ʻAʻole anei i kāohi ʻia kou koko e ka lāʻau lapaʻau? E kamaʻilio kākou e pili ana i ke 'Resistant Hypertension'!

Ua ʻike anei ʻoe, i kekahi manawa ʻoiai ke lawe nei mākou i ka lāʻau no ko mākou koko koko, aia kekahi mau manawa he mea paʻakikī loa ke kāohi iā ia. Manaʻo ʻoe ʻaʻole e emi ana kou koko koko ma hope o ka hoʻololi ʻana i ka lāʻau lapaʻau i hāʻawi ʻia e ke kauka pākahi? ʻAʻole ʻoe wale nō, aia kekahi poʻe e kū nei i kēia kūlana. No laila i kēia lā e kamaʻilio mākou e pili ana i kēia maʻi i kapa ʻia ʻo "Resistant Hypertension".

He aha kēia 'hypertension kūpaʻa'?

I ka ʻōlelo maʻalahi, ʻo ke 'resistant hypertension' ʻo ia ka wā e mau ana kou koko ma 140/90 millimeters o ka mercury (140/90 mmHg) a ʻoi aku paha - ʻoiai inā ʻoe e lawe ana i ʻekolu mau ʻano lāʻau lapaʻau koko ma nā nui kiʻekiʻe loa. ʻO kēia mau ʻano lāʻau lapaʻau ʻekolu e komo pū me:

• Hoʻokahi diuretic (kapa mākou ia he " nā pila wai ").
• Hoʻokahi mea pale i ke kahawai calcium.
• He mea hoʻopaʻa i ka enzyme hoʻololi angiotensin (ACE) a i ʻole he mea pale i ka receptor angiotensin II (ARB).

ʻO ke koko kiʻekiʻe, a i ʻole "kaomi" e like me kā kākou e ʻike nei, he pilikia olakino nui ia e hoʻonui ai i ka pilikia o nā maʻi cardiovascular (nā maʻi puʻuwai a me nā kīʻaha koko). Hiki iā ʻoe ke noʻonoʻo, inā ʻaʻole i kāohi ʻia kou koko ma hope o ʻeono mahina o ka mālama mau ʻana, hoʻomaka nā kauka e kānalua he "koko kiʻekiʻe i kāohi ʻole ʻia" kou. Ke hana ʻia nei nā haʻawina lapaʻau e ʻimi i nā lāʻau lapaʻau hou e hiki ke kōkua i ka poʻe me kēia maʻi i ka wā e hiki mai ana.

Pehea ka maʻamau o ke 'koko kiʻekiʻe i kāohi ʻole ʻia'?

Wahi a ka ʻikepili mai ʻAmelika Hui Pū ʻIa, ma kahi o 29% o nā pākeke he koko kiʻekiʻe . Ma waena o lākou , ma kahi o 12% e hāʻule ana i loko o ka māhele o ke 'koko kiʻekiʻe i kāohi ʻole ʻia.' Me he mea lā ʻaʻole he mea liʻiliʻi kēia kūlana ma Sri Lanka.

He aha nā hōʻailona o kēia?

E noʻonoʻo, ʻaʻole ʻike kekahi poʻe he koko kiʻekiʻe ko lākou no nā makahiki. Eia nō naʻe, hiki i ke koko kiʻekiʻe i mālama ʻole ʻia ke lilo i mea weliweli loa i kou olakino . ʻOiai inā ʻaʻole ʻoe e loaʻa mau i nā hōʻailona, ​​​​ua ʻike kekahi poʻe i nā mea e like me ke poʻo ʻeha, ka ʻūlū o ka umauma, a i ʻole ka pōkole o ka hanu . No laila, pono ʻoe a me kāu kauka e makaʻala mau i kou koko, ʻoiai i kou wā ʻelemakule. Hiki iā ʻoe ke ana i kou koko ma ka home me kahi mea nānā koko uila maikaʻi a kūpono hoʻi. Hiki iā ʻoe ke loaʻa i ia ʻano mea ma kahi hale kūʻai lāʻau lapaʻau a i ʻole ma ka pūnaewele.

No ke aha e kū mai ai kēia 'hypertension i kāohi ʻole ʻia'? He aha nā kumu?

Aia kekahi mau kumu e loaʻa ai ke 'koko kiʻekiʻe i kāohi ʻole ʻia'. Hiki i kēia mau mea ke pili i kou nohona, kekahi mau lāʻau lapaʻau āu e lawe ai, a i ʻole nā ​​​​​​kūlana olakino ʻē aʻe āu e loaʻa nei.

ʻAno nohona a me ka meaʻai

Hiki i kēia mau mea ke kōkua i ke koko kiʻekiʻe a me ke 'koko kiʻekiʻe i kāohi ʻole ʻia':

• ʻOi aku ka nui o kou Body Mass Index (BMI) ma mua o 25 (ʻo ia hoʻi, he nui kou momona o ke kino).
• Ka nele o ka hana kino (ʻaʻole hoʻoikaika kino).
• ʻAi nui i ka paʻakai (he pilikia kēia no nā kānaka he nui!).
• Ka inu nui ʻana i ka waiʻona .

Kekahi mau lāʻau lapaʻau

ʻO kekahi o nā lāʻau lapaʻau āu e lawe ai, ʻo nā lāʻau lapaʻau i kuhikuhi ʻia a me nā lāʻau lapaʻau ma luna o ka counter (OTC), hiki ke hoʻolilo iā ia i mea paʻakikī ke kāohi i kou koko. Eia kekahi laʻana:

• Nā lāʻau hoʻopau ʻeha , ʻoiai nā mea i kapa ʻia ʻo "NSAIDs - Nonsteroidal Anti-inflammatory Drugs). No ka laʻana "( Ibuprofen )" a me "( Naproxen )".
• Nā lāʻau wehe ihu paʻa.
• Nā lāʻau pale hānau waha (nā lāʻau hoʻomalu hānau).
• ʻO kekahi mau huahana mea kanu e like me Ginseng a me Licorice.

Nā kūlana olakino ʻē aʻe (Nā kumu lua)

I kekahi manawa, hiki i nā kūlana olakino ʻē aʻe hiki ke mālama ʻia ke kumu o kou 'koko koko kiʻekiʻe i kāohi ʻole ʻia'. Kāhea mākou i kēia mau kumu lua. Eia kekahi mau laʻana:

• ʻO ka hyperaldosteronism mua: ʻO kēia ka wā e hana nui ai kāu mau kelepa adrenal i kekahi mau hormones .
• ʻO ka stenosis o ke aʻa Renal: ʻO kēia ka ʻūlū ʻana o nā aʻa e hoʻolako i ke koko i kou mau puʻupaʻa.
• Maʻi puʻupaʻa mau loa ( CKD ).
• ʻAneʻane hiamoe .
• Pheochromocytoma: He puʻupuʻu e hana ʻia i loko o kou kelepa adrenal (he mea laha ʻole kēia).
• ʻO ka hoʻohaiki ʻana o Aortic (he mea kākaʻikahi kēia).
• ʻO ka maʻi Cushing: Ka hana nui ʻana o kekahi mau hormones steroid (he mea kākaʻikahi nō hoʻi kēia).

ʻO wai ka mea i ʻoi aku ka pilikia o ka hoʻomohala ʻana i ke 'hypertension i kāohi ʻole ʻia'?

ʻOi aku ka nui o ka poʻe e loaʻa i ke 'koko kiʻekiʻe i kāohi ʻole ʻia':

• No ka poʻe me ka maʻi puʻupaʻa mau loa.
• No ka poʻe me ka maʻi diabetes.
• No nā ʻAmelika ʻeleʻele, ʻo "(ʻApelika ʻAmelika)" (he mea kēia i loaʻa i nā haʻawina ʻAmelika).
• No nā wāhine.

He aha nā pilikia e hiki ke kū mai mai kēia maʻi?

Ke hoʻohālikelike ʻia me ka poʻe me ke koko kiʻekiʻe akā me ke kaohi ʻia ʻana, ʻoi aku ka nui o ka pilikia o ka poʻe me ke 'koko kiʻekiʻe i kaohi ʻole ʻia', kahi mea i maʻalahi ʻole ke kaohi ʻia me kēia mau lāʻau lapaʻau:

• Hahau.
• Hiki ke loaʻa ka maʻi puʻupaʻa.
• Hiki ke hana i ka hāʻule ʻana o ka puʻuwai.

He mea kēia e hoʻomanaʻo ai: Hōʻike kēia i ke koʻikoʻi o ka kaohi ʻana i kou koko koko, ʻeā?

Pehea e ʻike ai nā kauka i kēia 'koko kiʻekiʻe i kāohi ʻole ʻia'?

No ka ʻike ʻana i ke 'koko kiʻekiʻe i kāohi ʻole ʻia', e hōʻiliʻili kāu kauka i ka ʻike he nui mai iā ʻoe. Pono lākou e hōʻoia i kēia mau mea:

• Ua ana pololei ʻia anei kou mau helu koko ?
• Ke lawe pololei nei ʻoe i ka lāʻau lapaʻau i kuhikuhi ʻia i kēlā me kēia lā ?
• Loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo "white coat syndrome" (ʻo ia hoʻi, piʻi wale kou koko ke hele ʻoe i ke kauka).

Ke nīnau nei e pili ana i kāu mōʻaukala olakino

Hiki i kāu kauka ke nīnau i nā mea e like me:

• I ka manawa hea i hoʻomaka ai ʻoe e loaʻa i ke koko kiʻekiʻe?
• He aha nā hana āu e hana ai ke nānā ʻoe i kou koko ma ka home?
• He aha nā lāʻau lapaʻau (me nā mea kanu a me nā mea hoʻopihapiha) āu e lawe nei, a ke lawe nei ʻoe iā lākou e like me ke kauoha?
• Nā nīnau e pili ana i nā kumu lua e hiki ke kōkua i kou koko kiʻekiʻe i kāohi ʻole ʻia.
• Nā nīnau e pili ana i ka hoʻohana ʻana i ka waiʻona a me ka paka.

Hoʻokolokolo kino

Ke nānā nei ka hoʻokolohua kino i kēia mau mea:

• Nā loli maʻamau ʻole i kou mau maka (ua kapa ʻia kēia he hypertensive retinopathy).
• Nā leo ʻē i lohe ʻia ma o kekahi o nā aʻa nui (i kapa ʻia ʻo bruits - vascular murmurs). Hōʻike kēia mau leo ​​​​aia paha i kēia mau kīʻaha koko he mau waihona momona ʻē, i kapa ʻia ʻo plaques.

Nā hoʻokolohua lab

Hiki i nā hoʻokolohua hale hana ke komo pū me:

• He hoʻāʻo mimi e ʻike ai inā he protein i loko o ka mimi.
• Nānā nā hoʻāʻo koko i nā pae o ka creatinine, glucose, a me nā electrolytes e like me ka sodium a me ka potassium i loko o kou koko.
• He hoʻāʻo koko e nānā ai i ka maʻi o ka ʻōpū adrenal a i ʻole nā ​​​​maʻi puʻupaʻa.
• E hoʻāʻo ʻia no ka maʻi thyroid, ʻoiai ʻo kahi maʻi i kapa ʻia ʻo hypothyroidism hiki ke kōkua i ke koko kiʻekiʻe.

Nā hoʻokolohua kiʻi

Hiki iā ʻoe ke hana i kēia mau hoʻokolohua e nānā i kāu mau kelepa adrenal a i ʻole e ʻike inā ua ʻūlū ʻia kou mau aʻa renal:

• Nā kukuna X.
• Nā hoʻokolohua ultrasound.
• ʻO ke kiʻi CT `(Computered tomography - CT scans)`.

Hiki paha i kāu kauka ke ʻōlelo aku i kahi noiʻi hiamoe e ʻike ai inā he apnea hiamoe kāu.

Pehea ʻoe e kāohi ai i kēia 'koko kiʻekiʻe i kāohi ʻole ʻia'? He aha nā lāʻau lapaʻau?

Hiki ke hoʻohana ʻia nā loli o ke ʻano o ka nohona a me nā lāʻau lapaʻau e like me nā lāʻau lapaʻau no ke 'koko koko kiʻekiʻe i kāohi ʻole ʻia'.

Nā loli o ke ʻano o ka nohona

ʻO nā hoʻololi hiki iā ʻoe ke hana:

• Ka palena ʻana i ka paʻakai (ʻai ʻana ma lalo o 2,400 milligrams i ka lā) a me ka palena ʻana i ka waiʻona.
• E hōʻemi i ka hoʻohana ʻana i nā NSAID e like me nā lāʻau ʻeha a e hoʻohana i kahi mea e like me ka paracetamol (Acetaminophen).
• E komo i ka hana aerobic ma waho no ka liʻiliʻi he 30 mau minuke i ka lā, i kekahi mau lā o ka pule.

Nā lāʻau lapaʻau

ʻO ka mālama ʻana i ke 'koko kiʻekiʻe i kāohi ʻole ʻia' i kekahi manawa hiki ke maʻalahi e like me ka hōʻoia ʻana e hahai ana ʻoe i nā ʻōlelo kuhikuhi no ka lawe ʻana i kāu lāʻau lapaʻau. ʻO ka ʻoiaʻiʻo, ma kahi o 40% o nā hihia o ke 'koko kiʻekiʻe i kāohi ʻole ʻia', ʻaʻole hana pono nā lāʻau lapaʻau no ka mea ʻaʻole lawe pono ka poʻe iā lākou . I mea e loaʻa ai ka hapa nui o kāu lāʻau lapaʻau, pono ʻoe e lawe i kēlā me kēia lā, ma ka nui kūpono, a no ka manawa kūpono i kēlā me kēia lā .

Inā pilikia ʻoe i ka lawe ʻana i kāu lāʻau lapaʻau, e kamaʻilio me kāu kauka . ʻAʻole paha ʻoe e hiki ke lawe pono i kāu lāʻau lapaʻau ma muli o nā hopena ʻaoʻao. Inā loaʻa iā ʻoe nā hopena ʻaoʻao mai hoʻokahi lāʻau lapaʻau, hiki paha i kāu kauka ke hāʻawi iā ʻoe i kahi lāʻau lapaʻau ʻokoʻa. A i ʻole hiki paha iā lākou ke hoʻololi iā ʻoe i kahi lāʻau lapaʻau āu e pono ai ke lawe hoʻokahi wale nō i ka lā. Mai ho'ōki i ka lawe ʻana i kāu lāʻau lapaʻau me ka ʻole o ke kamaʻilio ʻana me kāu kauka.

Inā ʻoe e lawe pololei ana i kāu lāʻau lapaʻau a loaʻa mau iā ʻoe ke 'koko kiʻekiʻe i kāohi ʻole ʻia', hiki i kāu kauka ke hoʻohui i kahi lāʻau lapaʻau ʻē aʻe. Pono paha kekahi poʻe e lawe i ʻehā a ʻelima mau ʻano lāʻau lapaʻau koko like ʻole. ʻO nā ʻano lāʻau lapaʻau koko maʻamau:

• Nā lāʻau hoʻōla lāʻau.
• Nā mea ālai i ke kahawai kalipuna.
• Nā mea hoʻopaʻa ACE/nā mea pale i ka angiotensin receptor (ACE inhibitors/ARBs).

Ma muli o kou pae potassium, pono paha i kāu kauka ke pāpālua i kāu mahele diuretic, e hoʻohui i kahi lāʻau lapaʻau ʻehā - kahi antagonist aldosterone e like me ka spironolactone - e kāohi i kou koko. A i ʻole e koho paha kāu kauka i kahi beta-blocker.

Nā hopena ʻaoʻao o ka lāʻau lapaʻau

ʻAneʻane hiki i nā lāʻau lapaʻau āpau ke hana i nā hopena ʻaoʻao. ʻO nā hopena ʻaoʻao o nā lāʻau koko kiʻekiʻe:

• Pōʻaiʻī.
• ʻEha poʻo.
• Pono e mimi pinepine.
• Paʻakikī ke hele i ka lua (constipation).
• ʻŪhū maloʻo.
• Luhi.

Pehea e hōʻemi ai i ka pilikia o ke 'koko kiʻekiʻe i kāohi ʻole ʻia'?

I mea e pale ai i kou koko kiʻekiʻe mai ka lilo ʻana i mea kūʻē i ka lāʻau lapaʻau, e hana i kēia mau mea:

• E hahai pono i nā ʻōlelo a kāu kauka e pili ana i ka lawe ʻana i kāu lāʻau lapaʻau koko.
• E mālama i kahi kaumaha olakino e kūpono iā ʻoe.
• E hoʻoikaika kino no 150 mau minuke i ka pule (e hoʻohele iā ia ma luna o ʻekolu a ʻelima mau lā).
• E hōʻemi i ka nui o ka paʻakai āu e ʻai ai.
• E kaupalena i ka nui o ka waiʻona āu e inu ai.
• E hiamoe maikaʻi i kēlā me kēia pō.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu ke 'koko kiʻekiʻe i kāohi ʻole ʻia'?

Hiki i nā poʻe he nui me ke 'koko kiʻekiʻe i kāohi ʻole ʻia' ke kāohi i ko lākou koko me ka lāʻau lapaʻau. Ma waho aʻe o ke kuhikuhi ʻana i ka lāʻau lapaʻau, makemake paha kāu kauka e hoʻāʻo i kekahi mau ʻano hana like ʻole. No ka laʻana, ke hoʻololi ʻana mai kahi diuretic i kahi mea ikaika aʻe, a i ʻole ʻoe e lawe i kāu lāʻau lapaʻau non-diuretic i ka pō.

Pehea wau e mālama ai iaʻu iho?

ʻO ke ola ʻana me ke koko kiʻekiʻe kahi mea āu e hana ai i ka lā a pau, i kēlā me kēia lā. ʻO ka mālama ʻana iā ʻoe iho:

• Ke lawe nei i kāu lāʻau lapaʻau koko i ka manawa kūpono a me ka nui kūpono .
• Ke kaupalena nei i ka nui o ka paʻakai a me ka waiʻona āu e ʻai ai a inu ai.
• Ke hele ʻana e ʻike i ke kauka i nā lā i hoʻonohonoho ʻia (nā manawa nānā).
• Hoʻoikaika kino mau .
• Ka mālama ʻana i kahi kaumaha olakino e kūpono iā ʻoe.
• Ke nānā nei i kou kaomi koko ma ka home.

He aha nā mea ʻai maikaʻi loa e ʻai ai i ka wā e loaʻa ai iā ʻoe ke 'ke koko kiʻekiʻe i kāohi ʻole ʻia'?

Hoʻonui ka paʻakai i kou koko koko , no laila ʻoi aku ka maikaʻi o ka pale ʻana. Akā, ʻaʻole paha ʻoe e ʻike i nā meaʻai i loaʻa ka paʻakai. E kahaha paha ʻoe i ka ʻike ʻana he nui ka paʻakai i loko o nā meaʻai hale ʻaina a me nā meaʻai i hana ʻia . ʻO ka pale ʻana a/a i ʻole ka palena ʻana i kēia mau meaʻai hiki ke kōkua i ka hōʻemi ʻana i ka nui o ka paʻakai āu e lawe ai.

Āhea wau e ʻike ai i kaʻu kauka?

E ʻike i kāu kauka inā:

• Inā pilikia ʻoe i ka lawe ʻana i ka lāʻau lapaʻau a kāu kauka i kuhikuhi ai iā ʻoe.
• Inā ʻoe e lawe i kāu mau lāʻau lapaʻau a pau e like me ke kauoha, akā kiʻekiʻe nō kou pae koko .

Āhea wau e hele ai i ka Emergency Treatment Unit (ETU) ?

ʻO ka pilikia hypertensive kahi kūlana e pono ai ke kōkua koke ʻia e ke kauka . I kēia hihia, lilo koke kou koko i kiʻekiʻe loa (180/120 millimeters o ka mercury - `180/120 mmHg`), a ʻike ʻoe i nā hōʻailona e like me:

• ʻEha poʻo nui.
• ʻEha ka umauma (e like me ka halulu nui).
• Pōʻaiʻī.
• Paʻakikī ka hanu ʻana.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau penei:

• Pono anei au e hoʻololi i kaʻu mau lāʻau lapaʻau?
• He aha ka hui pū ʻana o nā lāʻau lapaʻau koko koko maikaʻi loa iaʻu?
• ʻEhia pinepine e pono ai iaʻu ke nānā i koʻu koko ma ka home?
• ʻEhia pinepine e pono ai iaʻu e hele mai e ʻike iā ʻoe no nā manawa hoʻonohonoho?

Hiki ke hoʻonāukiuki ke lawe ʻoe i nā lāʻau lapaʻau he nui a ʻaʻole ʻike ʻia kekahi hoʻomaikaʻi. Ke lawe ʻoe i ʻekolu mau lāʻau lapaʻau koko like ʻole, hiki ke manaʻo ʻia he hakakā maoli e hoʻihoʻi i kou koko i ka maʻamau. ʻO ke kamaʻilio pololei ʻana me kāu kauka hiki ke kōkua iā ʻoe e loaʻa kahi hopena no kēia pilikia. He mea maikaʻi loa ia nou ke nīnau i nā nīnau e pili ana i nā mea āu i maopopo ʻole ai.

ʻO ka mea hope loa, e hoʻomanaʻo i kēia (Leka Lawe-Home)

He ʻano paʻakikī ke ʻano o ka hypertension resistant, akā ʻaʻole ia manaʻo ʻaʻole hiki iā ʻoe ke kaohi.

• He mea nui loa ka loaʻa ʻana o kahi hōʻailona kūpono . Aia paha kekahi kumu ʻē aʻe no kou koko kiʻekiʻe.
• He mea nui e lawe pololei i kāu lāʻau lapaʻau, i ka manawa kūpono, a ma ke ʻano i kuhikuhi ʻia. Inā he mau nīnau kāu, e kamaʻilio me kāu kauka.
• Hiki i nā hoʻololi ʻana i ke ʻano o ka nohona ke loaʻa ka hopena nui. Mai poina i nā mea e like me ka hōʻemi ʻana i ka ʻai ʻana i ka paʻakai, ka hoʻoikaika kino ʻana, a me ka mālama ʻana i ke kaumaha olakino.
• E mālama i ke kamaʻilio maikaʻi me kāu kauka. E kamaʻilio ākea e pili ana i kou mau pilikia, pehea kou manaʻo, a me nā hopena ʻaoʻao o kāu mau lāʻau lapaʻau.
• Mai ho'ōki i ka lawe ʻana i ka lāʻau lapaʻau a hoʻololi paha i ka dosage ma kāu iho.

E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi i kēia huakaʻi. Eia kāu kauka a me ka hui mālama ola e kōkua iā ʻoe. Me ke ahonui iki, ka lāʻau kūpono, a me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki iā ʻoe ke kāohi i kēia maʻi!