Ubuwazi ukuthi ngezinye izikhathi, noma ulandela imithi yakho yokucindezeleka kwegazi, ihlala iphakeme kakhulu? Uzizwa sengathi umane ushintshashintsha imithi kadokotela ehlukene ngaphandle kokubona intuthuko yangempela emazingeni akho okucindezeleka kwegazi? Awuwedwa; abantu abaningi babhekene nale nselele. Namuhla eNirogi Lanka , ake sixoxe ngesimo esaziwa ngokuthi yi -Resistant Hypertension .
Kuyini Ukucindezeleka Okungapheli Kwegazi Okungamelani Nesifo?
Kalula nje, i-Resistant Hypertension yenzeka lapho umfutho wegazi wakho uhlala njalo ku -140/90 mmHg noma ngaphezulu , naphezu kokuthi uthatha okungenani imithi emithathu ehlukene yomfutho wegazi ngemithamo yayo ephezulu ebekezelelwayo. Ngokuvamile, le mithi emithathu ihlanganisa:
- Umuthi wokukhipha isisu (ovame ukubizwa ngokuthi “ amaphilisi amanzi ”).
- Isivimbeli sesiteshi se-calcium.
- I-angiotensin-converting enzyme (ACE) inhibitor noma i-angiotensin II receptor blocker (ARB).
Umfutho wegazi ophakeme, noma "umfutho wegazi ophakeme," kuyinkinga enkulu yezempilo eyandisa kakhulu ingozi yakho yezifo zenhliziyo (izimo ezithinta inhliziyo yakho nemithambo yegazi). Uma umfutho wegazi wakho ungalawuleki ngemva kwezinyanga eziyisithupha zokwelashwa okuqhubekayo, odokotela bazophenya ukuthi kungenzeka yini umfutho wegazi ophakeme ongamelana nawo. Izifundo zezokwelapha ziyaqhubeka ukuthuthukisa izindlela zokwelapha ezintsha nezisebenzayo kulabo ababhekene nalesi simo.
Kuvame kangakanani ukucindezeleka kwegazi okumelana nokucindezeleka?
Idatha ikhombisa ukuthi cishe abantu abadala abangama-29% baphila nomfutho wegazi ophakeme . Phakathi kwalabo, cishe abangu-12% bawela esigabeni se-Resistant Hypertension . Lokhu kuyinkinga ebalulekile yezempilo edinga ukuphathwa kochwepheshe.
Ziyini izimpawu?
Abantu abaningi baphila iminyaka eminingi bengaqapheli ukuthi banomfutho wegazi ophakeme. Kodwa-ke, umfutho wegazi ophakeme ongalashwanga uyingozi kakhulu empilweni yakho . Nakuba ungase ungabi nomuzwa wezimpawu njalo, abanye abantu baphathwa yikhanda elibuhlungu, ukuqina kwesifuba, noma ukuphelelwa umoya .
Ngenxa yalesi sizathu, wena nodokotela wakho kufanele niqaphe njalo umfutho wegazi lakho, ikakhulukazi njengoba nikhula. Kunconywa ukusebenzisa umshini wokuqapha umfutho wegazi osezingeni eliphezulu othembekile futhi ongabizi ekhaya, ongawuthenga ekhemisi lendawo noma ku-inthanethi.
Kungani kwenzeka i-Resistant Hypertension?
Kunezizathu eziningana zalesi simo, kusukela ezicini zendlela yokuphila kuya emithini ethile noma izinkinga zempilo eziyisisekelo.
Indlela Yokuphila Nokudla Okunomsoco
Izici ezilandelayo zingaba nomthelela kokubili ku-hypertension evamile kanye ne-Resistant Hypertension:
- I-Body Mass Index (BMI) engaphezu kuka-25 (ukuba nesisindo esingaphezulu).
- Ukuntuleka komsebenzi womzimba (indlela yokuphila yokuhlala phansi).
- Ukudla usawoti omningi (inkinga evame kakhulu).
- Ukuphuza utshwala ngokweqile .
Imithi Ethile
Eminye imithi kadokotela, kanye nemithi ethengiswa ngaphandle kwemithi kadokotela (OTC), ingenza kube nzima ukulawula umfutho wegazi lakho.
Ngokwesibonelo:
- Iziqeda ubuhlungu , ikakhulukazi ama-NSAID (Izidakamizwa Ezingavimbeli Ukuvuvukala), njenge-( Ibuprofen ) kanye ne-( Naproxen ).
- Izinto zokuqeda ukuminyana kwamakhala.
- Izindlela zokuvimbela inzalo ngomlomo.
- Imikhiqizo ethile yezitshalo efana ne-Ginseng ne-Licorice.
Izimo Zezokwelapha Eziyisisekelo (Izimbangela Zesibili)
Ngezinye izikhathi, izimo eziyisisekelo ezingelapheka zibangela ukuthi umfutho wegazi wakho ube namandla. Lokhu sikubiza ngokuthi izimbangela zesibili .
Izibonelo zifaka:
- I-hyperaldosteronism eyinhloko: Lapho izindlala zakho ze-adrenal zikhiqiza okuningi kakhulu kwento ethileama-hormone .
- I-Renal artery stenosis: Ukuncipha kwemithambo yegazi ehambisa igazi ezinso zakho.
- Isifo sezinso esingamahlalakhona (CKD).
- Ukuphefumula komoya .
- I-Pheochromocytoma: Isimila esingavamile endlaleni ye-adrenal.
- Ukuncipha kwe-aorta (futhi akuvamile).
- I-Cushing syndrome: Ukukhiqizwa ngokweqile kwama -hormone athile e-steroid (okungavamile).
Ubani osengozini enkulu yokucindezeleka kwegazi okumelana nomdlavuza?
Ungase ube nengozi enkulu uma une:
- Isifo sezinso esingamahlalakhona.
- Isifo sikashukela.
- Ifa lama-Afrika aseMelika (njengoba kuboniswe ezifundweni zezokwelapha).
- Uma ungowesifazane.
Yiziphi izinkinga ezingaba khona?
Uma kuqhathaniswa nalabo abanomfutho wegazi olawulwa kahle, abantu abane-Resistant Hypertension babhekene nengozi enkulu yalokhu okulandelayo:
- Isifo sohlangothi.
- Isifo sezinso.
- Ukwehluleka kwenhliziyo.
Sicela ukhumbule: Lokhu kugcizelela ngqo ukuthi kungani ukufeza ukulawula umfutho wegazi okuzinzile kubaluleke kangaka empilweni yakho yesikhathi eside.
Odokotela bakuthola kanjani ukuthi une-Resistant Hypertension?
Ukuqinisekisa lokhu, udokotela wakho uzoqoqa ulwazi oluningiliziwe ukuqinisekisa ukuthi:
- Umfutho wegazi lakho ulinganiswa ngokunembile .
- Uthatha imithi yakho oyinikezwe udokotela njalo .
- Awunayo i-“White coat syndrome” (lapho ingcindezi ikhuphuka khona kuphela lapho usehhovisi likadokotela).
Ukubukeza umlando wakho wezokwelapha
Udokotela wakho angase akubuze:
- Umfutho wegazi wakho waqala nini?
- Uyiqapha kanjani ingcindezi yakho ekhaya?
- Yimiphi imithi, okuhlanganisa imithi kanye nezithasiselo ezitholakala ngaphandle kwemithi kadokotela, oyithathayo njengamanje?
- Imibuzo mayelana nezimbangela zesibili ezingaba khona.
- Imibuzo mayelana nokusetshenziswa kotshwala nogwayi.
Ukuhlolwa Komzimba
Ngesikhathi sokuhlolwa kwakho ngokomzimba, udokotela wakho uzohlola okulandelayo:
- Izinguquko ezingavamile emehlweni akho (lokhu kwaziwa ngokuthi i-Hypertensive retinopathy).
- Imisindo engavamile ezwakala ngemithambo emikhulu yemithambo yegazi (lena ibizwa ngokuthi ama-Bruits). Le misindo iphakamisa ukuthi imithambo yegazi yakho ingaba nama-fat deposits angajwayelekile, aziwa nangokuthi ama-plaque.
Ukuhlolwa Kwelebhu
Ukuhlolwa kwakho kokuxilonga kungafaka:
- Ukuhlolwa komchamo ukuhlola amaprotheni.
- Ukuhlolwa kwegazi ukuze kuqashwe amazinga akho e-Creatinine, i-glucose, kanye ne-electrolyte (njenge-sodium ne-potassium).
- Ukuhlolwa kwegazi ukuze kuhlolwe izimo ezithinta izindlala zakho ze-adrenal noma izinso.
- Ukuhlolwa kokusebenza kwe-thyroid, njengoba izimo ezifana ne-Hypothyroidism zingabangela umfutho wegazi ophakeme.
Ukuhlolwa Kwezithombe
Ukuze uhlole izindlala zakho ze-adrenal noma uhlole imithambo yezinso emincane, udokotela wakho angase akuyalele:
- Ama-X-ray.
- Izikena ze-Ultrasound.
- I-computed tomography (CT) scans.
Ngaphezu kwalokho, udokotela wakho angase ancome ucwaningo lokulala ukuze anqume ukuthi unesifo sokulala.
Iphathwa kanjani i-'Resistant Hypertension'? Yiziphi izindlela zokwelapha?
Ukwelashwa kwe-hypertension engamelana nomfutho wegazi ophakeme kuhilela inhlanganisela yezinguquko zendlela yokuphila kanye nemithi.
Izinguquko Zendlela Yokuphila
Izinguquko ezibalulekile zendlela yokuphila ongayenza zifaka:
- Ukunciphisa usawoti odliwayo (ngaphansi kuka-2,400 mg ngosuku) kanye nokunciphisa ukusetshenziswa kotshwala.
- Ukunciphisa ukusetshenziswa kwemithi engeyona i-steroidal elwa nokuvuvukala (ama-NSAID) yokulawula ubuhlungu nokukhetha ezinye izindlela ezifana ne-Acetaminophen esikhundleni salokho.
- Ukuzibandakanya okungenani imizuzu engama-30 yomsebenzi we-aerobic ezinsukwini eziningi zesonto.
Imithi
Ukuphatha umfutho wegazi ophakeme omelana nokumelana ngezinye izikhathi kungaba lula njengokuqinisekisa ukuthi uthatha imithi yakho njengoba uyalelwe. Kulinganiselwa ukuthi cishe kuma -40% ezimo zomfutho wegazi ophakeme omelana nokumelana nokumelana nokucindezeleka, imithi iyehluleka ngoba ayithathwa njalo . Ukuze ubone imiphumela yangempela, kufanele uphuze imithi yakho nsuku zonke, ngesilinganiso esifanele, kanye nezikhathi eziningi ngosuku njengoba uyalelwe .
Uma unenkinga yokuphuza imithi yakho, sicela ukhulume nodokotela wakho ngokushesha . Ungase ube nemiphumela emibi eyenza kube nzima ukuhlala usesimweni esifanele. Uma umuthi owodwa udala izinkinga, udokotela wakho angase akwazi ukukushintshela komunye noma akuyise ohlelweni lomthamo oluyi-1 ngosuku. Ungalokothi uyeke ukuthatha imithi yakho ngaphandle kokubonisana nodokotela wakho kuqala.
Uma umfutho wegazi wakho uhlala uphezulu ngisho nangemva kokulandela ngokuqinile uhlelo lwakho lwemithi, udokotela wakho angase angeze omunye umuthi. Abanye abantu badinga imithi emine noma emihlanu ehlukene ukuze baphathe umfutho wegazi wabo ngempumelelo.
Imithi evamile yokucindezeleka kwegazi ihlanganisa:
- Imithi yokuhlanza.
- Ama-blocker eziteshi ze-calcium.
- Ama-ACE inhibitors/ama-Angiotensin receptor blockers (ama-ARB).
Kuye ngamazinga akho e-potassium, udokotela wakho angase aphinde kabili umthamo wakho wokukhipha isisu noma engeze umuthi wesine—njenge-aldosterone antagonist efana ne-Spironolactone—ukuze asize ekulawuleni umfutho wegazi lakho. Ngaphandle kwalokho, udokotela wakho angakhetha ukufaka i-Beta-blocker.
Imiphumela Engemihle Yokwelashwa
Imithi eminingi ingaba nemiphumela emibi. Evamile ehlotshaniswa nemithi yomfutho wegazi ihlanganisa:
- Isiyezi.
- Ikhanda elibuhlungu.
- Ukuchama njalo.
- Ukuqunjelwa.
- Ukukhwehlela okomile.
- Ukukhathala noma ukukhathala.
Ungayinciphisa kanjani ingozi yokucindezeleka kwegazi okungamelani nomfutho wegazi ophezulu?
Ukuze uvimbele umfutho wegazi lakho ukuthi ungabe usamelana nokwelashwa, gxila kulezi zinyathelo:
- Landela imiyalelo kadokotela wakho ngokuqinile mayelana nemithi yakho yokucindezela kwegazi.
- Gcina isisindo esinempilo esikufanele.
- Zibekele imizuzu engu-150 yokuzivocavoca ngesonto (izinsuku ezintathu kuya kwezinhlanu).
- Nciphisa ukudla kwakho usawoti .
- Nciphisa ukuphuza kwakho utshwala.
- Qiniseka ukuthi ulala kahle njalo ebusuku.
Yini okufanele ngiyikhumbule uma ngine-hypertension engamelani nayo?
Iningi labantu abanomfutho wegazi ophakeme omelana nokumelana bangakwazi ukuphatha isimo sabo ngempumelelo. Ngaphandle kokukunikeza imithi, udokotela wakho angase azame izindlela ezahlukene, njengokushintshela ku-diuretic enamandla kakhulu noma ukuhambisa imithi engeyona eyokwehlisa umfutho wegazi ohlelweni lwakho lwakusihlwa.
Ngingayiphatha kanjani impilo yami?
Ukuphila nomfutho wegazi ophezulu kuyisibopho sansuku zonke, sokuphila konke. Ukunakekela impilo yakho kuhlanganisa:
- Ukuthatha imithi yakho ngesikhathi esifanele nangesilinganiso esifanele .
- Ukunciphisa usawoti notshwala .
- Ukuya kuzo zonke izikhathi zakho zokuhlolwa ezihleliwe.
- Ukuzivocavoca njalo .
- Ukugcina isisindo esinempilo.
- Ukuqapha umfutho wegazi lakho ekhaya.
Yini okufanele ngiyigweme uma nginomfutho wegazi ophakeme omelana nokumelana nayo?
Usawoti unyusa umfutho wegazi lakho , ngakho-ke kungcono ukuwugwema. Ungase ungazi ukuthi usawoti ucashe kuphi. Ungase umangale ukuzwa ukuthi ukudla kwasezitolo zokudlela kanye nokudla okucutshunguliwe kuqukethe inani elikhulu le-sodium . Ukunciphisa noma ukugwema lokhu kuzosiza ukwehlisa inani likasawoti elingena emzimbeni wakho.
Kufanele ngimbone nini udokotela wami?
Hlela i-aphoyintimenti nodokotela wakho uma:
- Ubhekene nanoma yikuphi ukungakhululeki noma ubunzima ngemithi oyinikezwe.
- Ukufundwa komfutho wegazi lakho kuhlala kuphezulungisho nangemva kokuthatha yonke imithi njengoba nje kuyalelwe.
Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo?
Inkinga yomfutho wegazi ophakeme iyisimo esiphuthumayo sezokwelapha esidinga ukunakekelwa okusheshayo .
Lokhu kwenzeka lapho umfutho wegazi wakho ukhuphuka ngokuzumayo (ufike ku-180/120 mmHg noma ngaphezulu) futhi uhlangabezana nezimpawu ezifana nalezi:
- Ikhanda elibuhlungu kakhulu.
- Ukushaya kwenhliziyo esifubeni (ukuzwa sengathi inhliziyo yakho iyashaya).
- Isiyezi.
- Ukuphelelwa umoya.
Yimiphi imibuzo okufanele ngiyibuze udokotela wami?
Zizwe ukhululekile ukubuza udokotela wakho imibuzo efana nale:
- Ingabe ngidinga ukushintsha imithi yami?
- Iyiphi inhlanganisela yemithi yomfutho wegazi engcono kakhulu kimi?
- Kufanele ngihlole kangaki umfutho wegazi lami ekhaya?
- Kufanele ngihlele kangaki ama-aphoyintimenti okulandelela?
Kungaba yinto ekhungathekisayo uma uphuza imithi eminingana kodwa ungaboni ntuthuko. Uma kuthatha imithi engaphezu kwemithathu yomfutho wegazi, ukulawula umfutho wakho kungazwakala njengomzabalazo omkhulu. Ukwethembeka nokuvuleleka kudokotela wakho kuzokusiza ukuthola ikhambi. Ukubuza imibuzo nganoma yini engacacile kuhlale kuzuzisa wena.
Umyalezo Wokugcina Wokuya Nasekhaya
'Umfutho wegazi ophakeme omelana nokumelana' kungase kuzwakale njengesimo esiyinkimbinkimbi, kodwa ngokuqinisekile akusho ukuthi kungaphezu kwamandla akho.
- Ukuxilongwa okunembile kubalulekile. Ngezinye izikhathi, kungase kube nezici zempilo ezibangela umfutho wegazi ophakeme ezidinga ukuxazululwa.
- Phuza imithi yakho njengoba nje uyalelwe, ngesikhathi, nangesilinganiso esifanele. Uma uhlangabezana nanoma yiziphi izinselele, sicela ukhulume nodokotela wakho ngokushesha.
- Ukuguqulwa kwendlela yokuphila kunethonya elikhulu. Khumbula ukubeka phambili ukunciphisa usawoti odliwayo, ukuhlala umatasa ngokomzimba, kanye nokugcina isisindo esinempilo.
- Gcina ukuxhumana okuvulekile nomhlinzeki wakho wezempilo. Thembeka nganoma yimiphi imibuzo, ukukhathazeka, noma imiphumela emibi ongase ube nayo.
- Ungalokothi uyeke noma ushintshe umthamo wemithi yakho wedwa. Njalo xhumana nodokotela wakho kuqala.
Khumbula, awuwedwa kulolu hambo. Udokotela wakho kanye nethimba lezempilo eNirogi Lanka balapha ukuzokusekela. Ngokubekezela, uhlelo lokwelashwa olufanele, kanye nokulungiswa kwendlela yokuphila okuhle, unamandla okuphatha lesi simo ngempumelelo!
