Ngawaphi amanqanaba oxinzelelo lwegazi aqhelekileyo?

Imfundo yezeMpilo

Itshathi yamanqanaba oxinzelelo lwegazi | Igazi elonyukayo | Uxinzelelo lwegazi oluphantsi | Nini ukubona ugqirha

Uxinzelelo lwegazi ngamandla egazi ngokuchasene neendonga zemithambo yegazi njengoko ihamba kwinkqubo yokujikeleza kwegazi. Uxinzelelo lwegazi lomntu luya kuphakama kwaye lwehle imini yonke, kodwa ukuba noxinzelelo lwegazi oluphezulu ngokungaqhelekanga okanye okuphantsi kunokubonisa iimeko zempilo ezingaphantsi. Makhe sijonge ngakumbi kumanqanaba oxinzelelo lwegazi ukuqonda ukuba kuthetha ntoni ukuba uxinzelelo lwegazi luphezulu okanye luphantsi.

Luluphi uhlobo oluqhelekileyo loxinzelelo lwegazi?

Kuqhelekile kumanqanaba oxinzelelo lwegazi lomntu omdala ukuba atshintshe yonke imihla ngokusekelwe kwinto abayityayo, indlela abaxinezeleke ngayo, nokuba bayazilolonga na. Uxinzelelo lwegazi lulinganiswa kusetyenziswa amanani amabini: i-systolic (inombolo ephezulu) kunye ne-diastolic (inombolo engezantsi). Uxinzelelo lwegazi lwe-Systolic lilinganisela uxinzelelo kwimithambo xa intliziyo ibetha, kwaye uxinzelelo lwegazi lwe-diastolic lilinganisa uxinzelelo kwimithambo xa intliziyo ihleli phakathi kwentsimbi. Nantsi itshathi yoxinzelelo lwegazi ukusuka Umbutho wentliziyo yaseMelika (AHA) ukukunceda uqonde ngcono imilinganiselo yoxinzelelo lwegazi:

Uxinzelelo lwegazi lwabantu luya kuba kwindawo engaphantsi kwe-120/80 mmHg nangaphezulu kwe-90/60 mmHg. Uxinzelelo lwegazi lokufunda olubonisa amanani angaphandle kolu luhlu kunokubonisa ukuba umntu unoxinzelelo lwegazi (uxinzelelo lwegazi) okanye uxinzelelo lwegazi (hypotension). Xa kufikwa kumanani oxinzelelo lwegazi, zombini uxinzelelo lwe-systolic kunye ne-diastolic zibalulekile. Okwangoku, uxinzelelo lwegazi lwe-systolic (inombolo ephezulu) inikwa ingqalelo ngakumbi kuba uxinzelelo oluphezulu lwe-systolic lunokudityaniswa ne- ukwanda komngcipheko yesifo kunye nesifo sentliziyo.

Njengokuba abantu bekhula, umngcipheko wokufumana uxinzelelo lwegazi oluphezulu uyenyuka. Abantu abadala abaneminyaka engama-19 ukuya kwengama-40 ubudala baya kuba namanqanaba oxinzelelo lwegazi atshintshayo phakathi kwe-90-135 / 60-80 mmHg. Isikhokelo sokuxinzelela uxinzelelo lwamva nje esivela kwiilebheli zango-2017 aba bantu bancinci njengoxinzelelo lwegazi ukuba uxinzelelo lwegazi lwe-systolic yi-130-139 okanye uxinzelelo lwegazi lwe-diastolic luphakathi kwama-80-89, nangona kunjalo unyango luya kuxhomekeka kumngcipheko wabo obaliweyo wesifo sentliziyo.

Ezinxulumene: Yintoni ukubetha kwentliziyo okuqhelekileyo?

Uxinzelelo lwegazi

Phantse isiqingatha sabantu abadala baseMelika bane-hypertension, kwaye ngabantu abayi-1 kwaba-4 kuphela abanemeko ephantsi kolawulo, ngokwe-Centers for Disease Control and Prevention ( i-CDC ). Iinkcukacha-manani ezivela kuMbutho wezeMpilo weHlabathi ( I-WHO ) ityhila ukuba abantu abaqikelelwa kwi-1.13 yezigidigidi banexinzelelo lwegazi kwihlabathi liphela kwaye ingoyena nobangela wokufa ngaphambi kwexesha.

Ukuba noxinzelelo lwegazi oluphezulu kuchaphazela kakubi umzimba ngeendlela ezininzi. Uxinzelelo lwegazi lubangela ukuba intliziyo isebenze nzima kunesiqhelo, inokonakalisa imithambo yegazi, yonyuse i-ventricle yasekhohlo yentliziyo, kwaye ibangele nokonakala kwengqondo, ukubetha, kunye nokusilela kwentliziyo. Amanqanaba oxinzelelo lwegazi olungapheliyo anokulimaza i-retinas emehlweni, ibangele ukusilela kwesibindi, isifo sezintso, kunye nokungasebenzi kakuhle ngokwesondo.

Ezinxulumene: Izibalo zesifo senhliziyo

Iimpawu zoxinzelelo lwegazi oluphezulu

Nangona amanqanaba oxinzelelo lwegazi anokuchaphazela kakubi umzimba, ngokwesiqhelo awubangeli zimpawu de kube kukhokelele kwingxaki yezempilo enje ngokubethwa sistroke okanye isifo sentliziyo. Yiyo loo nto ngamanye amaxesha kubhekiswa kuye njengombulali othuleyo. Xa ibangela iimpawu kunye neziphumo ebezingalindelekanga, abantu abanexinzelelo oluphezulu lwegazi banokufumana enye okanye nangaphezulu koku kulandelayo:

• Ukuba nesiyezi
• Intloko ebuhlungu
• Ukugungxula ebusweni
• Iintlungu zesifuba
• Ukudideka
• Iimpumlo
• Kunzima ukuphefumla
• Ukubetha kwentliziyo ngokungaqhelekanga
• Igazi kumchamo

Ukuba unayo nayiphi na le mpawu, oko akuthethi ukuba uxinzelelo lwegazi luphezulu kakhulu. Abanye abantu baya kuba nesinye okanye ezingaphezulu kwezi mpawu ngenxa yezizathu ezingadibaniyo, ke kuhlala kungumbono olungileyo ukujonga uxinzelelo lwegazi rhoqo.

Oonobangela boxinzelelo lwegazi oluphezulu

Abantu abathile baya kuba nomngcipheko ophezulu wokufumana uxinzelelo lwegazi kunabanye, kwaye abo bantu kufuneka banakekele ngakumbi ekujongeni uxinzelelo lwegazi. Ngokubanzi, amanqanaba oxinzelelo oluphezulu lwegazi ayenzeka kancinci ngokuhamba kwexesha, nangona into efana noxinzelelo inokubangela i-spikes zexesha elincinci kuxinzelelo lwegazi. Nazi izinto ezinobungozi kunye nezizathu zoxinzelelo lwegazi:

• Seswekile
• Ukutyeba kakhulu
• Awonelanga umthambo
• Ukutya okungenampilo
• Ukutshaya
• Ukusela kakhulu utywala
• Imbali yosapho yoxinzelelo lwegazi oluphezulu
• Ukwaluphala

Nangona uxinzelelo lwegazi luthathelwa phezulu ukuba yi-130/80 mmHg okanye ngaphezulu, kunokwenzeka ukuba nenani eliphezulu loxinzelelo lwegazi kunye nenani eliqhelekileyo loxinzelelo lwegazi. Le yimeko ebizwa uxinzelelo lwegazi olusisigxina , ikakhulu ebangelwa yimeko zonyango ezinje ngeswekile, hyperthyroidism, kunye neengxaki zentliziyo yevalvu. Inani eliphantsi kakhulu kufundo loxinzelelo lwegazi kunokuba sisiphumo sokutya isodium kakhulu, ukutyeba kakhulu, ukusela kakhulu utywala, nokungafumani umthambo ngokwaneleyo.

Unyango oluphezulu lwegazi

Ukunyanga uxinzelelo lwegazi rhoqo kubandakanya indibaniselwano yotshintsho kwindlela yokuphila kunye namayeza. Nazi iindlela zonyango eziqhelekileyo zoxinzelelo lwegazi:

Amayeza aqhelekileyo egazi
Igama leziyobisi	Iklasi yeziyobisi	Ugcino olulodwa
Atenolol	Ibhloko blocker	Fumana isigqebhezana
Indawo	I-Angiotensin-eguqula i-enzyme (ACE) inhibitor	Fumana isigqebhezana
Ingqokelela	Isithintelo se-ACE	Fumana isigqebhezana
Prinivil	Isithintelo se-ACE	Fumana isigqebhezana
IVasotec	Isithintelo se-ACE	Fumana isigqebhezana
ILotensin	Isithintelo se-ACE	Fumana isigqebhezana
UDiovan	I-Angiotensin II receptor blocker (i-ARB)	Fumana isigqebhezana
I-Norvasc	Isikhululo seCalcium blocker	Fumana isigqebhezana
IHydrochlorothiazide	Womchamo	Fumana isigqebhezana

Ezinxulumene: I-ACE inhibitors kunye ne-beta blockers

Qaphela: ICDC ibandakanya abaguli abanesifo soxinzelelo lwegazi kwi amaqela anobungozi yokufumana ikhontrakthi i-COVID-19 okanye ukuphuhlisa iingxaki ze-coronavirus.

Utshintsho kwindlela yokuphila inokunciphisa amanqanaba oxinzelelo lwegazi. Olunye utshintsho olusebenzayo lubandakanya:

• Ukufumana umthambo rhoqo
• Ukutya ukutya okusempilweni
• Ukunciphisa ukutya okutyiwa kakhulu
• Ukugcina ubunzima bomzimba obusempilweni
• Ukulawula uxinzelelo
• Ukusikela umda ekusebenziseni utywala
• Ukuyeka ukutshaya

Amanqanaba oxinzelelo lwegazi asezantsi

Nangona ngqo ukuxhaphaka koxinzelelo lwegazi olusezantsi ayaziwa, iseyimeko eqhelekileyo echaphazela abantu kwihlabathi liphela. Ukuba noxinzelelo lwegazi oluphantsi kunokuchaphazela umzimba ngeendlela ezininzi.

Iimpawu zoxinzelelo lwegazi olusezantsi

Nazi iimpawu eziqhelekileyo ze-hypotension:

• Ukuba nesiyezi
• Ubuthathaka
• Ubumhlophe
• Ukudideka
• Umbono omfiliba
• Isicaphucaphu
• Ukudinwa
• Isikhumba esibandayo nesibilayo
• Ukuphefumla ngokukhawuleza nangaphantsi

Ukuhla ngesiquphe koxinzelelo lwegazi kunokubangela nayiphi na kwezi mpawu, kwaye ukuba uxinzelelo lwegazi lwakho lwehla ngesiquphe, umzimba wakho ungothuka. Ukuba noxinzelelo lwegazi olungenasiphelo kunokuba yingozi kuba umzimba awuyi kufumana ioksijini eyaneleyo entliziyweni nasengqondweni, enokubangela umonakalo ongapheliyo. Nangona kunokwenzeka ukuba ufumane iimpawu zoxinzelelo lwegazi olusezantsi, kuyinto eqhelekileyo ukuba noxinzelelo lwegazi oluphantsi kwaye ungabi nazimpawu. Kungenxa yoko le nto ukujonga rhoqo uxinzelelo lwegazi kunye nokujonga uxinzelelo lwegazi kubalulekile.

Izinto ezibangela uxinzelelo lwegazi

Naliphi na inqanaba loxinzelelo lwegazi eliya ngaphantsi kwe-90/60 mmHg ithathwa njengephantsi. Ezona zizathu zixhaphakileyo zokwehlisa uxinzelelo lwegazi ngumthamo wegazi ophantsi (cinga: ukuphelelwa ngamanzi emzimbeni okanye ukulahleka kwegazi), kunyango lwexinzelelo lwegazi, okanye ukuthatha amayeza athile anokunciphisa uxinzelelo lwegazi, utshilo uSusan Besser, MD, umboneleli ophambili IZiko lezoNyango leNceba eBaltimore.

Nazi ezinye zezizathu eziqhelekileyo zokuhla ngesiquphe kumanqanaba oxinzelelo lwegazi kunye ne-hypotension engapheliyo:

• Ukukhulelwa
• Amayeza athile, njengamayeza entliziyo okanye amayeza oxinzelelo
• Ezinye iingxaki zempilo njengesifo sentliziyo okanye isifo se-thyroid
• Umonzakalo obangela ukulahleka kwegazi okanye usulelo lwegazi
• Utshintsho olukhulu kubushushu bomzimba

Abanye abantu kunokwenzeka ukuba banamanqanaba asezantsi oxinzelelo lwegazi ngokusekwe kubudala babo, isini, kunye nembali yezonyango. Nazi izinto eziphambili zomngcipheko wokufumana i-hypotension:

• Ukwaluphala
• Ukuba ukhulelwe
• Ukuba neswekile
• Ukuba neengxaki zentliziyo
• Ukuba nesifo sesibindi
• Ukuba nokungalingani kwehomoni
• Ukuba neevithamini kunye / okanye ukusilela kwezondlo

Unyango lwexinzelelo lwegazi

Isicwangciso esifanelekileyo sonyango lwe-hypotension siya kwahluka ngokuxhomekeka emntwini kwaye yintoni ebangela uxinzelelo lwegazi oluphantsi. Oyena mntu ukubuza malunga nendlela yokulinganisa amanqanaba oxinzelelo lwegazi ngugqirha, kodwa ngokubanzi, ukukhokelela kwindlela yokuphila esempilweni kunye nokuthatha amayeza oxinzelelo lwegazi kunokunceda ukulungisa uxinzelelo lwegazi olusezantsi:

Amayeza aziwayo aphantsi koxinzelelo lwegazi
Igama leziyobisi	Iklasi yeziyobisi	Ugcino olulodwa
IFludrocortisone	ICorticosteroid	Fumana isigqebhezana
IMidodrine	IAlfa-1-agonist	Fumana isigqebhezana

Olunye utshintsho kwindlela yokuphila olunokuthi ngokwendalo luphakamise uxinzelelo lwegazi, kubandakanya:

• Ukusela amanzi amaninzi
• Ukwandisa ityuwa yakho ukuba uvunyiwe ngugqirha
• Ukusela utywala obuncinci
• Ukuphepha ukuma ixesha elide
• Ukutya izixa ezincinci zecaffeine ukuba kugunyazisiwe ngugqirha
• Ukutya rhoqo, ukutya okuncinci, okuphantsi kwe-carb imini yonke

Ezinxulumene: Uxinzelelo lwegazi kunye namayeza

Amanqanaba oxinzelelo lwegazi anobungozi-xa ufuna ukubona ugqirha

Ukuba namanqanaba oxinzelelo lwegazi anyukayo esihla kancinci kancinci kuqhelekile, kodwa amanye amanqanaba oxinzelelo lwegazi athathwa njengezempilo. Xa uxinzelelo lwegazi luphezulu kakhulu, oku kubeka uxinzelelo entliziyweni, kwimithambo yegazi, kwingqondo nakwamehlo.

Inkqubo ye- i-CDC uxela ukuba uninzi lweengcali zokhathalelo lwempilo zijonga amanqanaba oxinzelelo lwegazi aphezulu ukuba afunda i-130/80 mmHg, kodwa uxinzelelo lwegazi oluphezulu alubeki bungozi de lufike kwi-180/120 mmHg okanye ngaphezulu. Oku kubizwa ngokuba yingxaki yoxinzelelo lwegazi kwaye kufuna unyango kwangoko. Ukuba uxinzelelo lwegazi lwakho lungaphezulu kwe-180/120 mmHg kwaye unentlungu esifubeni, iimpawu zestroke, okanye isifo sentliziyo, kuya kufuneka uye kwi-ER, utshilo uGqirha Besser. Amanqanaba oxinzelelo lwegazi ayingozi angaqwalaselwanga nawo angabangela:

• Iingxaki zememori
• Ukumelwa yintliziyo
• Iimpawu
• Ukuphulukana ngesiquphe nomsebenzi wezintso
• Iingxaki zokukhulelwa
• Ubumfama

Kwelinye icala, ukwehla ngesiquphe koxinzelelo lwegazi kunokuba yingozi, ngakumbi kubantu abadala, kuba bathambekele ekufumaneni ubuthathaka, isiyezi, kunye nokuphelelwa ngamandla. Ukuba nolunye uxinzelelo lwegazi olungaqhelekanga ngokufunda okungaphantsi kwe-90/60 mmHg kulungile, kodwa ukuba uqhubeka nokufumana uxinzelelo lwegazi oluphantsi, kunokuba lixesha lokuba undwendwele iofisi kagqirha.