I-ACE inhibitors vs i-beta blockers: Loluphi unyango lwexinzelelo lwegazi olukufaneleyo?

Ulwazi lweziyobisi

Abantu abadala baseMelika abangamashumi asixhenxe anesihlanu banexinzelelo oluphezulu lwegazi (uxinzelelo lwegazi), kodwa kuphela Iipesenti ezingama-54 amanqanaba abo aphantsi kolawulo. Ngethamsanqa imeko exhaphakileyo njengoxinzelelo lwegazi, kukho iindidi zamayeza ezinokunceda. Phakathi kwazo kukho i-ACE inhibitors kunye ne-beta blocker, uninzi loogqirha oluya kuyichaza ngaphambi kwalo naluphi na olunye uhlobo lwamayeza.

Ukuba awunampawu, njengabantu abaninzi abanexinzelelo oluphezulu lwegazi, ugqirha uya kuthi azame i-ACE inhibitor kuqala. Ukuba uxinzelelo lwegazi oluphezulu luhamba kunye nesifuba okanye uxinzelelo, i-beta blocker inokuba yinto ebhetele. Oogqirha banokumisela zombini iintlobo zamayeza ngaxeshanye phantsi kweemeko ezithile.

Loluphi olona nyango lonyango lwegazi lungcono kuwe? Sebenzisa esi sikhokelo ukuthelekisa i-ACE inhibitors kunye ne-beta blockers ukulungiselela utyelelo lukagqirha wakho olandelayo.

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Zisebenza njani ii-ACE inhibitors kunye ne-beta blocker?

I-ACE inhibitors (i-angiotensin-converting-enzyme inhibitors) yandisa imithambo yegazi kwaye yehlise umthamo wegazi, olwehlisa uxinzelelo lwegazi kunye nokunyusa ukuhamba kwegazi kuye entliziyweni. Ukwenza njalo, I-ACE inhibitors vimba i-enzyme eguqula i-angiotensin ukusuka ekuguquleni i-angiotensin I ukuya kwi-angiotensin II-ihomoni ethintela imithambo yegazi. Ngokuthintela i-hormone, uxinzelelo lwegazi lomntu luyehla.

I-ACE inhibitors zihlala zichazwe ngoogqirha ukunyanga uxinzelelo lwegazi kunye nokusilela kwentliziyo. Banokukunceda ukunciphisa umngcipheko wokufa emva kokuhlaselwa yintliziyo (i-myocardial infarction).

Ibhlokhi yeBeta (ii-beta-adrenergic blocking agents) zithintela iziphumo zoxinzelelo lwehomoni eziyinxalenye yenkqubo yemfesane enovelwano. Ezi hormone zibandakanya i-norepinephrine kunye ne-epinephrine (ekwabizwa ngokuba adrenaline ). Ukuthintela la mahomoni kuvumela imithambo yegazi ukuba iphumle kwaye yande. Emva koko, iibhloko ze-beta zinokucothisa ukubetha kwentliziyo, uxinzelelo lwegazi olusezantsi, kunye nokuphucula ukuhamba kwegazi.

I-Beta blockers inokunyanga uxinzelelo lwegazi oluphezulu kunye nezinye iimeko ze-hmnealth ezinje ngokusilela kwentliziyo yokuxinana, izingqisho zentliziyo engaqhelekanga, ixhala kunye nentlungu esifubeni.

Fumana ikhadi lesaphulelo somntu ongatshatanga

I-ACE inhibitors kunye ne-beta blockers
	I-ACE inhibitors	Ibhlokhi yeBeta
Ukuphathwa kweemeko zempilo	Igazi elonyukayo Ukumelwa yintliziyo Imithambo yegazi Isifo sezintso esinganyangekiyo	Igazi elonyukayo Ukusilela kwentliziyo Isingqisho sentliziyo esingaqhelekanga Iintlungu zesifuba Ixhala Iglaucoma Imigraines Tachycardia
Amayeza aqhelekileyo amiselweyo	Lisinopril I-Enalapril eyindoda IBenazepril HCl	I-Acebutolol HCl Atenolol Bisoprolol fumarate
Iziphumo eziqhelekileyo	Ukuba nesiyezi Ukukhohlela owomileyo Ukudideka	Ukuqunjelwa Ingxaki yokulala Ezinye zinokubangela ukutyeba
Izilumkiso	Kuyingozi kwabasetyhini abakhulelweyo kwaye kunokubangela iziphene zokuzalwa Ukuphakamisa amanqanaba e-potassium kwaye kunokubangela i-hyperkalemia	Kuyingozi kwabasetyhini abakhulelweyo kwaye kunokubangela iziphene zokuzalwa Ezinye zinokuchaphazela amanqanaba e-cholesterol kunye ne-triglyceride
Unxibelelwano	Izidakamizwa ezichasayo ezichasayo (i-NSAID) Izongezo zePotassium okanye izitshizi zetyuwa eziqulathe i-potassium	Izidakamizwa ezichasayo ezichasayo (i-NSAID)

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Ungathatha i-ACE inhibitors nge-beta blocker?

Ugqirha unokuyalela i-ACE inhibitor kunye ne-beta blocker kwangaxeshanye ukuphucula amanqanaba egazi kwizigulana ezinobungozi obuphezulu okanye abantu abaneemeko ezithile zonyango ezinje ngesifo sentliziyo okanye ukusilela kwentliziyo okungapheliyo.

Kuqikelelwa ukuba iipesenti ezingama-75 zezigulana ezinexinzelelo oluphezulu ziya kufuna unyango oludibeneyo (ngaphezulu kwelinye amayeza) ukufikelela kwiinjongo zoxinzelelo lwegazi, ngokwe Ijenali yoMbutho waseMelika woxinzelelo lwegazi . Olu nyango lwendibaniselwano lunokubandakanya ukuthatha i-ACE inhibitors kunye ne-beta blockers ngaxeshanye okanye ukuthatha enye ngolunye uhlobo lonyango loxinzelelo lwegazi njenge-angiotensin receptor blockers (ARBs).

I-ACE inhibitors kunye ne-beta blocker zisebenza ngokwahlukileyo kwaye zijolise kwiindawo ezahlukeneyo zomzimba. Ngale ndlela, banokuncedisana.

Izilumkiso

Zombini i-ACE inhibitors kunye ne-beta blocker kunokuba yingozi kwabasetyhini abakhulelweyo. Banokubangela isiyezi koxinzelelo lwegazi olusezantsi kwaye kunokubangela iziphene zokuzalwa. Ukuba ukhulelwe okanye unokukhulelwa, ukuthetha nogqirha yeyona ndlela ifanelekileyo yokufumanisa ukuba ngaba ii-beta blockers okanye ii-ACE inhibitors zikulungele na.

I-ACE inhibitors iphakamisa amanqanaba egazi e-potassium, ngoko ke ukubeka esweni ukutya i-potassium ngexesha lonyango kunyanzelekile. Ngenxa yoko, ukuthatha izongezo zepotassium okanye ukusebenzisa izinto zetyuwa eziqulathe i-potassium kunokubangela amanqanaba e-potassium egazi ngokugqithisileyo (hyperkalemia). IHyperkalemia inokukhokelela kwezinye, ezinokuba semngciphekweni weengxaki zempilo. Iimpawu zehyperkalemia zibandakanya ukudideka, ukubetha kwentliziyo ngokungaqhelekanga, kunye nokugungqa okanye ukuphazamiseka ezandleni okanye ebusweni.

Kwelinye icala, ezinye iibhloko ze-beta zinokunyusa i-triglycerides kunye nokunciphisa amanqanaba e-cholesterol elungileyo. Oku kuhlala kuyinto yethutyana kodwa kunokuchaphazela abaguli abane-metabolic syndrome.

Ukusebenzisana kweziyobisi

I-ACE inhibitors kunye ne-beta blockers zisenokungasebenzi ngokukuko xa zithathwa ngamachiza angenayo intsholongwane (i-NSAIDs) njenge-ibuprofen, i-Advil ne-Aleve. Thetha nogqirha wakho ngaphambi kokuba uthathe naziphi na ii-NSAID ngelixa uthatha i-ACE inhibitors, i-beta blockers, okanye zombini.

Ukutshintsha ukusuka kwi-beta blocker ukuya kwi-ACE inhibitors

Ngamanye amaxesha, ugqirha unokutshintsha iyeza lakho le-beta blocker iye kwi-ACE inhibitor okanye ngokuchaseneyo.

Kwiimeko apho izigulana zinezinga eliphantsi lentliziyo okanye isifo senhliziyo esingaqhelekanga, nokuba ithamo le-beta blockers kufuneka lincitshiswe, okanye elinye iyeza loxinzelelo lwegazi njenge-ACEi linokusetyenziswa, utsho Atif Zafar , MD, umlawuli wezonyango kwiNkqubo yeYunivesithi yaseNew Mexico Stroke. Kwenye imeko, apho abaguli banesifo se-renal isifo (njenge-stenosis yemithambo ye-renal), i-ACEi ayikhuthazwa kulawulo lwexinzelelo lwegazi. Amanye amayeza e-BP afaneleke ngakumbi kwezi zigulana.

Abanye izifundo cebisa ukuba ukutshintshela kwi-beta blocker ukuya kwi-ACE inhibitors kunokunceda ukunciphisa iimpawu zokozela kunye nokuphucula ukuqonda. Nangona kunjalo, oku akuthethi ukuba ii-beta blocker zibhetele kune-ACE inhibitors.

Iyeza ngalinye linenjongo yalo kwaye kunokuba ngcono ekunyangeni imeko ethile kunenye. [I-ACE inhibitors] yonyango lodidi lokuqala ngelixa iibhloko ze-beta zihlelwa njengonyango lodidi lwesibini lokulawula i-BP, utshilo uGqirha Zafar. Nangona kunjalo, kwizigulana ezinesifo se-coronary artery disease (CAD), okanye isifo esomeleleyo sesifo sentliziyo njenge-comorbid yoxinzelelo lwegazi, iibhloko ze-beta kunye ne-ACEI ziyacetyiswa ekukhetheni umgca wokuqala.

Eyona nto ibaluleke kakhulu, kukuthetha nogqirha okanye ingcali yezonyango yeyona ndlela ifanelekileyo yokufumanisa ukuba ngaba awutshintshi kwi-beta blockers uye kwi-ACE inhibitors lukhetho olufanelekileyo kuwe ngokusekwe kwimpendulo yakho kunyango kunye naziphi na iziphumo ebezingalindelekanga ohlangabezana nazo.

Imiphumela

Njengawo nawaphi na amayeza, kuhlala kukho iziphumo ebezingalindelekanga. Ukuthatha iibhlokhi ze-beta, ii-ACE inhibitors, okanye zombini zinokubangela ezinye zezi ziphumo zilandelayo:

I-ACE inhibitor ngokuchasene neziphumo ebezingalindelekanga ze-beta
Iziphumo ze-ACE inhibitor	Iziphumo ebecaleni zeBeta blocker
Ukuba nesiyezi Ukukhohlela owomileyo Ukudideka Intloko ebuhlungu Ukudinwa Ukudumba kolusu Amanqanaba aphakamileyo e-potassium egazi Isinyithi okanye incasa enetyiwa emlonyeni Ubuthathaka	Izandla kunye neenyawo ezibandayo Ukuqunjelwa Uxinzelelo Ukuba nesiyezi Umlomo owomileyo, ulusu namehlo Ukungasebenzi kakuhle kwe-Erectile Ubumhlophe Ukudinwa Intloko ebuhlungu Isicaphucaphu Ukuqhawukelwa ngumphefumlo Ukubetha kwentliziyo kancinci Ingxaki yokulala Ukutyeba kwakho

Olu luhlu lweziphumo ebezingalindelekanga alubanzi. Ingcali yezonyango inokukunika uluhlu olupheleleyo lweziphumo ebezingalindelekanga ezinxulunyaniswa ne-ACE inhibitors vs.

Nangona kunqabile, i-ACE inhibitors kunye ne-beta blockers zinokudityaniswa neziphumo ebezingalindelekanga ezibi kakhulu. Ukuthatha i-ACE inhibitors kunokubangela angioedema , imeko enqabileyo ebangela ukudumba kobuso namanye amalungu omzimba. I-ACE inhibitors inokubangela ukusilela kwezintso okanye ukwehla kweeseli ezimhlophe zegazi.

I-Beta blockers zibangele uhlaselo olubi lwe-asthma. Kubantu abanesifo seswekile, iibhloko ze-beta zinokugcina umzimba ungabonisi zimpawu zeswekile esezantsi yegazi (njengokungcangcazela kunye nokubetha). Uxinzelelo lwegazi kunye nenqanaba lentliziyo kufuneka libekwe esweni ngelixa kuthathwa iibhlokhi ze-beta.

Zeziphi ezona nyango zibalaseleyo zoxinzelelo lwegazi?

Nangona kungekho liyeza elinye elilungileyo ekunyangeni uxinzelelo lwegazi, i-ACE inhibitors kunye ne-beta blockers ziphakathi kweentlobo ezithandwayo zeziyobisi. Amayeza amiselweyo aya kuxhomekeka kwimbali yezonyango, iimpawu, kunye nokuphendula kunyango. Ingcali yezempilo inokukunceda ukumisela Olona nyango lonyango luphezulu kwimeko-ngamatyala. Nalu uluhlu lwamanye amayeza aqhelekileyo amiselweyo kunyango lwegazi:

I-ACE inhibitor vs amayeza e-beta blocker
I-ACE inhibitors	Ibhlokhi yeBeta
ILotensin (benazepril HCl) IVasotec (enalapril eyindoda) Prinivil (lisinopril) Zestril (lisinopril) ICapoten ( captopril ) Monopril ( fosinopril isodiyam ) Ingqokelela ( quinapril HCl ) Indawo ( zitshisa ) Univasc ( moexipril HCl ) UMavik ( inyanda ) I-Aceon ( perindopril erbumine )	Icandelo ( I-acebutolol HCl ) Tenormin ( atenolol ) Zebeta ( bisoprolol fumarate ) Ngobungqina (nebivolol) Lopressor ( itartrate yemetoprolol ) Itrolol XL ( Ukunyanzeliswa kwemetoprolol ) Umxholo ( umfanekiso oqingqiweyo ) Corgard ( nadolol ) Inderal LA ( ipropranolol )

Amayeza oxinzelelo lwegazi akhethwe ngokusekwe kwindlela olwehlisa ngayo uxinzelelo lwegazi kunye nokunciphisa umngcipheko wokuhlaselwa sisifo sentliziyo, ukubetha, kunye nokusilela kwentliziyo, ngokweIjenali yoMbutho waseMelika woxinzelelo lwegazi. Ukuba i-ACE inhibitor okanye i-beta blocker ayizukusebenzela wena, ugqirha wakho unokucebisa olunye uhlobo lweziyobisi ezichasayo, ezinje nge-calcium channel blockers, diuretics, alpha blockers, njl.

Ukongeza, utshintsho kwindlela yokuphila Unokunceda ukulawula uxinzelelo lwegazi kunye namayeza. Kodwa ngaphezulu kwako konke, ingcali yezonyango inokukunceda ukumisela esona sicwangciso sonyango silungileyo kuwe ngokusekwe kwiimpawu zakho nakwimbali yezonyango.