Ingaba uxinzelelo lwakho lwegazi alulawulwa ngamayeza? Masithethe 'nge-Resistant Hypertension'!

Uyazi, ngamanye amaxesha nangona sisela amayeza oxinzelelo lwethu lwegazi, kukho amaxesha apho kunzima kakhulu ukuwalawula. Ngaba uvakalelwa kukuba uxinzelelo lwakho lwegazi alunciphisi nasemva kokutshintsha amayeza anikwe ngugqirha ngalinye ngalinye? Asinguwe wedwa, kukho abantu abajongene nale meko. Ngoko ke namhlanje siza kuthetha ngale meko ibizwa ngokuba yi-``Resistant Hypertension``.

Yintoni le 'ingxaki yoxinzelelo lwegazi oluxhathisayo'?

Ngamafutshane, 'uxinzelelo lwegazi oluxhathisayo' kuxa uxinzelelo lwakho lwegazi, ukuba sithetha ngokuchanekileyo, luhlala lukwi-140/90 millimeters yemercury (140/90 mmHg) okanye ngaphezulu - nokuba uthatha ubuncinane iintlobo ezintathu zamayeza oxinzelelo lwegazi kwiidosi eziphezulu. Ezi ntlobo zintathu zamayeza zihlala ziquka:

• I-diuretic enye (siyibiza ngokuba " ziipilisi zamanzi ").
• Isithinteli se-calcium channel esinye.
• I-angiotensin-converting enzyme (ACE) inhibitor okanye i-angiotensin II receptor blocker (ARB).

Uxinzelelo lwegazi oluphezulu, okanye "uxinzelelo" njengoko sonke sisazi, yingxaki enkulu yezempilo eyonyusa umngcipheko wezifo zentliziyo (izifo zentliziyo nemithambo yegazi). Ungacinga, ukuba uxinzelelo lwakho lwegazi alulawulwa emva kweenyanga ezintandathu zonyango oluqhubekayo, oogqirha baqala ukurhanela ukuba "uxinzelelo lwegazi oluphezulu olungalawulwayo." Izifundo zeklinikhi ziyaqhubeka ukufumana unyango olutsha olunokunceda abantu abanale meko kwixesha elizayo.

Ixhaphake kangakanani 'uxinzelelo lwegazi oluphezulu olungalawulekiyo'?

Ngokwedatha evela eMelika, malunga nama-29% abantu abadala banoxinzelelo lwegazi oluphezulu . Kwabo , malunga ne-12% bawela kuluhlu 'loxinzelelo lwegazi oluphezulu olungalawulwayo.' Kubonakala ngathi le meko ayibalulekanga kangako naseSri Lanka.

Zithini iimpawu zoku?

Khawucinge nje, abanye abantu abazi nokuba bane-high blood pressure kangangeminyaka. Nangona kunjalo, uxinzelelo lwegazi oluphezulu olunganyangwa lunokuba yingozi kakhulu kwimpilo yakho . Nokuba awusoloko uneempawu, abanye abantu baye bahlangabezana nezinto ezifana neentloko ezibuhlungu, ukuqina kwesifuba, okanye ukuphefumla nzima . Ke ngoko, wena nogqirha wakho kufuneka nihlale niqaphela uxinzelelo lwegazi, ingakumbi njengoko nikhula. Ningalinganisa uxinzelelo lwegazi lakho ekhaya ngesixhobo sokujonga uxinzelelo lwegazi esifanelekileyo nesingabizi kakhulu. Ungasifumana esi sixhobo kwikhemesti okanye kwi-intanethi.

Kutheni le nto kukho 'uxinzelelo lwegazi olungalawulekiyo'? Zithini izizathu?

Kunokubakho izizathu ezininzi zokuba kubekho 'uxinzelelo lwegazi oluphezulu olungalawulekiyo'. Ezi zinokuqala kwindlela ophila ngayo, amayeza athile owasebenzisayo, okanye nezinye iimeko zempilo onazo.

Indlela yokuphila nokutya

Ezi zilandelayo zinokubangela uxinzelelo lwegazi oluphezulu kunye 'noxinzelelo lwegazi oluphezulu olungalawulekiyo':

• I-Body Mass Index yakho (BMI) ingaphezulu kwama-25 (oko kuthetha ukuba unamafutha amaninzi emzimbeni).
• Ukungawusebenzisi umzimba (ukungazilolongi).
• Ukutya ityuwa eninzi kakhulu (le yingxaki kubantu abaninzi!).
• Ukusela utywala ngokugqithisileyo .

Amanye amayeza

Amanye amayeza owasebenzisayo, omabini amayeza kagqirha kunye namayeza athengiswa ngaphandle kwemvume kagqirha (OTC), angenza kube nzima ukulawula uxinzelelo lwegazi lwakho. Umzekelo:

• Iipilisi zokunciphisa iintlungu , ingakumbi ezo zibizwa ngokuba yi-"NSAIDs - Nonsteroidal Anti-inflammatory Drugs)``. Umzekelo ``( Ibuprofen )`` kunye ``( Naproxen )```.
• Izinto zokuvala iimpumlo.
• Iipilisi zokuthintela ukukhulelwa ezithathwa ngomlomo (iipilisi zokuthintela ukukhulelwa).
• Ezinye iimveliso zezityalo ezifana neGinseng kunye neLicorice.

Ezinye iimeko zempilo ezisisiseko (Izizathu zesibini)

Ngamanye amaxesha, ezinye iimeko zonyango ezinganyangekiyo zinokuba ngunobangela 'woxinzelelo lwakho lwegazi oluphezulu olungalawulekiyo'. Ezi sizibiza ngokuba zizizathu zesibini. Nazi imizekelo embalwa:

• I-hyperaldosteronism ephambili: Oku kwenzeka xa amadlala akho e-adrenal evelisa iihomoni ezithile ezininzi kakhulu.
• I-Renal artery stenosis: Oku kukuncitshiswa kwemithambo yegazi ehambisa igazi kwizintso zakho.
• Isifo sezintso esingapheliyo ( CKD ).
• Ukuphelelwa ngamandla xa ulele .
• I-Pheochromocytoma: Ithumba elenzeka kwi-adrenal gland yakho (oku kunqabile kancinci).
• Ukuncitshiswa kwe-aorta (oku nako kunqabile).
• I-Cushing syndrome: Ukuveliswa ngokugqithisileyo kwee-hormone ezithile ze-steroid (oku nako kunqabile).

Ngubani osengozini enkulu yokuba 'noxinzelelo lwegazi olungalawulekiyo'?

Abantu abalandelayo banamathuba amaninzi okuba 'noxinzelelo lwegazi oluphezulu olungalawulekiyo':

• Kwabo banesifo sezintso esinganyangekiyo.
• Kwabo banesifo seswekile.
• Kubantu abamnyama baseMelika, ``(abaNtsundu baseMelika)`` (le yinto efumaneka kwizifundo zaseMelika).
• Kwabasetyhini.

Zeziphi iingxaki ezinokuvela kule meko?

Xa kuthelekiswa nabantu abanoxinzelelo lwegazi oluphezulu kodwa olulawulwayo, abantu abanoxinzelelo lwegazi oluphezulu olungalawulwayo, olungalawulwa lula ngolu nyango, basengozini enkulu :

• Istroke.
• Isifo sezintso sinokubakho.
• Ukungaphumeleli kwentliziyo kunokwenzeka.

Nantsi into ekufuneka uyikhumbule: Oku kubonisa indlela ekubaluleke ngayo ukulawula uxinzelelo lwakho lwegazi, akunjalo?

Oogqirha bayixilonga njani le 'ngcinezelo yegazi ephezulu engalawulekiyo'?

Ukuze axilonge 'uxinzelelo lwegazi oluphezulu olungalawulekiyo', ugqirha wakho uza kuqokelela ulwazi oluninzi kuwe. Kuya kufuneka aqinisekise oku kulandelayo:

• Ngaba amaxabiso akho oxinzelelo lwegazi alinganiswe ngokuchanekileyo ?
• Ngaba amayeza owanikwe ngugqirha uwathatha ngokuchanekileyo yonke imihla ?
• Ingaba unesifo esibizwa ngokuba yi-"white coat syndrome" (oko kuthetha ukuba uxinzelelo lwakho lwegazi luyanda kuphela xa uye kugqirha).

Ukubuza ngembali yakho yezonyango

Ugqirha wakho unokubuza izinto ezifana nezi:

• Uqale nini ukuba noxinzelelo lwegazi oluphezulu?
• Ngawaphi amanyathelo owathathayo xa uhlola uxinzelelo lwakho lwegazi ekhaya?
• Ngawaphi amayeza (kuquka amayeza emifuno kunye nezongezo) owasebenzisayo ngoku, kwaye ngaba uwasebenzisa njengoko kumiselwe?
• Imibuzo malunga nezizathu zesibini ezinokuba negalelo kuxinzelelo lwakho lwegazi oluphezulu olungalawulekiyo.
• Imibuzo malunga nokusetyenziswa kotywala kunye necuba.

Uvavanyo lomzimba

Uvavanyo lomzimba lujonga ezi zinto:

• Utshintsho olungaqhelekanga emehlweni akho (oku kubizwa ngokuba yi-hypertensive retinopathy).
• Izandi ezingaqhelekanga ezivakalayo ngemithambo emikhulu (ebizwa ngokuba yi-bruits - i-vascular murmurs). Ezi zandi zibonisa ukuba le mithambo yegazi inokuba nee-deposits ezingaqhelekanga zamafutha, ezibizwa ngokuba yi-plaques.

Uvavanyo lwelabhoratri

Uvavanyo lwelebhu lungabandakanya:

• Uvavanyo lomchamo ukuze kubonwe ukuba kukho iproteni na kumchamo.
• Uvavanyo lwegazi lujonga amanqanaba e-creatinine, i-glucose, kunye nee-electrolytes ezifana ne-sodium kunye ne-potassium egazini lakho.
• Uvavanyo lwegazi ukuze kuhlolwe isifo se-adrenal gland okanye sezintso.
• Hlola isifo se-thyroid, kuba imeko ebizwa ngokuba yi-hypothyroidism inokubangela uxinzelelo lwegazi oluphezulu.

Uvavanyo lokufota

Ungenza olu vavanyo ukujonga amadlala akho e-adrenal okanye ukubona ukuba imithambo yakho yezintso inciphile na:

• Ii-X-reyi.
• Uvavanyo lwe-ultrasound.
• Iskeni se-CT `(I-computed tomography - Iskeni se-CT)`.

Ugqirha wakho unokucebisa ukuba uphande ngokulala ukuze ubone ukuba unesifo sokungalali kakuhle okanye awunaso isifo sokungalali kakuhle.

Ungayilawula njani le 'ngcinezelo yegazi ephezulu engalawulekiyo'? Zithini iindlela zonyango?

Utshintsho kwindlela yokuphila kunye namayeza angasetyenziswa njengonyango 'loxinzelelo lwegazi oluphezulu olungalawulekiyo'.

Utshintsho kwindlela yokuphila

Utshintsho onokulwenza zezi:

• Ukunciphisa ityuwa (ukutya ngaphantsi kwe-2,400 milligrams ngosuku) kunye nokunciphisa utywala.
• Nciphisa ukusetyenziswa kwee-NSAID njengee-painkillers kwaye endaweni yoko sebenzisa into efana ne-paracetamol (Acetaminophen).
• Yenza umthambo we-aerobics ngaphandle ubuncinane imizuzu engama-30 ngosuku, iintsuku eziliqela ngeveki.

Amayeza

Ukunyanga 'uxinzelelo lwegazi oluphezulu olungalawulekiyo' ngamanye amaxesha kunokuba lula njengokuqinisekisa ukuba ulandela imiyalelo yokusela amayeza akho. Enyanisweni, malunga nama-40% amatyala 'oxinzelelo lwegazi oluphezulu olungalawulekiyo', amayeza awasebenzi kakuhle kuba abantu abawathathi kakuhle . Ukuze ufumane okuninzi kumayeza akho, kufuneka uwathathe yonke imihla, ngedosi efanelekileyo, kwaye ube nexesha elifanelekileyo yonke imihla .

Ukuba unengxaki yokusebenzisa amayeza akho, qiniseka ukuba uthetha nogqirha wakho . Usenokungakwazi ukuwasebenzisa kakuhle amayeza akho ngenxa yemiphumo emibi. Ukuba unemiphumo emibi evela kwelinye iyeza, ugqirha wakho unokukwazi ukukunika elinye iyeza. Okanye banokukwazi ukukutshintshela kwelinye iyeza ekufuneka ulisebenzise kube kanye ngemini. Ungaze uyeke ukusebenzisa amayeza akho ngaphandle kokuthetha nogqirha wakho.

Ukuba usela amayeza akho ngokuchanekileyo kwaye usenoxinzelelo lwegazi oluphezulu olungalawulekiyo, ugqirha wakho unokongeza elinye iyeza. Abanye abantu banokufuna ukuthatha iintlobo ezine okanye ezintlanu ezahlukeneyo zamayeza oxinzelelo lwegazi. Ezona ntlobo zixhaphakileyo zamayeza oxinzelelo lwegazi zezi:

• Iziyobisi zomchamo.
• Izithinteli zemijelo yecalcium.
• Ii-ACE inhibitors/ii-angiotensin receptor blockers (ii-ACE inhibitors/ii-ARB).

Ngokuxhomekeke kwinqanaba le-potassium yakho, ugqirha wakho unokufuna ukuphinda kabini idosi yakho yokukhupha isisu, wongeze iyeza lesine - i-aldosterone antagonist efana ne-spironolactone - ukulawula uxinzelelo lwegazi lwakho. Okanye ugqirha wakho unokukhetha i-beta-blocker.

Iziphumo ebezingalindelekanga zonyango

Phantse onke amayeza anokubangela iziphumo ebezingalindelekanga. Iziphumo ebezingalindelekanga zamayeza oxinzelelo lwegazi oluphezulu ziquka:

• Isiyezi.
• Intloko ebuhlungu.
• Ukufuna ukuchama rhoqo.
• Ukuqhinwa (ubunzima bokuya kwindlu yangasese).
• Ukukhohlela okomileyo.
• Ukudinwa.

Ungayinciphisa njani ingozi 'yoxinzelelo lwegazi oluphezulu olungalawulekiyo'?

Ukuze uthintele uxinzelelo lwakho lwegazi oluphezulu ukuba lunganyangeki lunyango, yenza oku kulandelayo:

• Landela imiyalelo kagqirha wakho ngqo malunga nokuthatha amayeza akho oxinzelelo lwegazi.
• Gcina ubunzima obusempilweni obukufaneleyo.
• Zilolonge imizuzu eli-150 ngeveki (yisasaze kangangeentsuku ezintathu ukuya kwezintlanu).
• Nciphisa ubuninzi betyuwa oyityayo.
• Nciphisa umlinganiselo wotywala obuselayo.
• Lala kakuhle ubusuku ngabunye.

Yintoni endimele ndiyilindele ukuba 'ndine-high blood pressure engalawulekiyo'?

Abantu abaninzi 'abanoxinzelelo lwegazi oluphezulu olungalawulekiyo' banokulawula uxinzelelo lwabo lwegazi ngamayeza. Ukongeza ekunikeni amayeza, ugqirha wakho usenokufuna ukuzama iindlela ezimbalwa ezahlukeneyo. Umzekelo, ukutshintsha ukusuka kwenye iyeza lokuhambisa amanzi ukuya kwenye enamandla, okanye ukuba usele amayeza akho angengowokuhambisa amanzi ebusuku.

Ndingazinyamekela njani?

Ukuphila noxinzelelo lwegazi oluphezulu yinto ekufuneka uyenze imini yonke, yonke imihla. Ukuzinyamekela kuquka:

• Ukusela amayeza akho oxinzelelo lwegazi ngexesha elifanelekileyo nangedosi efanelekileyo .
• Ukunciphisa ubuninzi betyuwa kunye notywala obutyayo nobusiselayo.
• Ukuya kugqirha ngeentsuku ezicwangcisiweyo (ii-aphoyintimenti zokuhlolwa).
• Ukuzilolonga rhoqo .
• Ukugcina ubunzima obusempilweni obukufaneleyo.
• Ukujonga uxinzelelo lwakho lwegazi ekhaya.

Zeziphi izinto ezilungileyo onokuzitya xa 'une-high blood pressure' engalawulekiyo?

Ityuwa inyusa uxinzelelo lwakho lwegazi , ngoko ke kungcono ukuyiphepha. Kodwa usenokungazi ukuba zeziphi ukutya ezinetyuwa. Ungamangaliswa kukwazi ukuba ukutya okutyelwa kwiindawo zokutyela kunye nokutya okucutshungulwayo kuqulethe ityuwa eninzi . Ukuphepha kunye/okanye ukunciphisa oku kutya kunokunceda ukunciphisa ityuwa oyityayo.

Ndifanele ndimbone nini ugqirha wam?

Bona ugqirha wakho ukuba:

• Ukuba unengxaki yokusebenzisa amayeza owanikwe ngugqirha wakho.
• Ukuba uthatha onke amayeza akho njengoko kuyalelwe, kodwa amanqanaba oxinzelelo lwakho lwegazi asephezulu .

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ingxaki yoxinzelelo lwegazi yimeko efuna unyango olukhawulezileyo . Kwimeko enjalo, uxinzelelo lwegazi lwakho luba phezulu kakhulu ngequbuliso (180/120 millimeters yemercury - `180/120 mmHg`), kwaye ufumana iimpawu ezifana nezi:

• Intloko ebuhlungu kakhulu.
• Intlungu yesifuba (njengokukhwaza okukhulu).
• Isiyezi.
• Ubunzima bokuphefumla.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungabuza ugqirha wakho imibuzo efana nale:

• Ngaba kufuneka nditshintshe amayeza am?
• Yeyiphi indibaniselwano yamayeza oxinzelelo lwegazi engcono kum?
• Ndifanele ndijonge uxinzelelo lwegazi kangaphi ekhaya?
• Ndifanele ndize kuni kangaphi ukuze ndinibone emva kokudibana nani?

Kunokuba yinto ecaphukisayo xa usela amayeza amaninzi kodwa ungaboni tshintsho. Xa usebenzisa amayeza amathathu ahlukeneyo oxinzelelo lwegazi, kunokuba nzima kakhulu ukubuyisela uxinzelelo lwakho lwegazi esiqhelweni. Ukuthetha ngokunyaniseka nogqirha wakho kunokukunceda ufumane isisombululo sale ngxaki. Kungcono ukubuza imibuzo ngayo nantoni na ongaqinisekanga ngayo.

Okokugqibela, khumbula oku (Umyalezo Wokuya Ekhaya)

Uxinzelelo lwegazi oluxhathisayo luyinto enzima kancinci, kodwa oko akuthethi ukuba awukwazi ukululawula.

• Ukuxilongwa ngokufanelekileyo kubaluleke kakhulu. Kusenokuba kukho esinye isizathu esibangela uxinzelelo lwakho lwegazi oluphezulu.
• Kubalulekile ukuthatha amayeza akho ngokuchanekileyo, ngexesha, nangomlinganiselo omiselweyo. Ukuba unemibuzo, thetha nogqirha wakho.
• Utshintsho kwindlela yokuphila lunokuba nefuthe elikhulu. Ungalibali izinto ezifana nokunciphisa ukutya ityuwa, ukuzilolonga, kunye nokugcina ubunzima obusempilweni.
• Hlala unxibelelana kakuhle nogqirha wakho. Thetha ngokukhululekileyo ngeengxaki zakho, indlela oziva ngayo, kunye nemiphumo emibi yamayeza akho.
• Ungaze uyeke ukuthatha amayeza okanye utshintshe umthamo ngokwakho.

Khumbula, awuwedwa kolu hambo. Ugqirha wakho kunye neqela lezempilo balapha ukukunceda. Ngomonde omncinci, unyango olufanelekileyo, kunye notshintsho kwindlela yokuphila, nawe ungayilawula le meko!