So ɛsɛ sɛ wohwɛ wo mogya mmoroso da mũ no nyinaa? Biribiara a ɛfa Nnɔnhwerew 24 Ambulatory Blood Pressure Monitoring ho!

So woakɔ oduruyɛfo nkyɛn pɛn na wɔahwɛ wo mogya mmoroso na woaka sɛ, "Oh, ɛte sɛ nea me mogya mmoroso kɔ soro kakra"? Saa bere no, ebia wubesusuw sɛ, "Oh, mehwɛɛ mu wɔ fie, nanso ɛnkɔ soro saa." Eyi ne bere a ɔkwan titiriw bi a yɛrebɛka ho asɛm betumi aboa yɛn. Wɔfrɛ eyi nnɔnhwerew 24 a wɔde hwɛ mogya mmoroso, anaasɛ wɔ Borɔfo kasa mu no , mogya mmoroso a wɔde nantew . Ma yɛnhwɛ nea ɛyɛ, sɛnea wɔyɛ, ne onii ko a ɛho hia wɔn.

Dɛn ne eyi wɔ wo mogya mmoroso a wobɛhwɛ da mũ nyinaa no ho?

Sɛ yɛbɛka no tiawa a, eyi yɛ ɔkwan a wofa so kɔ so susuw wo mogya mmoroso , anaa mogya mmoroso, wɔ nnɔnhwerew 24 mu, bere a woreyɛ adwuma sɛnea ɛsɛ, woda, ne bere nyinaa. Hypertension yɛ bere a wo mogya mmoroso dodow a ɛwɔ soro, anaa systolic pressure , yɛ 130 mmHg anaa nea ɛboro saa, ne/anaasɛ dodow a ɛwɔ ase, anaa diastolic pressure , yɛ 80 mmHg anaa nea ɛboro saa.

Mpɛn pii no, bere a wokɔ oduruyɛfo nkyɛn nkutoo na wobɛhwɛ wo mogya mmoroso. Wɔde afiri bi a wɔfrɛ no sphygmomanometer a wɔde bata wo nsa ho na wɔpiapia no na ɛyɛ eyi. Nanso wɔ ɔkwan a wɔfa so nantew yi mu no, wode nsateaa hyɛ wo nsa ne afiri ketewaa bi a wɔde bata abɔso anaa abɔso ho nnɔnhwerew 24 da biara. Saa afiri yi susuw wo mogya mmoroso simma 15-30 biara awia ne simma 60 biara anadwo. Ebetumi asusuw wo koma bɔ nso , a ɛno ne sɛnea wo koma bɔ ntɛmntɛm no. Oduruyɛfo no de saa nsɛm yi di dwuma de hwehwɛ sɛnea sɛ wɔkyekyem pɛpɛɛpɛ a, wo mogya mmoroso yɛ wɔ nnɔnhwerew 24 no nyinaa mu, nsakrae a ɛba wo mogya mmoroso mu, ne nsakrae a ɛba wɔ koma a ɛbɔ mu.

Dɛn nti na wɔde saa kwan yi di dwuma?

Nneɛma pii nti na nnuruyɛfo de saa kwan yi di dwuma. Momma yɛnhwɛ emu atitiriw no bi:

• Si Hypertension tebea no so dua: Ɛtɔ mmere bi a, oduruyɛfo nkutoo na obetumi ahu mogya mmoroso. Saa kwan yi so no, wubetumi ahu no yiye sɛ ebia wowɔ mogya mmoroso ampa anaa.
• Hwɛ sɛnea wo mogya mmoroso sesa wɔ wo da biara da dwumadi ne nna mu: Mpɛn pii no, sɛ yɛda a, mogya mmoroso dodow a ɛwɔ soro (systolic) no so tew bɛyɛ 10% - 20%. Nanso eyi to obiara. Ebinom fam no, ebetumi atra hɔ sɛnea ɛte no ara anaasɛ ɛbɛkɔ soro.
• Hwɛ sɛ wo mogya mmoroso aduru no reyɛ adwuma yiye anaa: Ebia wo mogya mmoroso aduru no ntumi nni wo mogya mmoroso so da mũ no nyinaa. Ebia wo duruyɛfo betumi ayɛ nsakrae wɔ dodow a wode di dwuma no mu, asesa bere a wode nom no, anaa wama wo aduru foforo a wode besiw wo mogya mmoroso so.
• Kyerɛ nsonsonoe a ɛda nhyɛso a oduruyɛfo no hwɛ ne nhyɛso a wowɔ wɔ fie no ntam:Nsakrae ahorow yi betumi ama woanya asiane a ɛwɔ hɔ sɛ wubenya koma ne ntini mu yare no ho adwene bi .

Saa kwan a wɔfa so hwɛ mogya mmoroso a wɔde nantew so yi betumi ahu nsakrae a ɛnteɛ a ɛba mogya mmoroso mu a ebia akwan foforo renhu.

Nhyɛso nhyehyɛe ahorow a wobehu

Sɛ oduruyɛfo no de saa kwan yi di dwuma a, obetumi ahu nhyɛso ahorow. Ma yɛnhwɛ nea wɔyɛ.

Dɛn ne ‘White Coat Hypertension’?

Fa no sɛ, nnipa bi wɔ hɔ a wɔn mogya mmoroso yɛ nea ɛfata wɔ fie, nanso sɛ wɔkɔ oduruyɛfo anaa ayaresabea a, wɔn mogya kɔ soro. Ɛte sɛ nea sɛ wuhu oduruyɛfo bi atade fitaa a, wo mogya kɔ soro. Ɛno nti na wɔfrɛ no ‘White Coat Hypertension’ anaa ‘White Coat Syndrome’. Esiane eyi nti, obi a onni mogya mmoroso ankasa mpo betumi adi mfomso asusuw sɛ ɔwɔ mogya mmoroso. Nnipa a wɔda mogya mmoroso adi wɔ oduruyɛfo adwumayɛbea no mu 10% kosi 30% betumi anya saa tebea yi.

Mprempren akwankyerɛ ahorow nkamfo nnuru nkyerɛ sɛ wo mogya mmoroso yɛ nea ɛfata wɔ wo duruyɛfo adwumayɛbea akyi denam ɔkwan a wɔfa so kɔ ayaresabea akyi yi so a. Nanso, nhwehwɛmu foforo ho hia wɔ asɛm yi ho. Esiane sɛ ‘white coat hypertension’ nso betumi ayɛ mogya mmoroso ho haw ho sɛnkyerɛnne ntɛm nti, ɛho hia sɛ wo ne wo duruyɛfo no hu eyi.

Ntini a Ɛkɔ So a Ɛkɔ So

Eyi kyerɛ sɛ wo mogya mmoroso yɛ kɛse sɛ́ ebia wowɔ oduruyɛfo adwumayɛbea, fie, anaa baabiara a wowɔ no. Nhwehwɛmu ada no adi sɛ saa tebea yi ma asiane a ɛwɔ hɔ sɛ koma ne asaabo bɛsɛe no yɛ kɛse , ne tebea horow te sɛ ɔyare a ɛma obi hwe ase nso .

'Masked Hypertension'.

Eyi ne bere a wo mogya mmoroso yɛ nea ɛfata bere a wokɔ wo duruyɛfo nkyɛn no, nanso ɛkɔ soro bere a worehwɛ mu wɔ fie anaa bere foforo no. Ɛte sɛ nea mogya mmoroso no ahintaw . Saa tebea yi betumi aka mpanyimfo a wɔn mogya mmoroso a ɛfata wɔ wɔn duruyɛfo nkyɛn no mu bɛyɛ 30%. Sɛ wowɔ asaabo mu yare , asikreyare , anaasɛ obstructive sleep apnea , wowɔ asiane kɛse mu sɛ wubenya saa ‘masked hypertension’ yi.

Nocturnal Hypertension - Mogya mmoroso a ɛkɔ soro anadwo

Eyi kyerɛ sɛ wo mogya mmoroso kɔ soro bere a woada no. Saa tebea yi ka aborɔfo 10 biara mu bɛyɛ baanu na ɛka abibifo 10 biara mu bɛyɛ baanan. Ɛtaa ba nnipa a wɔwɔ asikreyare ne asaabo mu yare so. Wɔrekɔ so ayɛ nhwehwɛmu de ahu sɛnea mogya mmoroso a ɛkɔ soro anadwo betumi aka koma ne ntini mu yare.

Henanom na saa kwan yi fata paa?

Saa kwan a wɔfa so hwɛ mogya mmoroso a wɔde nantew so yi betumi ayɛ nea mfaso wɔ so ama nnipa pii. Ebia wo duruyɛfo bɛkamfo saa kwan yi akyerɛ wɔ tebea horow a edidi so yi mu:

• Sɛnea akenkan a wɔkenkan wɔ oduruyɛfo adwumayɛbea kyerɛ no, wowɔ mogya mmoroso, nanso wunnya mfii nnuru no ase.
• Sɛ ɛho hia sɛ wosakra wo mogya mmoroso aduru a.
• Sɛ wo mogya mmoroso da so ara yɛ kɛse ɛmfa ho sɛ wonom nnuru a.
• Sɛ worenom nnuru afoforo a ebetumi aka wo mogya mmoroso a.
• Sɛ wotaa te nka sɛ wo ho yɛ wo yaw anaasɛ wo mogya mmoroso (hypotension) .
• Sɛ wowɔ mogya mmoroso bere a wonyinsɛn a.

So akenkan ahorow a efi afiri yi mu no yɛ nokware?

Yiw, koraa. Saa kwan a wɔfa so hwɛ mogya mmoroso a wɔde nantew so yi yɛ ɔkwan a edi mu na etu mpɔn yiye a wobɛfa so asusuw wo mogya mmoroso. Ɛma oduruyɛfo no nya nsɛm a eye sen sɛ wobɛkɔ oduruyɛfo nkyɛn na woahwɛ wo mogya mmoroso saa bere no nkutoo. Efisɛ ɛsusuw wo mogya mmoroso ne wo koma bɔ bere nyinaa wɔ nnɔnhwerew 24 no nyinaa mu.

Wobɛyɛ dɛn asiesie wo ho ama eyi?

Wo duruyɛfo bɛkyerɛ wo sɛnea wubesiesie wo ho ama eyi, nanso mpɛn pii no, ma nneɛma yi ntra w’adwenem:

• Paw da bi fi nnɔnhwerew 24 yi mu a ɛfata wo dwumadi a wotaa yɛ . Ebia dapɛn da ye sen dapɛn awiei.
• Yɛ nhyehyɛe kyerɛw biribiara a wobɛyɛ wɔ nnɔnhwerew 24 yi mu wɔ kyerɛwtohɔ mu , a bere a wosɔre, bere a worekɔda, bere a wonom w’aduru, bere a wudidi, ne nea ɛkeka ho ka ho Afei nso, kyerɛw sɛnkyerɛnne biara a wubehu (e.g., adwenemhaw, ahome a ɛyɛ tiaa).

Nneɛma bi nso wɔ hɔ a ɛnsɛ sɛ woyɛ wɔ nnɔnhwerew 24 yi mu:

• Mma nnyɛ apɔw-mu-teɛteɛ a emu yɛ den .
• Mma nkɔguare anaa nkɔguare.
• Mfa afiri no fã biara mfi hɔ a wommisa wo duruyɛfo.

Woyɛ dɛn yɛ eyi?

Ɛwom sɛ wɔyɛ mogya mmoroso a wɔde nantew hwɛ yi wɔ oduruyɛfo no adwumayɛbea akyi de, nanso ɛsɛ sɛ woda so ara kɔ oduruyɛfo nkyɛn ansa na woafi ase. Ɛhɔ na wunya saa mfiri ne akwankyerɛ ahorow yi.

Sɛ wokɔ oduruyɛfo nkyɛn a, dɛn na ɛba?

• Wo nsa ka nnwinnade no: Nea ɛka eyi ho ne mfiri bi a ɛte sɛ radio ketewaa bi ne cuff. Wɔde afiri ketewa no bata abɔso anaa abɔso ho. Wɔde afiri bi na ɛka cuff no ne afiri no bom.
• Oduruyɛfo no de ahama no bɛbata wo basa ho na wasiesie afiri no: Sɛ wɔde biribiara hyehyɛ mu yiye a, oduruyɛfo no befi ase akyere nsɛm agu hama so.
• Wo nsa bɛka akwankyerɛ: Oduruyɛfo no bɛma wo akwankyerɛ a emu da hɔ. Ɛsɛ sɛ wudi wɔn akyi pɛpɛɛpɛ. Bisa nsɛm biara a ebia wowɔ ansa na woafi adwumayɛbea hɔ. Saa afiri yi bɛbata wo nipadua ho bere a worefi hɔ no. Oduruyɛfo no nso bɛkyerɛ wo bere a ɛsɛ sɛ wuyi fi hɔ ne bere a ɛsɛ sɛ wode san ba.

Sɛ wodu fie a, dɛn na ɛba?

• Wo nsa so cuff no ma mframa bɔ wɔ bere a ɛfata mu:Eyi betumi asi simma 15-30 biara awiabere, ne simma 60 biara anadwo. Band no mu yɛ hyew bere a afiri no resusuw wo nhyɛso no. Wobɛte nka sɛ ɛrepiapia wo basa. Ɛtra hɔ bere tiaa bi pɛ. Wubetumi anya akenkan a edi mu denam wo nsa a wobɛma ayɛ dinn wɔ saa bere no mu no so .
• Ebia nna bɛhaw: Ebia wobɛsɔre bere a wɔresusuw mogya mmoroso anadwo no. Eyi yɛ ade a ɛfata. Nanso bɔ mmɔden sɛ wubebu w’ani agu so sɛnea wubetumi biara na woasan akɔda.
• Toa wo dwumadi a wotaa yɛ no so: Yɛ biribiara sɛnea wotaa yɛ no, gye aguare, asuguare, ne apɔw-mu-teɛteɛ a emu yɛ den. Fa da biara da nsɛm sie sɛnea wo duruyɛfo ka kyerɛ wo no.
• Fa w’aduru no sɛnea wo duruyɛfo akyerɛ wo: Bisa wo duruyɛfo sɛ ebia ɛsɛ sɛ wokɔ so nom w’aduru no bere a woresusuw mogya mmoroso yi anaa. Di saa akwankyerɛ ahorow no akyi pɛpɛɛpɛ.

Ɔkwan bɛn so na wode afiri a wɔde hwɛ mogya mmoroso da?

Ampa, ebia wobɛda ɔhaw kakra. Efisɛ ɛnyɛ wo su sɛ wode ahama bɛda wo nsa so. Nanso bɔ mmɔden sɛ wubegye w’ahome sɛnea wubetumi biara. Yɛ nneɛma afoforo a ɛbɛma wo nna ayɛ mmerɛw. Nhwɛsoɔ:

• Fa dwom a emu yɛ hare to hɔ.
• To mfɛnsere no mu na siw kanea a ɛhyerɛn no kwan.
• Ma dan no nyɛ hyew a ɛfata ma wo (ɛnyɛ hyew dodo anaasɛ awɔw dodo).

Bisa wo duruyɛfo sɛ wubetumi ayɛ nsakrae biara wɔ wo mfiri no mu bere a woada no anaa. Sɛ nhwɛso no, sɛ wubetumi ayi abɔso a ɛwɔ w’asen mu no na wode abɛn wo pillow no a. Nanso sɛ wo duruyɛfo ka kyerɛ wo sɛ yɛ saa nkutoo a. Sɛ wowɔ wo nsateaa mu ahama a, ɛbɛyɛ papa sɛ worennyi kosi saa bere yi. Wo ne wo duruyɛfo nkasa mfa nea wubetumi ayɛ na ama woada yiye ho asɛm.

Mfaso bɛn na ɛwɔ eyi so?

Saa kwan a wɔfa so hwɛ mogya mmoroso a wɔde nantew so yi yɛ adwinnade a mfaso wɔ so yiye a ɛboa wo ma wunya ayaresa a ɛfata ma wo. Mfaso a ɛwɔ saa kwan yi so no bi ne:

• Wubetumi asusuw wo mogya mmoroso pɛpɛɛpɛ: Saa kwan yi susuw wo mogya mmoroso da mũ no nyinaa, ɛnyɛ pɛnkoro anaa mprenu pɛ. Esiane sɛ mogya mmoroso taa sesa gyina da no mu bere ne nea woreyɛ so nti, eyi nkutoo ne ɔkwan a wobɛfa so asusuw wo mogya mmoroso ne sɛnea ɛte no pɛpɛɛpɛ.
• Wubetumi ahu no yiye sɛ wowɔ ‘White Coat Syndrome’: Sɛ wo mogya mmoroso kɔ soro bere a wowɔ oduruyɛfo nkyɛn nkutoo a, ɛkyerɛ sɛ wowɔ ‘White Coat Syndrome.’ Sɛ wunim saa a, ebetumi aboa wo ma woakwati sɛ wobɛnom nnuru a ɛho nhia.
• Wubetumi ahu sɛ wowɔ ‘masked hypertension’: Sɛ wo mogya mmoroso sua bere a wokɔ wo duruyɛfo nkyɛn, nanso ɛkɔ soro wɔ mmere foforo mu a, ɛkyerɛ sɛ wo mogya mmoroso a ɛfata no "asie." Eyi yɛ asiane a ɛma obi nya koma ne ntini mu yare a anka wɔrenhu. Wɔ tebea horow a ɛtete saa mu no, wo duruyɛfo betumi akyerɛw wo nnuru a ɛbɛma wo mogya so atew, na ama asiane a ɛwɔ hɔ sɛ wubenya ɔhaw ahorow te sɛ akisikuru no so atew.
• Wɔbɛkyerɛ w’ayaresa nhyehyɛe no kwan wɔ:Saa nhwehwɛmu yi boa ma wosusuw sɛnea woreyɛ w’ade wɔ mogya mmoroso nnuru a wɔde ma bere tenten ho. Wo duruyɛfo betumi ayɛ nsakrae wɔ w’ayaresa nhyehyɛe mu sɛnea ɛho hia.

So ɔhaw ahorow bi wɔ hɔ?

Ɛwom sɛ ɔkwan a wɔfa so susuw mogya mmoroso yi nyɛ nea wɔde hyɛ nipadua no mu na ɛnsɛe nipadua no de , nanso ebetumi ayɛ nea ɛnyɛ dɛ kakra ama nnipa binom. Nea enye wɔ ho ne:

• Abasa mu yaw: Abasa a ɛwɔ soro no betumi ayɛ yaw efisɛ wɔrema abɔso no mu ayɛ hyew bere nyinaa.
• Dae a ɛyɛ basaa: Sɛ wosusuw mogya mmoroso anadwo a, ebetumi asɛe nna.
• Honam ani akisikuru: Ebia abɔso no bɛma honam ani akisikuru ketewaa bi aba. Mpɛn pii no, eyi ankasa kɔ.
• Ɛka: Insurance nnwumakuw binom tua saa mfiri a wɔde nantew yi ho ka wɔ nsɛm titiriw bi mu nkutoo. Sɛ nhwɛso no, sɛ wo duruyɛfo susuw sɛ wowɔ ‘white coat syndrome’ anaa ‘masked hypertension’ a. Bisa wo duruyɛfo sika dodow a ɛbɛbɔ wo ka.

Ɔkwan bɛn so na wonya nea efi mu ba? Dɛn na wɔka?

Wo duruyɛfo bɛtwe data no afi afiri no so akɔ kɔmputa so, na ɛbɛhwehwɛ wo nhyɛso akenkan mu. Afei oduruyɛfo no ne wo bɛka nea ebefi mu aba ne nea ɛkyerɛ ma wo ho asɛm.

Nea ebefi mu aba a oduruyɛfo no betumi ne wo asusuw ho no bi ni:

• Nnɔnhwerew 24 mogya mmoroso: Eyi ne wo nhyɛso bo a wɔkyekyem pɛpɛɛpɛ wɔ bere a wɔde hwɛ ade no nyinaa mu.
• Mogya mmoroso awiabere: Eyi ne wo nhyɛso a ɛfata wɔ bere a woda no mu.
• Anadwo mogya mmoroso: Eyi ne wo nhyɛso a ɛfata wɔ nnɔnhwerew a woda no mu.
• Sɛnea wode nsu gu nsu mu anadwo: Eyi ne nsonsonoe a ɛda wo awiabere nhyɛso ne wo anadwo nhyɛso ntam. Ɛsɛ sɛ anadwo akenkan no ba fam.

Dɛn ne mogya mmoroso gyinapɛn pa a wɔde nantew?

Wobu nea edidi so yi sɛ gyinapɛn ahorow a ɛfata (papa) a wɔde hwɛ mogya mmoroso a wɔde nantew hwɛ:

• Sɛ wɔkyekyem pɛpɛɛpɛ a, nnɔnhwerew 24: 125/75 mmHg anaa nea ennu saa.
• Awiabere mu BP: 130/80 mmHg anaa nea ennu saa.
• Anadwo BP: 110/65 mmHg.
• Anadwo a wɔde wɔn ho hyɛ nsu mu: Nhyɛso a ɛso tew fi 10% kosi 20%.

Oduruyɛfo no bɛkyerɛ wo bere a wubetumi ahwɛ kwan sɛ wubehu nea ebefi mu aba no. Wɔne wo nso bɛbɔ nea ebefi mu aba no ho nkɔmmɔ na wɔakyerɛ wo nea ɛsɛ sɛ woyɛ akyi, sɛ nhwɛso no, sɛ ɛho hia sɛ wɔsesa w’aduru a wode di dwuma a.

Bere bɛn na ɛsɛ sɛ wofrɛ oduruyɛfo no?

Bere a worehwɛ nnɔnhwerew 24 bere yi no, frɛ wo duruyɛfo wɔ mmere te sɛ eyinom mu:

• Sɛ mfiridwuma mu ɔhaw bi wɔ afiri no ho a.
• Sɛ wowɔ nsɛmmisa bi fa nea ɛsɛ sɛ woyɛ anaasɛ ɛnsɛ sɛ woyɛ wɔ saa bere a wode hwɛ ade yi mu a.

Ɛmfa ho mpɛn dodow a wobɛka akyerɛ wo ho sɛ "ma wo bo dwo, wo ho dwo wo" no, ebia wobɛte ehu ne dadwen kakra nka bere a oduruyɛfo no de mogya mmoroso afiri no to wo nsa so no. Ɛno yɛ ade a ɛfata, na ɛyɛ den sɛ wobɛma wo ho adwo wo. Sɛ ɛte saa a, saa nhyehyɛe a wɔde hwɛ mogya mmoroso a ɛkɔ baabiara yi betumi aboa wo. Saa mfiri yi hwɛ wo mogya mmoroso bere a woreyɛ wo da biara da dwumadi ahorow no. Ebetumi akyerɛ wo sɛ ebia mogya mmoroso akenkan a wo duruyɛfo reda no adi no yɛ nea ɛfata ma wo nipadua ankasa anaa.

Wɔ ‘white coat syndrome’ a wohu akyi no, saa kwan yi betumi aboa wo duruyɛfo ma wahu mogya mmoroso ho haw afoforo ahorow na wasa. Wo ne wo duruyɛfo nkasa sɛnea mogya mmoroso nhwehwɛmu a wɔde nantew yi betumi aboa wo ne nea wubetumi asua afi nea efi mu ba no mu ho asɛm.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ yɛkae

Ambulatory Blood Pressure Monitoring (ABPM) yɛ ɔkwan a ɛsom bo a wobɛfa so anya wo mogya mmoroso ho mfonini a edi mu . Ebetumi aboa wo ma woahu sɛ ebia wowɔ ‘white coat hypertension’, a ɛkɔ soro wɔ oduruyɛfo adwumayɛbea nkutoo, ‘masked hypertension’, a ɛkɔ soro wɔ fie a oduruyɛfo no nni hɔ, anaasɛ ‘sustained hypertension’, a ɛkɔ so ankasa. Ebetumi nso akyerɛ wo pii afa sɛ ebia wo mogya mmoroso aduru no reyɛ adwuma yiye, awia bere a wo mogya mmoroso kɔ soro sen biara, ne sɛ ebia ɛkɔ fam anadwo anaa. Enti sɛ wo duruyɛfo kamfo nhwehwɛmu yi kyerɛ a, nsuro sɛ wobɛma wɔayɛ. Ɛho hia paa ma wo koma akwahosan!

` Mogya mmoroso, nhyɛso a wɔhwɛ so, da mũ nyinaa nhyɛso, atade fitaa mogya mmoroso, mogya mmoroso, komayare, nhyɛso nhwehwɛmu