Yu nɔ tink se mɛrɛsin de kɔntrol yu blɔd prɛshɔn? Lɛ wi tɔk bɔt ‘Resistant Hypertension’!

Yu no, sɔntɛnde pan ɔl we wi kin tek mɛrɛsin fɔ wi blɔd prɛshɔn, tɛm kin de we i kin rili at fɔ kɔntrol am. Yu fil se yu blɔd prɛshɔn nɔ de go dɔŋ ivin afta yu dɔn chenj di mɛrɛsin we di dɔktɔ gi yu wan bay wan? Nɔto yu nɔmɔ, pipul dɛn de we de fes dis sityueshɔn. So tide wi go tɔk bɔt dis kɔndishɔn we dɛn kɔl ``Resistant Hypertension``.

Wetin na dis ‘resistant hypertension’?

Fɔ tɔk am simpul wan, ‘resistant hypertension’ na we yu blɔd prɛshɔn, fɔ bi prɛsis, de ɔltɛm na 140/90 milimita mɛkkyuri (140/90 mmHg) ɔ pas dat - ivin if yu de tek at le tri kayn blɔd prɛshɔn mɛrɛsin pan maksimam dos. Dɛn tri kayn mɛrɛsin ya kin bi:

• Wan diuretic (wi kɔl am " wata pils ").
• Wan kalsiɔm chanɛl blɔk.
• wan angiotensin-kכnvεrt εnzym (ACE) inhibito כ wan angiotensin II rεsεptכr blכk (ARB).

Ha blɔd prɛshɔn, ɔ "prɛshɔn" lɛk aw wi ɔl no am, na big wɛlbɔdi prɔblɛm we de mek pɔsin gɛt sik dɛn we de mek pɔsin gɛt at ɛn blɔd vesel (at ɛn blɔd vesel sik). Yu kin imajin, if dɛn nɔ kɔntrol yu blɔd prɛshɔn afta siks mɔnt we dɛn dɔn tek yu tritmɛnt ɔltɛm, dɔktɔ dɛn kin bigin fɔ sɔprayz se yu gɛt “ay blɔd prɛshɔn we dɛn nɔ ebul fɔ kɔntrol.” Dɛn de du klinik stɔdi fɔ fɛn nyu tritmɛnt wae go ɛp pipul dɛm wae gɛt dis sik tumara bambay.

Aw kɔmɔn tin fɔ ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol’?

Di data we kɔmɔt na Amɛrika sho se na lɛk 29% pan di big pipul dɛn gɛt ay blɔd prɛshɔn . Fɔ dɛn wan ya , lɛk 12% pan dɛn kin fɔdɔm insay di kategori we dɛn kɔl ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol.’ I tan lɛk se dis tin we apin nɔto tin we nɔ impɔtant na Sri Lanka sɛf.

Wetin na di sayn dɛm fɔ dis?

Imajin, sɔm pipul dɛn nɔ kin ivin no se dɛn gɛt ay blɔd prɛshɔn fɔ lɔng lɔng tɛm. Bɔt if yu nɔ trit yu ay blɔd prɛshɔn, dat kin rili denja fɔ yu wɛlbɔdi . Ivin if yu nɔr kin gɛt sɔm sayn dɛm ɔltɛm, sɔm pipul dɛm dɔn gɛt tin dɛm lɛk ed pen, chɛst tayt, ɔr nɔr de blo fayn . So, yu ɛn yu dɔktɔ fɔ no ɔltɛm bɔt yu blɔd prɛshɔn, mɔ we yu de ol. Yu kin mɛzhɔ yu blɔd prɛshɔn na os wit gud ilɛktronik blɔd prɛshɔn monita we yu nɔ go pe fɔ. Yu kin fɛn dis kayn tin na famasi ɔ na di Intanɛt.

Wetin mek dis ‘haypa prɛshɔn we dɛn nɔ kin kɔntrol’ kin apin? Wetin na di rizin dɛn?

Bɔrku rizin kin de wae mek ‘hay blɔd prɛshɔn we nɔr kin kɔntrol’ kin apin. Dɛn tin ya kin kɔmɔt frɔm di we aw yu de liv yu layf, sɔm mɛrɛsin dɛn we yu de tek, ɔ ivin ɔda mɛrɛsin dɛn we yu gɛt.

Layf ɛn it

Dɛn tin ya kin ɛp fɔ mek yu gɛt ay blɔd prɛshɔn ɛn ‘hay blɔd prɛshɔn we yu nɔ kin kɔntrol’:

• Yu Bɔdi Mas Indeks (BMI) pas 25 (we min se yu gɛt bɔku bɔku bɔdi fat).
• Nɔr de du bɔdi wok (nɔr fɔ du ɛksɛsayz).
• Fɔ it bɔku sɔl (dis na prɔblɛm fɔ bɔku pipul dɛn!).
• Fɔ drink rɔm pasmak .

Sɔm mɛrɛsin dɛn

Sɔm pan di mɛrɛsin dɛn we yu kin tek, ɔl tu di mɛrɛsin dɛn we dɛn kin gi yu ɛn di mɛrɛsin dɛn we yu kin bay (OTC), kin mek i nɔ izi fɔ kɔntrol yu blɔd prɛshɔn. Fɔ ɛgzampul:

• Di mɛrɛsin dɛn we de mek pɔsin fil pen , mɔ di wan dɛn we dɛn kɔl ``NSAIDs - Nonsteroidal Anti-inflammatory Drugs)``. Fɔ ɛgzampul ``( Ibuprofen )`` ɛn ``( Naproxen )``.
• Di tin dɛn we de mek di nos nɔ klin.
• Di tin dɛn we dɛn kin yuz fɔ mek uman nɔ gɛt bɛlɛ (pils fɔ kɔntrol bɔn pikin).
• Sɔm ɛbul prɔdak dɛn lɛk Ginseng ɛn Licorice.

Ɔda ɔndalayn mɛdikal kɔndishɔn dɛm (Sɛkɛnd kɔz dɛm) .

Sɔmtɛm, ɔda ɔndalayn mɛdikal kɔndishɔn dɛm wae dɛn kin trit kin bi di kɔz fɔ yu ‘hay blɔd prɛshɔn we yu nɔr kin kɔntrol’. Wi kin kɔl dɛn sɛkɔndari kɔz ya. Na sɔm ɛgzampul dɛn ya:

• Praymari hayparaldosteronism: Dis na we yu adrenal gland dɛn de mek tumɔs pan sɔm ɔmon dɛn .
• di rεnal atεri stεnosis: Dis na we di atεri dεm we de gi bכdi to yu kidni dεm de sכmtεm sכmtεm.
• Kronik kidni sik ( CKD ).
• Slip apnɛa fɔ slip.
• Fiokromosaytoma: na tכmכro we de fכm na yu adrenal gland (dis nכ kin apin sכmtεm).
• di aorta narrowing (dis tu nכ kin apin).
• Cushing syndrome: Fɔ mek sɔm stɛroyd ɔmon dɛn pasmak (dis nɔ kin apin bak).

Udat de pan ay risk fɔ gɛt ‘uncontrolled hypertension’?

Dɛn pipul ya kin gɛt ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol’:

• Fɔ di wan dɛn we gɛt krɛse sik na dɛn kidni.
• Fɔ di wan dɛn we gɛt dayabitis.
• Fɔ blak Amɛrika pipul, ``(African American)`` (dis na sɔntin we dɛn kin si na Amɛrika stɔdi).
• Fɔ uman dɛn.

Us prɔblɛm dɛn kin kam wit dis sik?

We yu kɔmpia pipul dɛn we gɛt ay blɔd prɛshɔn bɔt we gɛt am ɔnda kɔntrol, pipul dɛn we gɛt ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol’, we nɔ kin izi fɔ kɔntrol wit dɛn tritmɛnt ya, kin gɛt ay risk :

• Strok.
• Kidni sik kin apin.
• At kin apin.

Dis na sɔntin we yu fɔ mɛmba: Dis de sho aw i impɔtant fɔ kɔntrol yu blɔd prɛshɔn, nɔto so?

Aw dɔktɔ dɛn kin no dis ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol’?

Fɔ no se yu gɛt ‘uncontrolled high blood pressure’, yu dɔktɔ go gɛda bɔku infɔmeshɔn frɔm yu. Dɛn go nid fɔ kɔnfɔm dɛn tin ya:

• Dɛn dɔn mɛzhɔ yu blɔd prɛshɔn valyu kɔrɛkt wan ?
• Yu de tek di mɛrɛsin we dɛn gi yu kɔrɛkt wan ɛvride ?
• Yu gɛt wan sik we dɛn kɔl "wayt kot sindrom" (we min se yu blɔd prɛshɔn kin jɔs go ɔp we yu go to dɔktɔ).

Fɔ aks bɔt yu mɛdikal istri

Yu dɔktɔ kin aks yu tin dɛn lɛk:

• Ustɛm yu bigin fɔ gɛt ay blɔd prɛshɔn?
• Us step yu kin tek we yu de chɛk yu blɔd prɛshɔn na os?
• Us mɛrɛsin (inklud ɔyl ɛn sɔpɔtmɛnt) yu de tek naw, ɛn yu de tek dɛn lɛk aw dɛn tɛl yu fɔ tek?
• Kwɛstyɔn dɛn bɔt sɛkɔndari tin dɛn we kin mek yu gɛt ay blɔd prɛshɔn we yu nɔ ebul fɔ kɔntrol.
• Kwɛstyɔn dɛn bɔt aw fɔ drink rɔm ɛn fɔ smok.

Fɔ chɛk yu bɔdi

Di fyzikal egzamin de luk fɔ dɛn tin ya:

• di chenj dεm we nכ de apin na yu yay (dεn kכl dis haypatεnshכn rεtinopathy).
• abnכmal sawnd dεm we dεn kin yεri tru sכm pan di mεjכr atεri dεm (dεn kכl dεm bruit - vaskulכr mכrmur). Dɛn sawnd ya de sho se dɛn blɔd vesel dɛn ya kin gɛt fat we nɔmal, we dɛn kɔl plek.

Lab tɛst dɛn

Di tɛst dɛn we dɛn kin du na lɛbɔtri kin inklud:

• Wan tɛst fɔ urine fɔ si if prɔtin de na di urine.
• Blɔd tɛst de chɛk di lɛvɛl dɛn we kriaytinin, glukɔs, ɛn ilɛktrɔlayt dɛn lɛk sɔdiɔm ɛn potashɔm de na yu blɔd.
• Wan blɔd tɛst fɔ chɛk if adrenal gland ɔ kidni sik.
• Gɛt tɛst fɔ tayroyd sik, bikɔs wan sik we dɛn kɔl haypotayroyd kin mek yu gɛt ay blɔd prɛshɔn.

Test dɛn fɔ tek imej

Yu kin mek dɛn du dɛn tɛst ya fɔ chɛk yu adrenal gland dɛn ɔ fɔ si if yu rɛnɛral at dɛn dɔn smɔl:

• X-ray we dɛn kin du.
• Ultrasound tɛst dɛn we dɛn kin du.
• CT skan `(Kɔmpyut tomografi - CT skan)`.

Yu dɔktɔ kin tɛl yu bak fɔ stɔdi bɔt aw yu de slip fɔ si if yu gɛt slip apnea.

Aw yu kin kɔntrol dis ‘hay blɔd prɛshɔn we yu nɔ kin kɔntrol’? Wetin na di tritmɛnt dɛn?

Dɛn kin yuz layf stayl chenj ɛn mɛrɛsin as tritmɛnt fɔ ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol’.

Di we aw pipul dɛn de liv dɛn layf kin chenj

Di chenj dɛn we yu kin mek na:

• Fɔ stɔp sɔl (fɔ it smɔl pas 2,400 miligram fɔ wan de) ɛn nɔ fɔ it bɔku rɔm.
• Limit fɔ yuz NSAID as pen kil ɛn yuz sɔntin lɛk paracetamol (Acetaminophen) insted.
• Du aerobic aktiviti na do fɔ at le 30 minit insay di de, sɔm dez insay di wik.

Mɛrɛsin dɛn we dɛn kin yuz

Fɔ trit ‘hay blɔd prɛshɔn we nɔr kin kɔntrol’ kin simpul sɔmtɛm lɛk fɔ mek shɔ se yu de fala di instrɔkshɔn fɔ tek yu mɛrɛsin. Infakt, na lɛk 40% pan di kes dɛm wae dɛn kin gɛt ‘hay blɔd prɛshɔn we nɔr kin kɔntrol’, di mɛrɛsin nɔr kin woke fayn bikɔs pipul nɔr kin tek am fayn . Fɔ mek yu gɛt di bɛst pan yu mɛrɛsin, yu nid fɔ tek am ɛvride, di rayt doz, ɛn fɔ di rayt tɛm ɛvride .

If yu gɛt prɔblɛm fɔ tek yu mɛrɛsin, mek shɔ se yu tɔk to yu dɔktɔ . Yu nɔ go ebul fɔ tek yu mɛrɛsin fayn bikɔs ɔf di bad tin dɛn we kin apin to yu. If yu de gɛt sayd ɛfɛkt frɔm wan mɛrɛsin, yu dɔktɔ go ebul fɔ gi yu difrɛn mɛrɛsin. Ɔ dɛn kin ebul fɔ chenj yu to mɛrɛsin we yu jɔs nid fɔ tek wan tɛm insay di de. Nɔ ɛva stɔp fɔ tek yu mɛrɛsin we yu nɔ tɔk to yu dɔktɔ.

If yu de tek yu mɛrɛsin kɔrɛkt wan ɛn stil gɛt ‘ay blɔd prɛshɔn we yu nɔ ebul fɔ kɔntrol’, yu dɔktɔ kin ad ɔda mɛrɛsin. Sɔm pipul dɛn kin nid fɔ tek 4 ɔ 5 difrɛn kayn blɔd prɛshɔn mɛrɛsin. Di kayn mɛrɛsin dɛn we dɛn kin yuz fɔ mɛn blɔd prɛshɔn na:

• Diuretiks we dɛn kin yuz fɔ mek wata.
• Di wan dɛn we de blok di chanɛl we gɛt kalsiɔm.
• ACE inhibito dεm/angiotensin rεsεptכr blכk dεm (ACE inhibito dεm/ARB dεm).

dipכnt pan yu potashכm lεvεl, yu dכkta kin nid fכ dכbl yu diuretic doz, ad fכs mεdikeshכn – wan aldosterone antagonist lεk spironolactone – fכ kכntrכl yu blכd prεshכn. Ɔ yu dɔktɔ kin pik wan beta-blɔk.

Di sayd ɛfɛkt dɛn we di tritmɛnt kin gɛt

Klosap ɔl di mɛrɛsin dɛn kin mek pɔsin gɛt sayd ɛfɛkt. Di bad tin dɛn we kin apin we dɛn de tek mɛrɛsin we gɛt ay blɔd prɛshɔn na:

• Diziz we pɔsin kin gɛt.
• Ed de at.
• Nid fɔ pis bɔku tɛm.
• Kɔnstipɛshɔn (i nɔ izi fɔ go na tɔylɛt).
• Dray kɔf.
• We pɔsin taya.

Aw fɔ ridyus di risk fɔ ‘hay blɔd prɛshɔn we dɛn nɔ kin kɔntrol’?

Fɔ mek yu ay blɔd prɛshɔn nɔ go ebul fɔ gɛt tritmɛnt, du dɛn tin ya:

• Fɔ fala yu dɔktɔ in instrɔkshɔn dɛn gud gud wan bɔt aw fɔ tek yu blɔd prɛshɔn mɛrɛsin.
• Mek yu gɛt wɛlbɔdi wet we go fayn fɔ yu.
• Ɛksesaiz fɔ 150 minit insay di wik (spred am fɔ tri to fayv dez).
• Ridyus di sɔl we yu de it.
• Limit di rɔm we yu de drink.
• Slip fayn ɛvri nɛt.

Wetin a fɔ ɛkspɛkt if a gɛt ‘ay blɔd prɛshɔn we a nɔ ebul fɔ kɔntrol’?

Bɔrku pipul dɛm wae gɛt ‘hay blɔd prɛshɔn wae nɔr kin kɔntrol’ kin kɔntrol dɛn blɔd prɛshɔn wit mɛrɛsin. Apat frɔm we yu dɔktɔ de gi yu mɛrɛsin, yu go want fɔ tray sɔm difrɛn we dɛn. Fɔ ɛgzampul, fɔ chenj frɔm wan diuretic to wan we strɔng, ɔ fɔ mek yu tek yu nɔ-diuretic mɛrɛsin na nɛt.

Aw a kin kia fɔ misɛf?

Fɔ liv wit ay blɔd prɛshɔn na sɔntin we yu fɔ du ɔl di de, ɛvride. Fɔ kia fɔ yusɛf inklud:

• Fɔ tek yu blɔd prɛshɔn mɛrɛsin di rayt tɛm ɛn di rayt doz .
• Fɔ stɔp di sɔl ɛn rɔm we yu de it ɛn drink.
• Go si dɔktɔ pan di de dɛn we dɛn dɔn sɛtul (chɛk ap apɔntinmɛnt).
• Fɔ ɛksesaiz ɔltɛm .
• Fɔ mek yu gɛt wɛlbɔdi wet we fit yu.
• Fɔ chɛk yu blɔd prɛshɔn na os.

Wetin na di bɛst tin fɔ it we yu gɛt ‘hay blɔd prɛshɔn we yu nɔ ebul fɔ kɔntrol’?

Sɔl kin mek yu blɔd prɛshɔn go ɔp , so i bɛtɛ fɔ lɛ yu avɔyd am. Bɔt yu nɔ go no us it dɛn gɛt sɔl. Yu go sɔprayz fɔ no se di it dɛn we dɛn kin it na rɛstɔrant ɛn di it dɛn we dɛn dɔn prosɛs gɛt bɔku sɔl . If yu nɔ it ɛn/ɔ nɔ it dɛn it ya, dat kin ɛp fɔ ridyus di sɔl we yu de tek.

Ustɛm a fɔ go to mi dɔktɔ?

Si yu dɔktɔ if:

• If yu gɛt prɔblɛm fɔ tek di mɛrɛsin we yu dɔktɔ dɔn tɛl yu.
• If yu tek ɔl yu mɛrɛsin dɛn lɛk aw dɛn tɛl yu fɔ tek, bɔt yu blɔd prɛshɔn stil ay .

Ustɛm a fɔ go na di Imejɛnsi Tritmɛnt Yunit (ETU) ?

Hapatɛnshɔn kraysis na wan sik we nid fɔ go to dɔktɔ kwik kwik wan . If na so i bi, yu blɔd prɛshɔn kin rili ay wantɛm wantɛm (180/120 milimita mɛkkyuri - `180/120 mmHg`), ɛn yu kin gɛt sɔm sayn dɛn lɛk:

• Di ed we de at bad bad wan.
• Chɛst pen (lɛk lawd thud).
• Diziz we pɔsin kin gɛt.
• I nɔ kin izi fɔ yu fɔ blo.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

Yu kin aks yu dɔktɔ kwɛstyɔn dɛn lɛk dɛn wan ya:

• A nid fɔ chenj di mɛrɛsin dɛn we a de tek?
• Us kɔmbayn blɔd prɛshɔn mɛrɛsin we bɛtɛ fɔ mi?
• Aw ɔltɛm a fɔ chɛk mi blɔd prɛshɔn na os?
• Aw ɔltɛm a fɔ kam si yu fɔ fala-ap apɔntinmɛnt?

E kin mek yu at pwɛl wae yu de tek bɔrku mɛrɛsin ɛn nɔr de si ɛni impɔtant tin. We yu de tek tri difrɛn blɔd prɛshɔn mɛrɛsin, i kin tan lɛk se yu rili de tray tranga wan fɔ mek yu blɔd prɛshɔn kam bak to nɔmal. If yu tɔk ɔnɛs wit yu dɔktɔ, dat kin ɛp yu fɔ fɛn sɔlv fɔ dis prɔblɛm. I go fayn fɔ yu fɔ aks kwɛstyɔn bɔt ɛnitin we yu nɔ shɔ bɔt.

Fɔ dɔn, mɛmba dis (Take-Home Message) .

Resistant hypertension na smɔl kɔmplikɛt kɔndishɔn, bɔt dat nɔ min se yu nɔ go ebul fɔ kɔntrol am.

• Fɔ no di sik fayn fayn wan rili impɔtant. Sɔntɛm ɔda tin de we kin mek yu gɛt ay blɔd prɛshɔn.
• I impɔtant fɔ tek yu mɛrɛsin kɔrɛkt wan, di rayt tɛm, ɛn di doz we dɛn tɛl yu fɔ tek. If yu gɛt ɛni kwɛstyɔn, tɔk to yu dɔktɔ.
• We pɔsin chenj di we aw i de liv in layf, dat kin rili afɛkt am. Nɔ fɔgɛt tin dɛn lɛk fɔ ridyus di sɔl we yu de it, fɔ du ɛksɛsayz, ɛn fɔ mek yu gɛt wɛlbɔdi.
• Kɔntinyu fɔ tɔk fayn to yu dɔktɔ. Tɔk opin wan bɔt yu prɔblɛm dɛn, aw yu de fil, ɛn di bad tin dɛn we yu de du we yu de tek di mɛrɛsin dɛn.
• Nɔ ɛva stɔp fɔ tek mɛrɛsin ɔ chenj di doz fɔ yusɛf.

Mɛmba se nɔto yu wangren de du dis waka. Yu dɔktɔ ɛn di tim we de kia fɔ yu wɛlbɔdi biznɛs de ya fɔ ɛp yu. If yu peshɛnt smɔl, di rayt tritmɛnt, ɛn chenj yu layf, yusɛf go ebul fɔ kɔntrol dis sik!