Orthostatic Hypotension (Postural Hypotension)

Orthostatic hypotension — inonziwo postural hypotension — rudzi rwekuoma kweropa kunoitika kana wakamira mushure mekugara kana kurara. Orthostatic hypotension inogona kukonzera kuzvinzwa musoro kana kushaya simba uye zvichida kupera simba.

Orthostatic hypotension inogona kuva yakapfava. Zviitiko zvingave zvipfupi. Zvisinei, orthostatic hypotension inogara kwenguva refu inogona kuratidza matambudziko makuru. Zvakakosha kuona chiremba kana iwe uchizviwana uchizvinzwa musoro kazhinji kana wakamira.

Orthostatic hypotension inowanzoitika inowanzo konzerwa nechimwe chinhu chakajeka, sekushaya mvura mumuviri kana kurara kwenguva refu. Iyo mamiriro ezvinhu ari nyore kurapwa. Orthostatic hypotension inogara ichiratidza chimwe dambudziko rehutano, saka kurapwa kunoenderana nechinokonzera.

Chirwere chinonyanya kuoneka che orthostatic hypotension ndeche kushaya simba kana kuzvinzwa musoro pakusimukira pashure pokugara kana kurara. Zviratidzo kazhinji zvinongogara kwemaminitsi mashoma.

Zviratidzo nezviratidzo zve orthostatic hypotension zvinosanganisira:

• Kushaya simba kana kuzvinzwa musoro pakusimukira
• Kuona kusapfava
• Kushaya simba
• Kufa nepfungwa (syncope)
• Kusapindirana kwepfungwa

Feeling dizzy or lightheaded sometimes is usually nothing to worry about. It can be caused by simple things like being a little dehydrated, having low blood sugar, or getting too hot. Even standing up quickly after sitting for a while can cause these feelings. If it only happens now and then, it's probably not a problem.

However, if you often feel dizzy or lightheaded, especially when standing up, you should see a doctor. This is called orthostatic hypotension. Passing out, even for a short time, is a serious sign and needs immediate medical attention.

To help your doctor understand what's happening, keep track of when you feel dizzy or lightheaded. Note how long it lasts and what you were doing at the time. It's also important to mention if the dizziness occurs in situations where it could be dangerous, like while driving.

Kana uchitsika kubva pakagara kana kurara, kuomarara kunokonzera ropa kuunganidzwa mumitsipa nemudumbu. Ropa rekuwedzera rinodonha nekuti kune ropa shoma rinodzoka kumoyo.

Kazhinji, masero chaiwo (baroreceptors) ari pedyo nemoyo nemidziyo yeropa yemutsipa anonzwa kuwedzera uku kweropa. Baroreceptors inotumira zviratidzo kuuropi. Izvi zvinotaurira moyo kuti arove nekukurumidza uye apompe ropa rakawanda, izvo zvinoenzanisa ropa rekuwedzera. Masero aya anovharirawo midziyo yeropa uye anowedzera ropa rekuwedzera.

Orthostatic hypotension inoitika kana chimwe chinhu chikapindira maitiro emuviri ekugadzirisa ropa rekuwedzera rakaderera. Zvirwere zvizhinji zvinogona kukonzera orthostatic hypotension, kusanganisira:

• Kushaya mvura mumuviri. Fivha, kurutsa, kusadya mvura yakakwana, manyoka akaomarara uye kurovedza muviri kwakanyanya nekubuda kwemukaka zvinogona kukonzera kushaya mvura mumuviri. Kushaya mvura mumuviri kunoderedza huwandu hweropa. Kushaya mvura mumuviri kwakapfava kunogona kukonzera zviratidzo zve orthostatic hypotension, senge kushaya simba, kuzvinzwa musoro uye kuneta.
• Matambudziko emoyo. Zvimwe zvirwere zvemoyo zvinogona kukonzera ropa rekuwedzera rakaderera zvinosanganisira kurova kwemoyo kwakaderera kwazvo (bradycardia), matambudziko emahara emoyo, kurwara kwemoyo nekukundikana kwemoyo. Aya mamiriro anoita kuti muviri usakwanise kupomba ropa rakawanda nekukurumidza kana uchitsika.
• Matambudziko ehormone. Zvirwere zve thyroid, kushomeka kwe adrenal (chirwere cheAddison) uye shuga yakaderera yeropa (hypoglycemia) zvinogona kukonzera orthostatic hypotension. Saka chirwere cheshuga, chinogona kukuvadza matura anobatsira kutumira zviratidzo zvinodzora ropa rekuwedzera.
• Zvirwere zvehurongwa hwematumbu. Zvimwe zvirwere zvehurongwa hwematumbu, senge chirwere cheParkinson, atrophy yemasystem akawanda, Lewy body dementia, kukundikana kwakakwana kweautonomic uye amyloidosis, zvinogona kukanganisa kugona kwemuviri kudzora ropa rekuwedzera.
• Kudya zvokudya. Vamwe vanhu vane ropa rekuwedzera rakaderera mushure mekudya (postprandial hypotension). Iyi mamiriro akajairika muvakuru vakwegura.

Zvinokonzera hypotension ye orthostatic zvinosanganisira:

• Age. Hypotension ye orthostatic inowanzoitika kune avo vane makore 65 nekupfuura. Masero chaiwo (baroreceptors) ari pedyo nemwoyo nemidziyo yeropa inodzora kumanikidza kweropa inogona kunonoka sezvaunokura. Zvinogona kuomawo kuti mwoyo unokura ikurumidze kuita kuti kudonha kwekumanikidza kweropa kuwedzere.
• Mishonga. Izvi zvinosanganisira mishonga inoshandiswa kurapa kumanikidza kweropa kukuru kana chirwere chemwoyo, senge diuretics, alpha blockers, beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors uye nitrates.

Mishonga yakawanda inogona kuwedzera njodzi ye orthostatic hypotension inosanganisira mishonga inoshandiswa kurapa chirwere cheParkinson, antidepressants dzimwe, antipsychotics dzimwe, muscle relaxants, mishonga yekurapa erectile dysfunction uye narcotics.

• Zvirwere zvimwe. Zvirwere zvinogona kuwedzera njodzi yekumanikidza kweropa kwakaderera zvinosanganisira mamiriro emwoyo, senge matambudziko emahombekombe emwoyo, kurwisa kwemwoyo uye kukundikana kwemwoyo. Zvinosanganisirawo matambudziko emusana, senge chirwere cheParkinson. Uye zvinosanganisira zvirwere zvinokonzera kukuvara kwetatu (neuropathy), senge chirwere cheshuga.
• Kupisa kwemhepo. Kunge uri munzvimbo inopisa kunogona kukonzera kupererwa kwakanyanya uye zvichida kuoma kwemuviri, izvo zvinogona kuderedza kumanikidza kweropa uye kutanga orthostatic hypotension.
• Kuvata pabhedha. Kugara pabhedha kwenguva yakareba nekuda kwechirwere kana kukuvara kunogona kukonzera kushaya simba. Izvi zvinogona kutungamira ku orthostatic hypotension.
• Doro. Kunwa doro kunogona kuwedzera njodzi ye orthostatic hypotension.

Kuderera kwenguva refu kweBP inoramba yakaderera kana wakamira (orthostatic hypotension) kunogona kukonzera matambudziko akakomba, kunyanya pakuru vakuru. Izvi zvinosanganisira:

• Kuwa. Kuwa nekuda kwekupotsa ndicho chiratidzo chakajairika muvanhu vane orthostatic hypotension.
• Stroke. Kushanduka-shanduka kweBP kubva pakusimukira nekusagara nekuda kwe orthostatic hypotension kunogona kuva njodzi yekurohwa nekuda kwedzikira ropa rinofamba kuuropi.
• Zvirwere zvemoyo. Orthostatic hypotension inogona kuva njodzi yezvirwere zvemoyo nemamwe matambudziko, akadai kurwadziwa pabvudzi, kutadza kwemoyo kana matambudziko ekurova kwemoyo.

'Chinangwa chechiremba mukutsvaga hypotension ye orthostatic ndechekuwana chikonzero uye kuona kurapwa. Chikonzero hachizivikanwi nguva dzose.\n\nChiremba angatarisa nhoroondo yezvokurapa, mishonga nezviratidzo uye kuita bvunzo yemuviri kuti abatsire kuona chirwere.\n\nChiremba angakurudzirawo chimwe chezvinotevera:\n\nElectrocardiogram (ECG kana EKG). Bvunzo iyi inokurumidza uye isina marwadzo inoyeresa basa remagetsi remwoyo. Panguva ye electrocardiogram (ECG), sensors (electrodes) inonamatira pachipfuva uye dzimwe nguva paruoko kana makumbo. Matambo anobatanidza muchina, unodhinda kana kuratidza mhinduro. Inogona kuratidza kuchinja mukukurumidza kwemwoyo kana kuumbwa kwemwoyo uye matambudziko ekugadzirwa kweropa neoksijeni kumhasuru yemwoyo.\n\n Inogona kusawana kuchinja kwenguva nenguva mukukurumidza kwemwoyo. Chiremba wenyu angakurudzira kutarisa kurova kwemwoyo kwenyu pamba. Chishandiso chep portable, chinonzi Holter monitor, chinogona kupfekerwa zuva rimwe kana kupfuura kuti chinyore basa remwoyo panguva yemabasa ezuva nezuva.\n\nMunhu ane bvunzo yetafura yekukotama anotanga nekurara pasi patafura. Mabhande anochengeta munhu panzvimbo. Mushure mekurara pasi kwenguva, tafura inokotama panzvimbo inofananidza kumira. Chiremba anotarisa kuti mwoyo uye tsinga dzinodzora sei inopindura kuchinja kwezvikamu.\n\n* Kutarisa kweropa. Izvi zvinosanganisira kuyera kweropa uchigara uye uchiramira. Kudonha kwemamirimita makumi maviri e mercury (mm Hg) munhamba yepamusoro (systolic blood pressure) mukati memaminitsi maviri kusvika mashanu ekumira chiratidzo che hypotension ye orthostatic. Kudonha kwe 10 mm Hg munhamba yepasi (diastolic blood pressure) mukati memaminitsi maviri kusvika mashanu ekumira kunoratidzawo hypotension ye orthostatic.\n* Kuongororwa kweropa. Izvi zvinogona kupa ruzivo nezvehutano hwese, kusanganisira shuga yakaderera yeropa (hypoglycemia) kana mazinga mashoma eropa tsvuku (anemia). Zvose zvinogona kukonzera kuderera kweropa.\n* Electrocardiogram (ECG kana EKG). Bvunzo iyi inokurumidza uye isina marwadzo inoyeresa basa remagetsi remwoyo. Panguva ye electrocardiogram (ECG), sensors (electrodes) inonamatira pachipfuva uye dzimwe nguva paruoko kana makumbo. Matambo anobatanidza muchina, unodhinda kana kuratidza mhinduro. Inogona kuratidza kuchinja mukukurumidza kwemwoyo kana kuumbwa kwemwoyo uye matambudziko ekugadzirwa kweropa neoksijeni kumhasuru yemwoyo.\n\n Inogona kusawana kuchinja kwenguva nenguva mukukurumidza kwemwoyo. Chiremba wenyu angakurudzira kutarisa kurova kwemwoyo kwenyu pamba. Chishandiso chep portable, chinonzi Holter monitor, chinogona kupfekerwa zuva rimwe kana kupfuura kuti chinyore basa remwoyo panguva yemabasa ezuva nezuva.\n* Echocardiogram. Mafungu esound anoshandiswa kugadzira mifananidzo yemwoyo uri kufamba. Echocardiogram inogona kuratidza kuyerera kweropa kuburikidza nemwoyo nemavharuvhu emwoyo. Bvunzo inogona kubatsira kuziva chirwere chemwoyo chekuvakwa.\n* Bvunzo yekumanikidza. Bvunzo yekumanikidza inoitirwa panguva yekurovedza muviri, sekufamba pane treadmill. Vanhu vasina kukwanisa kurovedza muviri vanogona kupiwa mishonga yekuita kuti mwoyo ushande zvakanyanya. Mwoyo wobva waratidzwa ne electrocardiography, echocardiography kana bvunzo dzimwe.\n* Bvunzo yetafura yekukotama. Bvunzo yetafura yekukotama inoratidza kuti muviri unopindura sei kuchinja kwezvikamu. Zvinosanganisira kurara patafura yakati sandara inokotama kukwidza chikamu chepamusoro chemuviri. Kuchinja kwezvikamu kunofananidza kufamba kubva pakurara kusvika pakumira. Ropa rinotorwa kazhinji sezvo tafura ikokoma.\n* Valsalva maneuver. Bvunzo iyi isina kukanganisa inotsanangura kuti tsinga dzinodzora muviri dzinoshanda zvakanaka sei. Inoda kufema zvakadzika uye kubuditsa mweya kuburikidza nemiromo, sekunge uchiedza kuvhara bhora rakaoma. Kuwanda kwemwoyo nekumanikidza kweropa kunotarwa panguva yebvunzo.'

Kurapa hypotension ye orthostatic kunangidzirwa pakonzera pane kudzika kweropa pachayo. Semuyenzaniso, kana kuoma kwemuviri kuchikonzeresa hypotension ye orthostatic, mushandi wako wehutano angakurudzira kuchinja mararamiro akadai sekunwa mvura yakawanda. Kana mushonga uchikonzeresa kudzika kweropa kana wakamira, kurapa kunogona kusanganisira kuchinja huwandu kana kumisa mushonga.

Kune hypotension ye orthostatic yakapfava, imwe yekurapa kwakapusa ndeyekugara pasi kana kurara pasi nekukurumidza mushure mekunzwa musoro uchitanga kumira. Kazhinji, zviratidzo zvichapera. Dzimwe nguva, mishonga inodiwa kurapa hypotension ye orthostatic.

Kana hypotension ye orthostatic isina kuvanduka nekuchinja mararamiro, mishonga inogona kudiwa kuwedzera kweropa kana huwandu hweropa. Rudzi rwemushonga runotsamira pane rudzi rwehypotension ye orthostatic.

Mishonga inogona kushandiswa kurapa hypotension ye orthostatic inosanganisira midodrine (Orvaten), droxidopa (Northera), fludrocortisone kana pyridostigmine (Mestinon, Regonol).

Taura nachiremba wako nezve njodzi uye mabhenefiti emishonga iyi kuti uone kuti ndeipi yakakunakira.

Matanho ari nyore anogona kubatsira kudzora kana kudzivirira orthostatic hypotension. Aya anosanganisira:

Compression stockings, zvinonziwo support stockings, inomanikidza makumbo, ichivandudza kuyerera kweropa. Munhu anogona kubatsirwa ne stocking butler pakupfeka stockings.

• Kupfeka compression stockings kusvika pakati pehudyu. Izvi zvinogona kubatsira kuvandudza kuyerera kweropa uye kuderedza zviratidzo zve orthostatic hypotension. Dzvipfeke masikati, asi ubvise kana uri kurara kana uri kurara pasi.
• Kunwa mvura yakawanda. Kugara wakanyorova kunobatsira kudzivirira zviratidzo zvekuoma kweropa. Inwa mvura yakawanda usati wamira kwenguva yakareba, kana chero mabasa anowanzoita kuti zviratidzo zvibude.
• Kudzivisa doro. Doro rinogona kuipa orthostatic hypotension, saka ridzikise kana urikuidzivisa zvachose.
• Kuwedzera munyu mune zvokudya. Izvi zvinofanira kuitwa nekuchenjerera uye chete mushure mekukurukura nachiremba. Munyu wakawanda unogona kuita kuti ropa riwedzere kupfuura nhanho ine hutano, zvichiita kuti pave nemigumisiro mitsva yehutano.
• Kudya zvidiki zvidiki. Kana ropa rako richidonha mushure mekudya, kudya zvidiki, zvine carbohydrate shoma zvinogona kubatsira.
• Kuita zvemitambo. Kuita zvemitambo nguva dzose uye kusimbisa muviri zvinogona kubatsira kuderedza zviratidzo zve orthostatic hypotension. Dzivisa kuita zvemitambo munzvimbo inopisa kwazvo, ine hunyoro.
• Kufamba uye kutambanudza nenzira dzakati. Tambanudza uye fambisa misungo yematsotsoka usati wagara pasi. Kuti uderedze zviratidzo, svinyira mapapiro pamwechete uye svinyira mudumbu nemisungo yemashure. Gara pasi, famba panzvimbo kana simuka pamitsipa.
• Kumuka zvishoma nezvishoma. Famba zvishoma nezvishoma kubva pakurara kusvika pakumira. Uyewo, kana uchibuda mubhedha, gara pamucheto webhedha kwechinguva usati wamira.
• Kusimudza musoro webhedha. Kurara nemusoro webhedha wakasimudzwa zvishoma zvinogona kubatsira kurwisa migumisiro ye gravity.