Uninzi lwabantu abangaphezu kweminyaka yobudala engama-65 banomfutho wegazi ophezulu ( uxinzelelo oluphezulu lwegazi), eyona nto ibangela ingozi enkulu yokugula, isifo se-coronary disease (CAD), ukungaphumeleli kwentliziyo kunye nesifo sesifo.
Kubaluleke kakhulu ukuba abantu abadala kunye nabantu abaselula banokuphathwa ngophezulu. Kodwa abaninzi abantu abadala bajamelana nemingeni ekhethekileyo emibini ekuphumezeni ukulawulwa kwengcinezelo efanelekileyo yegazi. Okokuqala, abaninzi babo banesifo sengqondo somfutho wegazi ophezulu.
Okwesibini, abantu asebekhulile bahlala benzima ukunyamezela unyango olushushu.
I-Systolic Hypertension kwi-Elderly
Uninzi lwabantu abadala abanesifo sengqondo esiphezulu banokuphakama kwi-systolic blood pressure yabo, ngelixa uxinzelelo lwabo lwe-diastolic luhlala luqhelekileyo okanye luqhelekileyo. Oku kungenxa yokuba njengoko sikhulile, iimitha zethu zegazi ziba "zincinci," ngoko uxinzelelo lwegazi lwe-systolic (uxinzelelo kwimibhobho ngexesha i-heart muscle ibetha) iya kunyuka. Uxinzelelo lwegazi lwe-systolic lwama-140 mm Hg lubonwa njengomlinganiselo ophezulu oqhelekileyo.
Ngaphezu koko, kubantu abangaphezu kweminyaka yobudala engama-65, uxinzelelo oluphezulu lwe-systolic lwegazi lwandisa ingozi ye-cardiovascular more than a high pressure diastolic. (Okuphambene nenyani kubantu abancinci.) Enyanisweni, ingozi yomshumbuliso we-systolic ngaphezu kokuphindaphinda umngcipheko wokuhlaselwa kwintliziyo kunye nesifo. Ngoko unyango lwe-hypertension kubalulekile.
Kodwa ukuphathwa kwengcinezelo ye-systolic ingabonisa ingxaki ekhethekileyo: kukuthi, ekunciphiseni uxinzelelo lwegazi lwe-systolic, kubalulekile ukuba ungadluli ngexesha elifanayo uxinzelelo lwegazi lwe-diastolic kakhulu.
Oku kuba kubadala abantu abane-CAD, ukunciphisa uxinzelelo lwe-diastolic ngaphantsi kwe-60 okanye i-65 mm ye-Hg inxulumene nokunyuka kwintliziyo kunye nokubetha.
Ngoko ukukhohlisa ukunyanga kwengxube ye-systolic kukunciphisa uxinzelelo lwe-systolic ukuya ngaphantsi kwama-140 mm Hg - okanye malunga ne-140 mm Hg ngangokunokwenzeka-ngelixa ugcina uxinzelelo lwe-diastolic ngaphezu kwe-60 okanye i-65 mm Hg.
Unyango lwe-Hypertension Treatment kubantu abadala
Njengomnye umntu onomfutho wegazi ophezulu, isinyathelo sokuqala sokunyanga uxinzelelo lwegazi kubantu abadala, kukuqalisa ukuguquka kwezinto zokuphila ezinokunciphisa uxinzelelo lwegazi, kuquka ukulahleka kwesisindo, ukuthintela ityuwa, ukuzivocavoca kunye nokuyeka ukutshaya.
Ukuba uxinzelelo lwegazi luhlala luphakanyisiwe emva kwenyanga okanye ezimbini zokuguqulwa kwendlela yokuphila, ugqirha wakho mhlawumbi uya kuncomela unyango lweziyobisi.
Kubantu asebekhulile, ukusebenzisa iziyobisi ezikhuselekileyo kunokukhuseleka. Akufuneki kuphela ukunyamekela ukuba kuthintele ukunciphisa uxinzelelo lwe-diastolic, kodwa abanye abantu abadala, ngokukodwa abo banomdla wokuxinzelela kwi-systolic, bangakwazi ukuvelisa i -hypotension ( or fall) kwi-blood pressure. I-postprandial hypotension (ukuwa kwexinzelelo lwegazi emva kokutya) kunokubonakala kubantu asebekhulile kwimishanguzo yonyango. I-Hypotension - nayiphi na into enokubangela yona-inokukhokelela ekumeni kunye nokuwa, kwaye kufuneka kugwenywe.
Ngoko igama lomdlalo kukuhamba ngokukhawuleza ukwenzela ukuba ugweme imiphumo emibi. Xa uqalise imishanguzo yomsinga wegazi kubantu asebekhulile, kufuneka kusetyenziswe isicatshulwa esisodwa, kwaye kufuneka siqalwe kwiqondo elisezantsi - rhoqo, kwiqondo elithatha isiqingatha somthamo onokusetyenziswa kwisigulane esincinane.
Uphulo luvame ukuqala nge- thiazide diuretic , i-calcium blocker ende ende okanye i-ACE inhibitor. Ukuba izilwanyana zinyanzeliswe ngaphandle kwemiphumo emibi, i-dosage inganyuswa emva kweeveki ezimbalwa ukuba kuyimfuneko. Ukuba i-dose ephezulu isengaphumelelanga kakuhle ukulawula uxinzelelo lwegazi, oogqirha abaninzi baya kutshintshela kwiyeza ezahlukileyo , kunokuba bongeze isilwanyana sesibini. Ukusetyenziswa kweyeza kweziyobisi ngokuqhelekileyo kusetyenziswa kuphela kuphela xa iinzame ezininzi zonyango lonyango lingenalo.
Emva kwayo nayiphi na utshintsho kwonyango - ukwandisa umthamo weziyobisi, ukutshintsha kumachiza ahlukeneyo, okanye ukongeza iyeza lesibini - ugqirha wakho kufuneka ahlole ngokucophelela i-hypotension ye-orthostatic.
Oku kwenziwa ngokulinganisa uxinzelelo lwegazi ngelixa ulele phantsi, kwaye ngoko xa usukuma, ngelixa ukhangele ukuhla kwexabiso elikhulu. Kwakhona kubalulekile ukuba uxelele ugqirha wakho malunga naluphi na utywala onokufumana xa usukuma, okanye emva kokutya.
Injongo kukuzisa ingcinezelo yakho yegazi ngokubhekiselele kumanqaku ekujoliswe kuwo, ngaphezu kweeveki okanye kwiinyanga (kuneentsuku) ngeli xesha uzinyamekile ngeli xesha ukuphepha ukunciphisa uxinzelelo lwegazi. Ukufezekisa le njongo kaninzi kuthatha izilingo ezininzi ngeyodwa okanye ngaphezulu kweziyobisi kunye nokuhlengahlengwa kwamanani amaninzi.
Isishwankathelo
Ukuba ungumntu okhulile, amathuba kukuba unesondlo soxinzelelo. Nangona ugxininiso lwengcinezelo luyingxaki ebalulekileyo, kwaye ngelixa ukuphathwa kwalo kungabangela imingeni, kusekhona nangona unomdla kunye nomonde (kwinqanaba lakho kunye nogqirha wakho), kukho ithuba elihle lokuba lwakho uxinzelelo luya kulawulwa ngaphandle iziphumo ezinobungozi, kunye nomngcipheko weengxaki ezinzulu zeengqondo ziya kuncitshiswa kakhulu.
Imithombo:
Aronow WS, Fleg JL, uPepine CJ, et al. I-ACCF / AHA 2011 ingqungquthela yobungqina bexinzelelo lwengqondo kwi-asebekhulile: ingxelo ye-American College of Cardiology Foundation Task Force kwiiNkcukacha zoLwazi lweeNtsholongwane. Ukuhamba ngo-2011; 123: 2434.
AV Chobanian. Ukusebenza kwezonyango. Ukuxinzelela kwi-systolic hypertension ekhulile. N Engl J Med 2007; 357: 789.