yi-alpha blockers ukunciphisa iimpawu zabo. La mayeza aye aqale ukuphuculwa ukuze aphathe uxinzelelo oluphezulu lwegazi, kodwa aphinde aphume iprotate kunye nentamo ye-bladder, evumela umchamo ukuba ukhululeke ngokukhululeka. I-Alpha-blockers yinto efanelekileyo yokonyango lwexinzelelo lwengqondo kumadoda ane-BPH.