Uxinzelelo lwegazi oluphezulu luqhelekileyo kubantu abadala abadala xa kuthelekiswa namaqela amancinci, kodwa akufanele iphathwe njengengxenye eqhelekileyo yokuguga. Iimitha ze-arteries ziba nzima kwaye zingathobeli kangangoko njengoko sibudala. Oku kubangela ukunyanzeliswa kwegazi lwe-systolic ephezulu, nangona i-diastolic yegazi igxininisa kubantu abaphakathi kweminyaka engama-50 no-60. "Uxinzelelo lwe-pulse" nguhluko phakathi kwe-systolic ne-diastolic yegazi.
Umngcipheko wesifo senhliziyo usanda njengoko ukunyuka kwengcinezelo kwandisa.
I- hypertension yama-systolic asebekhulile yayisetyenziselwa ukubizwa ngokuba yi "sysilic hypertension," echazwe ngumxinzelelo wegazi ophezulu ngaphezu kwe-160 mm Hg ne-blood pressure ye-diastolic engaphantsi kwe-90 mm Hg. kwizigulane ezingaphezu kweminyaka engama-50, nto ibalulekileyo kuba yinto ebalulekileyo yengozi yesifo senhliziyo kunye nesifo sokuqhathaniswa nokubetheka ngokuthelekiswa nezinye iindidi zengcinezelo eyintloko. ezinemibhobho engathobeliyo, iingcali zonke ziyavuma ukuba kubalulekile ukuqhubeka nokujolisa kwixinzelelo lwegazi oluqhelekileyo kubantu abadala.
Ukubaluleka kweNyango yokuXhatshazwa kweGciwane kwi-Elderly
Kukho imiba emininzi kwiindawo ezigugile okanye ukuguga okwenza ukulawula uxinzelelo lwegazi kubaluleke ngakumbi:
- Umngcipheko wokwanda kweziganeko zengqondo zifaniswa nezigulane ezincinci ezineengxaki ezifanayo.
- Uxinzelelo lwegazi lwe-Systolic luya kuba luphakamileyo, kunye nexinzelelo lwengqondo eliqhelekileyo eliqhelekileyo kule ndawo.
- Izigulane ezigugile zinemiphumo ephezulu yezinye iimeko zonyango kufuneka ziqwalaselwe xa ukhetha imishanguzo yegazi yegazi.
- Uxinzelelo lwengqondo luchaphazela ukuqonda ngokungafanelekanga nakwiminyaka ephakathi kwabantu abadala. Kukho kubonakala kubunxulumano phakathi kwegazi legazi kunye nomqondo wokugula ngengqondo. Izifundo ezininzi ziye zabonisa ukuba izigulane ezinyangwa ngamachiza angama-antihypertensive zinomngcipheko omncinci wokuphuhliswa kwengqondo, ukuphazamiseka kwengqondo kunye ne-atrophy yengqondo. Ukunyanga kwexesha elide loxinzelelo lwegazi oluphezulu kunciphise umngcipheko we-Alzheimer's dementia kunye nengqondo ye-vascular dementia.
Uxinzelelo oluphezulu lwegazi luyinto ebalulekileyo yengozi yesifo se-vascular kuzo zonke iintlobo kunye nokufa. Izifundo ezininzi zibonise ukuba izigulane ezinophezulu lwegazi eliphezulu zineenkcukacha ezincinci zokubethelwa, ukufa ngenxa yesifo, ukuhlaselwa yintliziyo, nezinye iziganeko zentliziyo, ukufa kweemeko zentliziyo kunye nazo zonke izizathu zokufa kwabantu. Uhlalutyo lwe "manani afunekayo ukunyanga," ebonisa ukuba bangaphi abantu kufuneka baphathwe ukuze umntu onokuzuza kwonyango, ubonisa ukuba abadala abangaphantsi kwekhulu bafuna ukuphathwa ngexinzelelo lwegazi eliphezulu ukukhusela omnye umntu ufumana umphumo obalulekileyo njengesihlungu okanye isifo senhliziyo. I-NNT ingumlinganiselo wexabiso / inzuzo yonyango. I-NNT ehambelana nokunyanga kwengcinezelo yegazi kubantu abadala abadala ibonisa ukuba unyango lwegazi luyinkcitho ngokugqithiseleyo ngexesha elide, ekubeni unyango lunokuthintela imimangaliso enobungozi enokuthi yonyango kwaye ingabangela ukulahlekelwa okukhululekile kokuzimela.
Yintoni Abafanele Bakhulile Abaxinzelelweyo Ngokwenza Ukuphucula Amanani Abo?
Indlela yokuphila iinguqulelo ezinciphise uxinzelelo lwegazi, kodwa akucaci ukuba bayayinciphisa le miba. I-DASH (Indlela Yokutya Yokumisa I-Hypertension) ekudleni kuyasebenza ekunciphiseni uxinzelelo lwegazi lwe-systolic kubantu abadala, kuba kubonakala ukuba banokuphendula ngakumbi kwimiphumo ye-sodium (ityuwa) kwizidlo zabo. Abantu asebekhulile abakhutheleyo banokuzuza kwindlela yokuvuthwa kwengqondo kunye nezinye iziphakamiso zendlela yokuphila, kubandakanywa ukuyeka ukucinywa kocuba kunye nokumodareyitha kokusetyenziswa kotywala, kusebenza kuwo onke amaqela.
Unyango lwexinzelelo lwegazi kubantu asebekhulile kufuneka uthathe ezinye iimeko:
- Ukunciphisa uxinzelelo lwegazi kubonakala kubaluleke ngaphezu kokusetyenziswa kweklasi ethile yeziyobisi.
- Unyango oluneeyeza ezinqamlekileyo luyanciphisa umngcipheko wokunyuka kwengcinezelo yegazi ephezulu ngamaphesenti angu-94.
- Ukungaphumeleli kwintliziyo, edla ngokubangela ukunyamezela kwengcinezelo yegazi engapheliyo, kuboniswe ukunciphisa ngamaphesenti angama-42 kwizigulane ezithe zakuba zixinzelelo lwegazi oluphathwa ngamachiza xa kuthelekiswa nalabo babenomfutho wegazi ophezulu ongapheliyo.
- Uxinzelelo oluphezulu lwegazi lunokubangela isifo sezintso, kodwa uphando olukhulu lubonisa ukuba ukunciphisa uxinzelelo lwegazi kusebenze ngakumbi kunokuguqulwa kokutya kwinqanaba lomngcipheko.
Uxinzelelo lwegazi olujoliswe kuBantu abadala
Nangona izikhokelo zamanje zoluntu ngokubanzi zibonisa injongo yexinzelelo lwegazi elingaphantsi kwe-140 mm ye-Hg systolic kunye ne-diastolic yomsindo wegazi ngaphantsi kwe-90 mm Hg, ukujoliswa kwezigulane ezisebekhulile kufuneka kube ngumxhesho wegazi we-systolic ngaphantsi kwe-150 mm Hg kunye negazi lwe-diastolic ngaphantsi kwama-90 mm Hg. Kwizigulane ezigugile ezineesifo seswekile okanye isifo esingasigxina sesifo, injongo yokunciphisa uxinzelelo lwegazi kufuneka ibe yomsinga wegazi we-systolic ngaphantsi kwama-140 mm Hg. Izigulane ezigugile ezinokuthi zilungele kwaye ziphilile zinokuqwalasela ithagethi yegazi phantsi kwe-140 mm Hg.
Injongo yonyango yokuxinzelelo lwegazi ifumaneka kuphela kuma-70 ekhulwini kwabasebekhulile abafumana unyango lwexinzelelo lwengqondo, kodwa izifundo zibonise iingenelo ezintle ngonyango, nangona iinjongo zengcinezelo yegazi ingaphumeleli. Ezi nzuzo ziquka ukunciphisa umngcipheko wokubethwa kwesigxina kunye ne-ischemic ishawulwe kwaye ukunciphisa i-4.4 ekhulwini kwintliziyo.
Ngaba bonke abantu abadala kunye neengcinezelo zegazi eziphezulu baphathwe ngemithi?
Nangona utshintsho kwindlela yokuphila, njengokulahleka kwesisindo, ukunciphisa ityuwa, kunye nokuzivocavoca, luncedo, empilweni yangempela kubonakala ukuba ukuguqulwa kwendlela yokuphila ayisoloko iqhutyelwa ngokuqhubekayo ngendlela yokuvumela izigulane ezidala ukuba zibone izibonelelo. Ukuguqulwa kwendlela yokuphila ayisoloko yenziwa lula kubantu abadala kwaye ingaba yindleko, xa abacebisi bezondlo zokuqeqeshwa, abavoti beengcali kunye neendleko zokuhamba, phakathi kwezinye izinto, ziqwalaselwa.
Kubalulekile kuzo zonke izigulane ezinexinzelelo lwegazi eliphezulu ukuba ziphile ngendlela ephilileyo, kodwa akukho ubungqina bobuxoki bokuthi le nyathelo inefuthe elikhulu ekunciphiseni umngcipheko we-sequelae yonyango ephezulu kwixinzelelo legazi kubantu abadala. Uphando lubonisa ukuba ukusebenzisa imishanguzo yegazi ephezulu kusebenza ngakumbi ekunciphiseni imicimbi ye-cardiovascular.
Ngokuqhelekileyo, abantu abaneengxaki ezinobungozi besifo se-cardiovascular disease, nokuba yintoni ubudala babo, kufuneka baphathwe ngesichengiselwano ukuze bahlangabezane noxinzelelo lwabo lwegazi. Ngesinye isikhathi, kwakukho ukwamkelwa kwesigqibo sokuyeka unyango kwizigulane ezingaphezu kweminyaka engama-79, kodwa ubungqina bubonisa ngokucacileyo ukuba iziphumo, kubandakanywa izibetho, isifo senhliziyo, kunye nentsikelelo yokuphelelwa yintliziyo, zibi kakhulu kwizigulane ezingaphathwa , nangomnyaka weshumi elinesithoba wobomi.
Isidakamizwa esiphezulu se-antihypertensive drug for a Elderlyly Person With High Pressure Pressure
Ngokuqhelekileyo, amachiza afanayo anconywayo kubemi jikelele ngokuqhelekileyo afanelekileyo kumntu osekhulile. I-ALLHAT isilingo (Ukwelashwa kwe-Antihypertensive and Liping-Lowering Treatment to Prevent Heart Attack) yabonisa ukuba i-alpha-blockers inxulumene nomngcipheko omkhulu wemicimbi ye-cardiovascular like the failure of heart compared to other classes. Nangona kunjalo, kwizigulane ezininzi ezisebekhulile ezinezifo zonyango, iingcali zivumile ukuba ukunyangwa kufuneka kube ngabanye ngokusekelwe kwiimfuno zesigulane.
Iingxaki zonyango ezifana nesifo sesifo, isifo sesifo seswekile, isifo sikashukela, i-osteoporosis, kunye nokungaphumeleli kwentliziyo kuya kuchaphazela ngqo ukukhethwa kwezilwanyana ezisetyenziselwa ukulawula uxinzelelo lwegazi, ingakumbi xa enye imeko ingaphathwa kunye neziyobisi ezifanayo ezisetyenziselwa uxinzelelo lwegazi. Iimeko ezininzi zezogulana kwizigulane ezigugile zidinga iingcebiso zobuchwephesha kwiinkliniki ukufumana ukuba imishanguzo yonyango yegazi iya kuhambelana njani neemfuno zomntu.
Umxinzelelo ophezulu wegazi unokuba nzima kunzima ukulawula kumntu omdala kwaye ngaphezulu kwesinye isilwanyana sisoloko sichazwe. Oku kunokubangela "i-hypotension" ye-orthostatic, okanye ukuwa kwexinzelelo lwegazi xa usuka kwindawo ehleli okanye ehleli kwindawo yokuma. Kubaluleke kakhulu ukulinganisela uxinzelelo lwegazi lomntu omdala xa bemi ukuqiniseka ukuba akuyi kuba phantsi kakhulu kwaye kubangela ukuphelelwa ngumzimba okanye ukutyhafaza. I-Orthostatic hypotension yingozi enkulu yokuwela kubantu asebekhulile kwaye kuba izigulane ezithe zahlala zihlala zithatha iindidi ezininzi zamachiza, zingaphinde zisebenzisane kwaye zandise olu hlobo lomphumo.
I-American Geriatrics Society incoma ukuhlolisisa ubuthathaka kubantu abadala ukuba bachaze nayiphi na ingozi ejongene nokunyangwa kwengcinezelo yegazi, kuquka neengozi zokuwa kunye nokukhathala. Uninzi lweengcali ziyavuma ukuba ukunciphisa uxinzelelo lwegazi kunye namayeza kwizigulane ezigugile kufuneka zenzeke ngokukhawuleza, ngokunyuka kweepayipi. Nangona izikhokelo zengcinezelo yegazi zibonisa ukuba ziqala izidakamizwa ezimbini ezahlukileyo xa uxinzelelo lwegazi luqala ngaphezu kwe-20 mm Hg phezu kwelitshe, elinye ilinga kufuneka liqaliswe ngokukhawuleza ngaphambi kokuba ungeze iziyobisi ezahlukeneyo.
Ezinye izinto
Njengoko sibudala, silahlekelwa ngumzwelo wokuqonda , ukuze abantu abadala baye banqumla ukutya kwabo ngaphandle kokuqonda ukuba bayandisa ingozi. Ukulala kwe-apnea kudibene nokuphuhliswa komfutho wexinzelelo, ngoko kuyacaca ukuthetha ukulala okungaqhelekanga kwimini okanye ukuziva ukukhathala xa ukhangela ugqirha wakho.
Njengabantu bethu bemihla, siya kuqhubeka sibona inani elikhulayo labantu abahlala kwi-9 okanye iminyaka elishumi elinesibini yobomi. Kubantu abangaphezu kweminyaka engama-60, ukuya kuma-80 ekhulwini kuya kutshatyalaliswa yingozi yengozi. Abantu abadala abakwazi ukunyusa nokuphucula umgangatho wobomi ngokunciphisa umngcipheko wesifo, ukuhlasela kwentliziyo, ukungaphumeleli kwentliziyo, nokufa ngokulawulwa kwegazi. Iziphakamiso zeSizwe soMbutho weSizwe (JNC8) zinikezele ubungqina obuninzi obufumaneka kwiingcebiso zabo zokulawula uxinzelelo lwegazi.
ILizwi
Ukunyangwa kwengcinezelo yegazi ephezulu kunokwandisa ubomi bakho kwaye kunciphise imingcipheko enkulu enobungozi okanye ukuhlasela kwentliziyo. Izigulane ezindala zizuzisa ngaphezu kwezigulane ezincinci kunyango lwegazi. Kwakhona banokuthi babe nezinye iimeko zonyango kwaye banokuba neengozi eyongeziweyo yemiphumo emibi yeyeza. Ukuba ungumntu omdala onomfutho wegazi ophezulu, kufuneka uqhagamshelane neengcali zonyango olwaziyo malunga nophatho lwayo. Uqeqesho olufanelekileyo lwezempilo luya kuba nolwazi olubanzi lwemingeni ejongene nokuguga kunye neengxaki ezininzi zezokwelapha ezidityanisiweyo kwiindawo ezikhulile.
> Imithombo:
> I-American Academy yooNtsapho beeNtsapho. (2014). I-JNC 8 Izikhokelo zoLawulo lwe-Hypertension kubantu abadala. U-Am Fam ugqirha , 90 (7), 503-504.
> Franklin SS, Gustin W 4, Wong ND, et al. Iipateni ze-Hemodynamic zenguqu ezinxulumene neminyaka kwixinzelelo legazi. I-Framingham Heart Study. Uhambo luka-1997; 96: 308.
> James PA, Oparil S, Carter BL, Cushman WC, uDennison-Himmelfarb C, uMphathiswa J, uLackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS , U- Ortiz E. 2014 Isikhokelo soBungqina boBungqina beCandelo eliPhezulu lokuPhepha kweGalelo kuBantu abadalaBika kwiiNdibano zePhaneli eziqeshwe kwiKomiti yeSizwe yeSizwe eYisibhozo (JNC 8). JAMA. 2014; 311 (5): 507-520. i-doi: 10.1001 / jama.2013.284427
> I-Mahajan R. I-National Joint Committee 8 ingxelo: Yeka njani ihluke kwi-JNC 7. I- International Journal ye-Applied and Basic Medical Research . 2014; 4 (2): 61-62. i-doi: 10.4103 / 2229-516X.136773.
> Patel MD, A. (2015, Februwari 20). Kwi-Hypertension kwi-Elderly: i-Epidemiologic Shift-i-American College yeCarology. Ukufunyanwa kwi-http: //www.acc.org/latest-in-cardiology/articles/2015/02/19/14/55/on-tension-in-the-