ʻOiai ma hope o ka hoʻohana ʻana i nā ʻano lāʻau lapaʻau ʻekolu, ʻaʻole e iho ke koko. E kamaʻilio kākou e pili ana i ka Resistant Hypertension.

He kanaka anei ʻoe i loaʻa i ke koko kiʻekiʻe, a i ʻole e like me kā mākou e ʻike nei, ke lawe nei i ka lāʻau lapaʻau no ke "kaomi"? Lawe ʻoe i nā lāʻau lapaʻau a pau i kuhikuhi ʻia e ke kauka i ka manawa kūpono, a kāohi ʻoe i kāu ʻai a me kāu mea inu, akā i kēlā me kēia manawa āu e nānā ai i kou koko ma ka home, aia mau ia ma luna o 140/90. Ke noʻonoʻo nei hoʻi ʻoe no ke aha e hana nei kēia? Malia paha he mea kāu e kamaʻilio nei i kēia lā, i kapa ʻia ʻo 'resistant hypertension' a i ʻole resistant hypertension . Mai hopohopo, e kamaʻilio mākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.

He aha maoli ka Resistant Hypertension?

I ka ʻōlelo maʻalahi, he ʻano kēia kahi e "pale loa" ai kou koko kiʻekiʻe i ka lāʻau lapaʻau. Ma ke ʻano lapaʻau, inā mau kou koko ma luna o 140/90 mmHg ʻoiai ke hāʻawi nei kāu kauka iā ʻoe i ʻekolu a ʻoi aku paha mau lāʻau lapaʻau e kāohi i kou koko kiʻekiʻe, ma ka nui loa, a laila ua kapa ʻia kēlā ʻano he Resistant Hypertension.

ʻO kēia mau ʻano lāʻau lapaʻau ʻekolu e komo pū me:

• He ʻano diuretic: ʻO kēia nā mea a mākou e kapa nei he 'nā pila wai.' Hana lākou ma ke kumu ʻana i ke kino e hoʻokuʻu i ka wai a me ka paʻakai keu ma o ka mimi.
• He ʻano mea pale kahawai calcium: Hoʻomaha kēia i nā kīʻaha koko a hoʻomaʻamaʻa i ke kahe koko.
• He ACE inhibitor a i ʻole ARB: Hana kēia mau lāʻau ʻelua (Angiotensin-Converting Enzyme inhibitor / Angiotensin II Receptor Blocker) ma ka hoʻopilikia ʻana i nā kīʻaha koko a me ka hoʻohaʻahaʻa ʻana i ke koko.

Inā ʻaʻole hiki iā ʻoe ke kaohi i kou koko ma hope o ʻeono mahina o ka lawe ʻana i kēia mau lāʻau lapaʻau ʻekolu i nā nui loa, hiki i kāu kauka ke manaʻo he hypertension kūpaʻa kou.

Pehea ka maʻamau o kēia ʻano?

He maʻi maʻamau loa ke koko kiʻekiʻe ma Sri Lanka a me ke ao holoʻokoʻa. Ua ʻike ʻia nā noiʻi ma kahi o 10% a 12% o ka poʻe me ke koko kiʻekiʻe e loaʻa paha kēia maʻi, ʻo ia hoʻi, ʻaʻole kēia he maʻi kakaikahi.

He aha nā hōʻailona o ka Hypertension Resistant?

ʻO ka mea weliweli loa ma ʻaneʻi, ʻo ke koko kiʻekiʻe he "mea pepehi leo ʻole." ʻAʻole hōʻike ka nui o ka poʻe i kekahi mau hōʻailona. ʻAʻole ʻike kekahi poʻe he koko kiʻekiʻe ko lākou no nā makahiki. Akā inā ʻaʻole mālama ʻia, hiki iā ia ke hōʻeha nui i ke kino.

Eia nō naʻe, hiki i kekahi poʻe ke loaʻa nā hōʻailona penei:

• ʻEha poʻo
• Paʻa a kaomi paha o ka umauma
• Paʻakikī ka hanu ʻana

No ke aha e hiki ʻole ai ke kāohi ʻia ke kaomi ma kēia ʻano? He aha nā kumu?

Aia kekahi mau kumu no kēia. E māhele kākou iā lākou i mau ʻāpana.

ʻO wai ka mea i ʻoi aku ka pilikia o ka hoʻomohala ʻana i ka hypertension resistant?

ʻOi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi i kēia poʻe:

• No ka poʻe me ka maʻi puʻupaʻa mau loa
• No ka poʻe me ka maʻi diabetes
• No ka poʻe o ka lāhui ʻApelika-ʻAmelika
• No nā wāhine (e pili ana i nā kāne)

He aha nā pilikia e hiki ke hana ma muli o kēia ʻano?

ʻO ke kanaka me ka hypertension kūpaʻa, kahi paʻakikī ke kaohi ma kēia ʻano, ʻoi aku ka nui o ka pilikia o kēia ma mua o ka mea i kaohi ʻia kona koko me ka lāʻau lapaʻau.

• Hahau
• Maʻi puʻupaʻa
• Maʻi puʻuwai a me ka hāʻule ʻana o ka puʻuwai

No laila, ʻaʻole maikaʻi ke lawe māmā i kēia kūlana.

Pehea e ʻike ai ke kauka i kēia?

No ka hoʻoholo pono inā he hypertension kūpaʻa kou, e nānā kāu kauka i kekahi mau kumu.

1. E nīnau e pili ana i kou mōʻaukala olakino a me kou nohona.

Hiki i ke kauka ke nīnau iā ʻoe i nā nīnau e like me kēia:

• "Pehea ka lōʻihi o kou pilikia?"
• "He aha kāu e hana ai ke nānā ʻoe i kou koko ma ka home? Ke hoʻohana pololei nei ʻoe i ka mīkini?"
• "He aha nā lāʻau lapaʻau āu e lawe nei i kēia manawa? (me nā huaora a me nā lāʻau lapaʻau lāʻau). Ke lawe nei ʻoe i kāu mau lāʻau lapaʻau e like me ke kauoha a kāu kauka, i ka manawa kūpono, a ma ke ʻano i kuhikuhi ʻia?"
• "Ke hoʻohana nei ʻoe i ka waiʻona a i ʻole nā ​​​​cigarette?"
• "Ke hānō nei ʻoe i kou hiamoe ʻana? Ke manaʻo nei ʻoe e like me ʻoe e hanu ana?"

2. Ke hana nei i kahi hoʻokolokolo kino

I loko o kēia hoʻokolokolo ʻana, e nānā pono ke kauka i kēia mau mea:

• Hoʻokolokolo maka: Nānā kēia no ka hōʻino ʻia ʻana o nā kīʻaha koko i loko o ka maka ma muli o ke koko kiʻekiʻe. Ua kapa ʻia kēia ʻo 'Hypertensive Retinopathy'.
• Hoʻolohe i nā kīʻaha koko nui: Ke hoʻolohe nei i ke kani o ke koko e hele ana ma kekahi mau kīʻaha koko nui (e laʻa, nā mea ma ka ʻāʻī a i ʻole nā ​​puʻupaʻa) e ʻike inā he kani ʻē (`bruit`). Hiki i kēia ke hāʻawi i kahi manaʻo inā ua haiki nā kīʻaha koko.

3. Nā hoʻokolohua keʻena hoʻokolohua a me nā hoʻokolohua ʻē aʻe

• Hoʻāʻo mimi:E nānā i ka protein i loko o ka mimi.
• Nā hoʻāʻo koko: E nānā i ka hana o nā puʻupaʻa (Creatinine), nā pae kō (Glucose), a me nā electrolytes e like me ka sodium a me ka potassium.
• Nā hoʻāʻo hormone: E nānā i nā pilikia me ka hana ʻana o nā kelepa adrenal a i ʻole kelepa thyroid.
• Nā Scan: Hiki ke hana ʻia nā scan Ultrasound a me CT e nānā i ke kūlana o nā puʻupaʻa a me nā kelepa adrenal.
• Haʻawina Hiamoe: Inā manaʻo ʻoe he apnea hiamoe kou, hiki ke kuhikuhi ʻia ʻoe no kahi haʻawina hiamoe kūikawā.

Pehea e mālama ʻia ai kēia?

Mai hopohopo. Aia kahi lāʻau lapaʻau no kēia. ʻElua mau ʻāpana nui.

1. Nā loli o ke ʻano o ka nohona

ʻO kēia nā mea nui loa hiki iā ʻoe ke hana. He mea ʻole ke lawe wale i ka lāʻau lapaʻau a hana ʻole i kēia mau mea.

• Kaohi ʻana i ka paʻakai: E kaupalena i kāu ʻai ʻana i ka paʻakai i 2,400 milligrams (ʻoi aku ma mua o hoʻokahi teaspoon) i kēlā me kēia lā. E ho'ōki i ka lawe ʻana mai i ka paʻakai i ka papaʻaina. E ho'ēmi i kāu ʻai ʻana i nā meaʻai i hana ʻia a me nā meaʻai i hoʻopili ʻia.
• Ke kaupalena nei i ka waiʻona.
• Nā lāʻau hoʻopau ʻeha: Mai lawe i nā lāʻau lapaʻau e like me Ibuprofen lāua ʻo Diclofenac me ka ʻole o ke kūkākūkā ʻana me kāu kauka. Inā pono, e kamaʻilio me kāu kauka e pili ana i kahi lāʻau lapaʻau e like me Paracetamol.
• Hoʻoikaika Kino: E hana i kekahi mau hoʻoikaika kino, e like me ka hele wāwae a i ʻole ke kaʻa paikikala, no ka liʻiliʻi he 30 mau minuke i ka lā, i kekahi mau lā o ka pule.

2. Ke hoʻohana pono ʻana i nā lāʻau lapaʻau

ʻO kēia kahi e hele hewa ai nā kānaka he nui.

I mea e hana ai ka lāʻau lapaʻau, pono e lawe ʻia i kēlā me kēia lā, i ka manawa kūpono, a ma ka nui kūpono . He paʻakikī i kekahi poʻe ke lawe i kā lākou lāʻau lapaʻau ma muli o nā hopena ʻaoʻao (e laʻa, ka poniuniu, ke kuni). Inā loaʻa iā ʻoe kēlā pilikia, e haʻi i kāu kauka. A laila hiki iā ia ke kuhikuhi i kahi lāʻau lapaʻau ʻokoʻa. Mai ho'ōki i ka lawe ʻana i kāu lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke noi ʻana i kāu kauka.

Inā ʻaʻole i kāohi ʻia kou koko koko ma hope o ka lawe pono ʻana i kāu lāʻau lapaʻau, hiki i kāu kauka ke hoʻohui i kahi lāʻau lapaʻau ʻehā a ʻelima paha. No ka laʻana, he diuretic i kapa ʻia ʻo Spironolactone a i ʻole he beta-blocker .

Āhea ʻoe e hele koke ai i ka haukapila (ETU)?

I kekahi manawa hiki ke piʻi koke ke koko i luna loa. Ua kapa ʻia kēia he pilikia hypertensive . He kūlana kēia e pono ai ka mālama olakino ulia pōpilikia.

Inā ʻoi aku ke kiʻekiʻe o kou koko ma mua o 180/120 mmHg a loaʻa iā ʻoe nā hōʻailona ma lalo nei, e hele koke i ka lumi pilikia haukapila kokoke loa:E hele i ka (ETU - Emergency Treatment Unit) .

• ʻEha poʻo nui
• Nā Palpitations (manaʻo e like me ka wikiwiki o kou puʻuwai)
• Pōʻino
• Paʻakikī ka hanu ʻana

Nā nīnau e nīnau aku ai i kāu kauka

He mea nui e loaʻa ka ʻike maikaʻi i kou kūlana. Mai kānalua e nīnau i kēia mau nīnau i ka manawa aʻe e ʻike ai ʻoe i kāu kauka.

• "E ke kauka, pono anei iaʻu e hoʻololi i kaʻu mau lāʻau lapaʻau?"
• "He aha ka hui pū ʻana o nā lāʻau lapaʻau i kūpono loa iaʻu?"
• "ʻEhia pinepine e pono ai iaʻu ke nānā i koʻu koko ma ka home?"
• "Āhea wau e hele hou aku ai e ʻike i ke kauka?"

He mea maʻamau ke manaʻo huhū ke lawe ʻoe i ka nui o nā lāʻau lapaʻau akā ʻaʻole ʻoe i ʻike i kahi hoʻomaikaʻi. Eia nō naʻe, ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke kamaʻilio ākea me kāu kauka a loaʻa nā hopena i kāu mau pilikia.