So nnuru ntumi nni wo mogya so? Momma yɛnka ‘Resistant Hypertension’ ho asɛm!

So wunim, ɛtɔ mmere bi a ɛwom sɛ yɛnom nnuru ma yɛn mogya mmoroso de, nanso mmere bi wɔ hɔ a ɛyɛ den yiye sɛ yebedi so. So wote nka sɛ wo mogya mmoroso so ntew bere a woasesa aduru a oduruyɛfo no de ama wo mmiako mmiako mpo akyi? Ɛnyɛ wo nko ara, nnipa bi wɔ hɔ a wohyia saa tebea yi. Enti ɛnnɛ yɛbɛka saa tebea yi a wɔfrɛ no ``Resistant Hypertension`` ho asɛm.

Dɛn ne eyi ‘a mogya mmoroso a ɛko tia’?

Sɛ yɛbɛka no tiawa a, ‘resistant hypertension’ yɛ bere a wo mogya mmoroso, sɛ yɛbɛka no pɛpɛɛpɛ a, ɛyɛ mercury milimita 140/90 (140/90 mmHg) anaa nea ɛboro saa bere nyinaa - sɛ mpo anyɛ yiye koraa no worenom mogya mmoroso nnuru ahorow abiɛsa wɔ dodow a ɛsen biara mu a. Mpɛn pii no, nnuru ahorow abiɛsa yi bi ne:

• Diuretic biako (yɛfrɛ no " nsuo aduru ").
• Calcium kwan a esiw kwan biako ano.
• Aduru a esiw angiotensin-dannan enzyme (ACE) ano anaasɛ angiotensin II receptor blocker (ARB).

Mogya mmoroso, anaa "nhyɛso" sɛnea yɛn nyinaa nim no, yɛ akwahosan ho haw kɛse a ɛma asiane a ɛwɔ hɔ sɛ wobenya koma ne ntini mu nyarewa (koma ne mogya ntini mu nyarewa) no yɛ kɛse. So wubetumi asusuw ho sɛ, sɛ wɔantumi anhyɛ wo mogya mmoroso so wɔ asram asia ayaresa a ɛkɔ so daa akyi a, nnuruyɛfo fi ase susuw sɛ wowɔ “mogya mmoroso a wontumi nni so.” Wɔreyɛ nhwehwɛmu wɔ ayaresabea de ahwehwɛ ayaresa foforo a ebetumi aboa nnipa a wɔwɔ saa tebea yi daakye.

‘Mogya mmoroso a wontumi nni so’ abu so dɛn?

Sɛnea nsɛm a efi United States kyerɛ no, mpanyimfo bɛyɛ 29% na mogya mmoroso . Wɔn mu , bɛyɛ 12% hyɛ ‘mogya mmoroso a wontumi nni so’ mu. Ɛte sɛ nea tebea yi nyɛ nea ɛho nhia wɔ Sri Lanka nso.

Dɛn ne eyi ho sɛnkyerɛnne?

Fa no sɛ, nnipa binom nnim mpo sɛ wɔwɔ mogya mmoroso mfe pii. Nanso, mogya mmoroso a wɔansa no betumi ayɛ asiane kɛse ama w’akwahosan . Sɛ ɛnyɛ bere nyinaa na wunya sɛnkyerɛnne ahorow mpo a, nnipa binom anya nneɛma te sɛ tiyɛ, koko a ɛyɛ den, anaa ahome a ɛyɛ tiaa . Enti, ɛsɛ sɛ wo ne wo duruyɛfo hu wo mogya mmoroso bere nyinaa, titiriw bere a worenyin no. Wubetumi de ɛlɛtrɔnik afiri pa a wɔde hwɛ mogya mmoroso a ne bo nyɛ den asusuw wo mogya mmoroso wɔ fie. Wubetumi ahu mfiri a ɛte saa wɔ nnurutɔnbea anaa Intanɛt so.

Dɛn nti na ‘nhyɛso a wontumi nni so’ yi ba? Dɛn ne nea enti a ɛte saa?

Nneɛma pii betumi ama ‘mogya mmoroso a wontumi nni so’ ba. Eyinom betumi afi w’asetra kwan, nnuru bi a wonom, anaa ayaresa tebea afoforo a wowɔ mpo so.

Asetra kwan ne aduan

Nea edidi so yi betumi aboa ma mogya mmoroso ne ‘mogya mmoroso a wontumi nni so’ nyinaa aba:

• Wo Body Mass Index (BMI) boro 25 (a ɛkyerɛ sɛ wowɔ nipadua mu srade a ɛboro so).
• Apɔw-mu-teɛteɛ a wɔnyɛ (apɔw-mu-teɛteɛ a wɔnyɛ).
• Nkyene pii a wodi (eyi yɛ ɔhaw ma nnipa pii!).
• Nsã a wɔnom boro so .

Nnuru bi

Nnuru a wonom no bi, nnuru a wɔkyerɛw ma wo ne nnuru a wɔtɔn (OTC) nyinaa betumi ama ayɛ den sɛ wubedi wo mogya mmoroso so. Nhwɛsoɔ:

• Nnuru a wɔde kum ɛyaw , titiriw nea wɔfrɛ no ``NSAIDs - Nonsteroidal Anti-inflammatory Drugs)``. Sɛ nhwɛso no ``( Ibuprofen )`` ne ``( Naproxen )``.
• Nnuru a wɔde tew hwene mu.
• Nnuru a wɔde siw nyinsɛn ano a wɔnom (awo ano aduru).
• Nnuadewa bi te sɛ Ginseng ne Licorice.

Ayaresa mu tebea afoforo a ɛhyɛ ase (Nea ɛto so abien a ɛde ba) .

Ɛtɔ da bi a, aduruyɛ mu tebea afoforo a ɛhyɛ ase a wobetumi asa betumi ayɛ nea ɛde wo ‘mogya mmoroso a wuntumi nni so’ no ba. Yɛfrɛ eyinom nneɛma a ɛto so abien a ɛde ba. Nhwɛso kakraa bi ni:

• Hyperaldosteronism titiriw: Eyi ne bere a wo adrenal ntini ahorow no ma hormone ahorow bi dɔɔso dodo .
• Renal artery stenosis: Eyi yɛ ntini a ɛde mogya kɔ w’asaabo mu no a ɛyɛ teateaa.
• Asaabo mu yare a enni sabea ( CKD ).
• Dae mu ahomegye a ɛyɛ den.
• Pheochromocytoma: Akisikuru a ɛba wo adrenal gland mu (eyi ho yɛ na kakra).
• Aortic narrowing (eyi nso ntaa nsi).
• Cushing syndrome: Steroid hormone ahorow bi a wɔyɛ boro so (eyi nso ntaa mma).

Hena na ɔwɔ asiane kɛse mu sɛ obenya ‘nhyɛso a wontumi nni so’?

Nnipa a wodi so yi taa nya ‘mogya mmoroso a wontumi nni so’:

• Wɔn a wɔwɔ asaabo mu yare a enni sabea no fam.
• Wɔn a wɔwɔ asikreyare no fam.
• Wɔ Amerikafoɔ abibifoɔ fam no, ``African American'' (eyi yɛ biribi a wɔhunu wɔ Amerikafoɔ adesua mu).
• Wɔ mmea fam.

Nsɛnnennen bɛn na ebetumi afi tebea yi mu aba?

Sɛ wɔde toto nnipa a wɔwɔ mogya mmoroso nanso wontumi nni so ho a, nnipa a wɔwɔ ‘mogya mmoroso a wontumi nni so’ a ɛnyɛ mmerɛw sɛ wɔde saa ayaresa ahorow yi bedi so no wɔ asiane kɛse mu :

• Nnwodwoɔ.
• Asaabo mu yare betumi aba.
• Koma a entumi nyɛ adwuma yiye betumi aba.

Eyi yɛ biribi a ɛsɛ sɛ wokae: Eyi ma yehu sɛnea ɛho hia sɛ wudi wo mogya mmoroso so, ɛnte saa?

Ɔkwan bɛn so na nnuruyɛfo hu ‘mogya mmoroso a wontumi nni so’ yi?

Sɛnea ɛbɛyɛ na woahu ‘mogya mmoroso a wontumi nni so’ no, wo duruyɛfo no bɛboaboa nsɛm pii ano afi wo hɔ. Wɔbɛpɛ sɛ wosi nea edidi so yi so dua:

• So wɔasusuw wo mogya mmoroso dodow yiye ?
• So worenom nnuru a wɔakyerɛw ama wo no yiye da biara ?
• So wowɔ tebea bi a wɔfrɛ no "white coat syndrome" (a ɛkyerɛ sɛ wo mogya mmoroso kɔ soro bere a wokɔ oduruyɛfo nkyɛn nkutoo).

W’aduruyɛ ho abakɔsɛm a wubebisa

Ebia wo duruyɛfo bebisa nneɛma te sɛ:

• Bere bɛn na wofii ase nyaa mogya mmoroso?
• Sɛ worehwɛ wo mogya mmoroso wɔ fie a, anammɔn bɛn na woyɛ?
• Nnuru bɛn (a nhabannuru ne nnuru a wɔde ka ho) na worenom mprempren, na so worenom sɛnea wɔakyerɛw ama wo no?
• Nsɛmmisa a ɛfa nneɛma a ɛto so abien a ɛde ba a ebia ɛrema wo mogya mmoroso a wuntumi nni so no aba ho.
• Nsɛmmisa a ɛfa nsa ne tawanom ho.

Nipadua mu nhwehwɛmu

Nipadua mu nhwehwɛmu no hwehwɛ nneɛma yi:

• Nsakrae a ɛnteɛ a ɛba w’ani so (wɔfrɛ eyi hypertensive retinopathy).
• Nnyigyei a ɛnteɛ a wɔte fa ntini akɛse no bi mu (a wɔfrɛ no bruits - vascular murmurs). Nnyigyei ahorow yi kyerɛ sɛ ebia srade a ɛwɔ mogya ntini yi mu wɔ ɔkwan a ɛnteɛ so, a wɔfrɛ no plaques.

Lab sɔhwɛ ahorow

Ebia nhwehwɛmu a wɔyɛ wɔ aduruyɛdan mu no bi ne:

• Nsu mu nhwehwɛmu a wɔyɛ de hwɛ sɛ protein wɔ nsu no mu anaa.
• Mogya mu nhwehwɛmu hwɛ sɛnea creatinine, glucose, ne electrolytes te sɛ sodium ne potassium dodow wɔ wo mogya mu.
• Mogya mu nhwehwɛmu a wɔyɛ de hwɛ sɛ ebia adrenal gland anaa asaabo mu yare bi wɔ hɔ anaa.
• Yɛ thyroid yare ho nhwehwɛmu, efisɛ tebea bi a wɔfrɛ no hypothyroidism betumi ama mogya mmoroso aba.

Mfoninitwa sɔhwɛ ahorow

Wubetumi ama wɔayɛ nhwehwɛmu ahorow yi de ahwɛ wo adrenal glands anaasɛ wobɛhwɛ sɛ wo renal ntini no ayɛ teateaa anaa:

• X-ray a wɔde yɛ adwuma.
• Ultrasound nhwehwɛmu ahorow.
• CT scan `(Kɔmputa so tomography - CT scans)`.

Ebia wo duruyɛfo nso bɛkamfo akyerɛ sɛ wɔnyɛ nna ho nhwehwɛmu na ama woahu sɛ ebia wowɔ nna mu ahometew anaa.

Wobɛyɛ dɛn adi ‘mogya mmoroso a wontumi nni so’ yi so? Dɛn ne ayaresa ahorow no?

Wobetumi de asetra mu nsakrae ne nnuru adi dwuma sɛ ayaresa a wɔde sa ‘mogya mmoroso a wontumi nni so’.

Asetra kwan mu nsakrae

Nsakrae a wubetumi ayɛ ne:

• Nkyene a wɔbɛtew so (adidi a ennu miligram 2,400 da biara) ne nsa a wɔbɛtew so.
• To NSAID a wode bedi dwuma sɛ nnuru a wɔde kum ɛyaw ano hye na fa biribi te sɛ paracetamol (Acetaminophen) di dwuma mmom.
• Fa wo ho hyɛ aerobic dwumadi mu wɔ abɔnten anyɛ yiye koraa no simma 30 da biara, nna pii dapɛn biara.

Nnuru a wɔde yɛ nnuru

Ɛtɔ mmere bi a ‘mogya mmoroso a wontumi nni so’ a wobɛsa no betumi ayɛ mmerɛw te sɛ nea wobɛhwɛ ahu sɛ woredi akwankyerɛ a ɛfa w’aduru a wobɛnom ho no akyi. Nokwarem no, wɔ bɛyɛ 40% a ɛfa ‘mogya mmoroso a wontumi nni so’ ho no, nnuru ntumi nyɛ adwuma yiye efisɛ nkurɔfo nnom yiye . Sɛnea ɛbɛyɛ a wubenya w’aduru no so mfaso kɛse no, ɛsɛ sɛ wonom no da biara, dodow a ɛfata, ne bere a ɛfata da biara .

Sɛ worehyia ɔhaw wɔ w’aduru no a wobɛnom ho a, hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa . Ebia wuntumi nnom w’aduru no yiye esiane nsunsuanso bɔne nti. Sɛ worenya nsunsuanso bɔne afi aduru biako mu a, ebia wo duruyɛfo betumi ama wo aduru foforo. Anaasɛ ebia wobetumi asesa wo akɔ aduru bi a ɛsɛ sɛ wonom pɛnkoro pɛ da biara so. Nnyae w’aduru nom da a wo ne wo duruyɛfo nkasa.

Sɛ worenom w’aduru no yiye na woda so ara wɔ ‘mogya mmoroso a wontumi nni so’ a, ebia wo duruyɛfo de aduru foforo bɛka ho. Ebia ebehia sɛ nnipa binom nom mogya mmoroso nnuru ahorow anan anaa anum. Mogya mmoroso nnuru ahorow a wɔtaa de di dwuma ne:

• Nnuru a ɛma nsu fi nipadua mu.
• Nnuru a esiw calcium kwan.
• Nnuru a esiw ACE ano/angiotensin a esiw ano (ACE inhibitors/ARBs).

Ɛgyina wo potassium dodoɔ so no, ebia ɛho bɛhia sɛ wo duruyɛfoɔ no ma wo diuretic dodoɔ mmɔho mmienu, de aduru a ɛtɔ so nnan ka ho – aldosterone antagonist te sɛ spironolactone – de hwɛ wo mogya mmorosoɔ so. Anaasɛ ebia wo duruyɛfo bɛpaw beta-blocker.

Nsunsuanso bɔne a efi ayaresa mu ba

Ɛkame ayɛ sɛ nnuru nyinaa betumi de ɔhaw ahorow aba. Nneɛma bɔne a mogya mmoroso nnuru de ba no bi ne:

• Adwene a ɛyɛ basaa.
• Tipaeɛ.
• Ɛho hia sɛ wɔtaa tow nsu.
• Constipation (ɛyɛ den sɛ wobɛkɔ tiafi).
• Ɔfe a ɛyɛ dry.
• Ɔbrɛ.

Ɔkwan bɛn so na wobetumi atew asiane a ɛwɔ hɔ sɛ obi benya ‘mogya mmoroso a wontumi nni so’ no so?

Nea ɛbɛyɛ na wo mogya mmoroso no antumi ansiw ayaresa ano no, yɛ nea edidi so yi:

• Di wo duruyɛfo akwankyerɛ a ɛfa wo mogya mmoroso aduru a wobɛnom ho no akyi pɛpɛɛpɛ .
• Kura mu duru a ɛfata a ɛfata wo mu.
• Fa simma 150 teɛteɛ w’apɔw mu dapɛn biara (trɛw mu nnansa kosi anum).
• Tew nkyene dodow a wudi no so.
• To nsa dodow a wonom ano hye.
• Da yiye anadwo biara.

Sɛ mewɔ ‘mogya mmoroso a wontumi nni so’ a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Nnipa pii a wɔwɔ ‘mogya mmoroso a wontumi nni so’ betumi de nnuru adi wɔn mogya so. Wɔ nnuru a wobɛkyerɛw ama wo akyi no, ebia wo duruyɛfo bɛpɛ sɛ ɔsɔ akwan horow kakraa bi hwɛ. Sɛ nhwɛso no, sɛ wobɛdan afi nnuru biako a ɛma nsu fi nipadua mu so akɔ nea ano yɛ den so, anaasɛ wobɛma woanom w’aduru a ɛnyɛ nea ɛma nsu fi nipadua mu no anadwo.

Mɛyɛ dɛn ahwɛ me ho?

Mogya mmoroso a wobɛtra ase no yɛ biribi a ɛsɛ sɛ woyɛ da mũ nyinaa, da biara da. Nea ɛka wo ho a wobɛhwɛ ho no bi ne:

• Wo mogya mmoroso aduru a wobɛnom wɔ bere a ɛfata mu ne dodow a ɛfata mu .
• Nkyene ne nsa dodow a wudi na wonom no ano hye.
• Oduruyɛfo nkyɛn a wobɛkɔ wɔ nna a wɔahyɛ da ayɛ mu (checkup appointments).
• Apɔw-mu-teɛteɛ a wɔyɛ daa .
• Mu duru a ɛfata a wobɛkɔ so akura mu.
• Wo mogya mmoroso a wobɛhwɛ wɔ fie.

Nneɛma bɛn na eye sen biara a ɛsɛ sɛ wudi bere a ‘wowɔ mogya mmoroso a wuntumi nhyɛ so’ no?

Nkyene ma wo mogya mmoroso kɔ soro , enti ɛbɛyɛ papa sɛ wobɛkwati. Nanso ebia wunnim nnuan a nkyene wom. Ɛbɛyɛ wo nwonwa sɛ wubehu sɛ nkyene pii wɔ adidibea nnuan ne nnuan a wɔayɛ no foforo mu . Sɛ wokwati na/anaasɛ woto saa nnuan yi ano hye a, ebetumi aboa ma nkyene dodow a wonom no so atew.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Hwɛ wo duruyɛfo sɛ:

• Sɛ worehyia ɔhaw wɔ nnuru a wo duruyɛfo akyerɛw ama wo no a wobɛnom no ho a.
• Sɛ wonom nnuru nyinaa sɛnea wɔakyerɛw ama wo, nanso wo mogya mmoroso da so ara yɛ kɛse a .

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Treatment Unit (ETU) ?

Mogya mmoroso ho haw yɛ tebea a ɛhwehwɛ sɛ wɔkɔ ayaresabea ntɛm ara . Sɛ ɛba saa a, wo mogya mmoroso no kɔ soro mpofirim ara (180/120 millimeters of mercury - `180/120 mmHg`), na wunya sɛnkyerɛnne ahorow te sɛ:

• Tiyɛ a emu yɛ den.
• Koko mu yaw (te sɛ nnyigyei a ano yɛ den).
• Adwene a ɛyɛ basaa.
• Ɔhome a ɛyɛ den.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Wubetumi abisa wo duruyɛfo nsɛm te sɛ eyinom:

• So ɛsɛ sɛ mesesa nnuru a mede di dwuma no?
• Mogya mmoroso nnuru a wɔaka abom bɛn na eye ma me?
• Mpɛn ahe na ɛsɛ sɛ mehwɛ me mogya mmoroso wɔ fie?
• Mpɛn ahe na ɛsɛ sɛ meba bɛhwɛ wo ma wɔayɛ nhyehyɛe a wɔde bedi akyi?

Ebetumi ayɛ abasamtu bere a worenom nnuru pii na wunhu nkɔso biara no. Sɛ wonom mogya mmoroso nnuru ahorow abiɛsa a, ebetumi ayɛ te sɛ apereperedi ankasa sɛ wobɛma wo mogya mmoroso asan ayɛ nea ɛfata. Sɛ wo ne wo duruyɛfo bɛkasa nokwarem a, ebetumi aboa wo ma woanya ɔhaw yi ano aduru. Ɛyɛ wo yiyedi sɛ wubebisa nsɛm afa biribiara a wunnim ho yiye ho.

Awiei koraa no, kae eyi (Take-Home Message) .

Mogya mmoroso a ɛko tia yɛ tebea a ɛyɛ den kakra, nanso ɛno nkyerɛ sɛ wuntumi nni so.

• Nhwehwɛmu a ɛfata a wɔde hu yare no ho hia yiye. Ebia ade foforo bi wɔ hɔ a ɛde wo mogya mmoroso ba.
• Ɛho hia sɛ wobɛnom w’aduru no yiye, bere ano, ne dodow a wɔakyerɛw ama wo no. Sɛ wowɔ nsɛmmisa bi a, wo ne wo duruyɛfo nkasa.
• Asetra mu nsakrae betumi anya nkɛntɛnso kɛse. Mma wo werɛ mmfi nneɛma te sɛ nkyene a wobɛtew so, apɔw-mu-teɛteɛ, ne wo mu duru a wobɛkɔ so akura mu.
• Kɔ so ne wo duruyɛfo nni nkitaho yiye . Ka wo haw ahorow, sɛnea wote nka, ne nea efi wo nnuru no mu ba no ho asɛm pefee.
• Nnyae nnuru nom da anaasɛ w’ankasa nnsesa dodow a wɔde ma no.

Kae sɛ ɛnyɛ wo nkutoo na woretu kwan yi. Wo duruyɛfo ne akwahosan ho kuw no wɔ ha sɛ wɔbɛboa wo. Sɛ wotɔ wo boasetɔ kakra, wonya ayaresa a ɛfata, na wosakra w’asetra kwan a, wo nso wubetumi adi tebea yi so!