Ukuhlolwa kweengcinezelo zegazi (HBPM) kubhekisela kwisenzo sokucela izigulane ukuba zilinganise iimpembezelo zegazi zabo ekhaya, nokuba zibone ukuba ingozi okanye ingancede ekulawuleni umfutho wegazi ophezulu emva kokufunyaniswa. I-HBPM iyenzeka ngexesha leminyaka embalwa edlulileyo, ngoku kungabizi ngexabiso (i-$ 40- $ 50), kulula ukuyisebenzisa, izixhobo zomshuwalense wegazi zifumaneka ngokukhawuleza, kwaye ukuchaneka kwazo ngokuqhelekileyo kulungile.
Kutheni iHBPM?
Imilinganiselo yempembelelo yegazi eyenziwe kwiofisi yegqirha isoloko iyanceda kakhulu kunokuba ikholwa ngaphambili. Mhlawumbi ngenxa yokugxininiswa kwesigulane kwi-ofisi yegqirha, okanye (ngaphezulu) ngenxa yeendawo ezixhatshaziweyo ezitholakala kwiiofisi ezininzi zamagqirha namhlanje, kunzima ukuba izigulane ziphumelele "kwindawo yokuphumla" efunekayo imilinganiselo echanekileyo yegazi. Ngenxa yoko, iimpembelelo zegazi ezifunyenwe eofisi zidla ngokuba "zibuxoki" ziphakanyisiwe. Umngcipheko kukuba i- Stage I-hypertension ingafunyanwa xa ingekho.
Kule nkcazelo ngoku kuyaqatshelwa yiengcali ezininzi, kwaye ngokufanelekileyo, ngoDisemba 2014, i-United States ye-Preventional Services Task Force (USPSTF) ikhuphe iziphakamiso ezintsha zokubhengezwa kokuxilongwa komfutho wexinzelelo, ugqugquzela oogqirha ukuba bangazithembeli kuphela kwiimilinganiselo zeofisi ukwenzela ukuba baxilongwe .
Kunoko, uthi i-USPSTF, oogqirha kufuneka baqaphele ukunyanzelisa ukunyanzelwa kwengcinezelo yegazi (ABPM) ukuqinisekisa ukuxilongwa ngaphambi kokuba enze isigulane kwi-antihypertensive treatment.
I-ABPM irekhoda iimfuno ezininzi zegazi kwiingxelo ezingama-24 (okanye 48).
Ngo-ABPM, ngumyinge wegazi ophakathi kwexesha lonke elibalulekileyo. Ixabiso legazi lexabiso eliqhelekileyo lisetyenziselwa ukuchonga ukuba i-hypertension ikhona. I-ABPM iqwalasela ukuba ixinzelelo legazi ngokuqhelekileyo liguqukayo kakhulu . I-ABPM ibonise ukuba iyisisombululo esisebenzayo sokubona ubungakho okanye ukungabikho komfutho wexinzelelo, ngokuchanekileyo kunokuba kungenziwa ngokubanzi kwiofisi yoogqirha. Nangona kunjalo, i-ABPM iyanzima kwaye iyabiza ukuyisebenzisa, kwaye, ngokubaluleke ngakumbi, i-ABPM ayizange ibe yinto eqhelekileyo yezenzo zoogqirha. Kukho ukungafuneki ukukhawuleza - ukuba kungenjalo ukuchasene ngokuthe ngqo - kwimiba yoogqirha kunye nabahlawuli ngokusasazeka kwe-ABPM.
Yiyo apho iHBPM ifika khona
Uhlolo lwengcinezelo lwegazi lwasekhaya, ngokuthethileyo, alukwazi ukunika umlinganiselo wenyinya wegazi ngaphezulu kweyure ezingama-24 njenge-ABPM. Kodwa inokunika amanani amaninzi ngemini - kwaye loo milinganiselo ingaqhutyelwa iintsuku eziliqela, okanye kwiiveki ezimbalwa. Ngoko, njenge-ABPM, i-HBPM ivumela ukulinganisa "umyinge" wexinzelelo lwegazi phezu kwexesha elide.
Ngoxa i-HBPM ingazange ihlolwe kwizifundo zekliniki njengoko i-ABPM iqhutywe ngamandla, uphando luye lwabonisa ukuba ixabiso loxinzelelo lwegazi elifunyenwe ne-HBPM lihambelana kakuhle kunye nexabiso elitholwe ne-ABPM-kwaye lichanile ngakumbi kunomlinganiselo wegazi owenziweyo kwiofisi yegqirha.
Ngoko ke, ngelixa i-HBPM ingeyona inxalenye esemthethweni yeengcomo ze-USPSTF, i-USPSTF iqinisekisa ukuba i-HBPM inokuthi ithathe indawo engafanelekanga kwi-ABPM-kungcono, nokuba kunjani na, kunokulinganisa uxinzelelo lwegazi kwiofisi yegqirha.
HBPM Yenzani?
Ukufumana umlinganiselo wempembelelo yegazi nge-HBPM, ngokuqhelekileyo kucetyiswa ukuba isiguli (xa uhleli ngomoya othulekileyo) kufuneka sithathe imilinganiselo yegazi lembini enye okanye emibini imizuzu, kokubili kusasa nangokuhlwa, ngokupheleleyo kwengcinezelo yegazi le-4 imilinganiselo ngosuku. Oku kufuneka kwenziwe ngeentsuku ezintathu ukuya kwezixhenxe ezilandelelanayo. Imilinganiselo emine efunyenweyo ngosuku lokuqala iyaxoshwa (ukuvumela ukuba i-curve yokufunda, kunye nokwenyuka kwee-jitters zangaphambili), kwaye yonke imilinganiselo yexinzelelo yegazi ihlaziywe kunye.
Isiphumo sisilinganiselo somlinganiselo wegazi wegazi.
I-HBPM Isisombululo Sengcinezelo Yegazi Ichazwe njani?
Uxinzelelo lwexinzelelo luvame ukufunyaniswa ukuba umbane wegazi ophakathi we-HBPM ukhulu kune 135 mm Hg systolic, okanye ngaphezulu kwe-80 mm Hg diastolic.
I-HBPM Enye Yayisebenzisa Njani?
I-HBPM ingaba luncedo kakhulu kwizigulane eziye zafumanisa ukuba zinegazi eliphezulu. Ngexesha elilandela uxinzelelo lwegazi kunye ne-HBPM, ngokwenza olunye umlinganiselo wenyxwaxhelelo lwegazi zonke iinyanga ezimbalwa, yindlela efanelekileyo yokuvavanya ukwanela kolwaphulo oluchasayo. Ucwaningo luye lwabonisa ukuba izigulane ezixinzelelekileyo ezisebenzisa i-HBPM ukujonga unyango lwabo zivame ukufezekisa ukulawula uxinzelelo lwegazi olungcono kunokuba izigulane zilandelwe kuphela "ngokuqhelekileyo" (oko kukuthi, kwi-ofisi).
Kunzima kangakanani iHBPM?
I-HBPM ayikho nzima kuninzi kubantu. Ngamanye amacebo oxinzelelo lwegazi lwangoku-othomathikhi lwekhaya, phantse nabani na onokufundiswa ngokulula ukwenza i-HBPM.
Okukwintsusa
Ngenxa yokuqaphela ukukhula ukuba imilinganiselo yexinzelelo yegazi ingabangela ingxaki, kwaye kunikezelwa ubunzima obunzima kunye neendleko ze-ABPM njengesongezelelo kwimilinganiselo ye-ofisi, kubonakala sengathi kusasaza oogqirha abaninzi kunye nezigulane ziza kwamkela i-HBPM njengoko indlela ekhethiweyo yokuqinisekisa ukuxilongwa komfutho wexinzelelo, kunye nokuncedisa ulawulo loxinzelelo lwegazi. Ukuba unogxininiso, okanye ukuba ugqirha wakho ucinga ukuba unakho, i-HBPM yinto enokufuna ukuxoxa ngayo naye.
Imithombo
I-Verberk WJ, iKroon AA, iKessels AG, kaLeeuw PW. Umlinganiselo wexinzelelo lwegazi: uhlolo oluhlelekile. J Am Coll Cardiol 2005; 46: 743.
Asayama K, Ohkubo T, Kikuya M, et al. Ukubikezelwa kwesithintelo ngokwemilinganiselo yokuzixinzelela kwegazi ekhaya ngokubhekiselele kwisicatshulwa soxinzelelo lwegazi ngokubhekiselele kwiCandelo leSizwe elihlangeneyo 7 isifundo se-Ohasama. Stroke 2004; 35: 2356.
Niiranen TJ, Hänninen MR, Johansson J, et al. Uxinzelelo lwegazi oluxhomekeke kwikhaya luyingozi kakhulu yongcinezelo lweengqondo kunokuba uxinzelelo lwegazi lwakhiwo: i-Finn-Home study. Uxinzelelo lwe-2010; 55: 1346.