Hypertension (High Blood Pressure)

Funda kabanzi ngo-hypertension kusuka ku-nephrologist uLeslie Thomas, M.D.

Abantu abaningi abane-high blood pressure abanawo ubuhlungu, ngisho noma amazinga okufundwa kwe-blood pressure efika emazingeni aphezulu ayingozi. Ungaba ne-high blood pressure iminyaka eminingi ngaphandle kwanoma yiluphi ubuhlungu.

Abantu abambalwa abane-high blood pressure bangaba:

• Izinhlungu zikhanda
• Ukuphefumula kanzima
• Ukopha kwesinhlungu

Kodwa-ke, le mihlola ayicaci. Ngokuvamile ayiveli kuze kube yilapho i-high blood pressure ifinyelele esigabeni esinzima noma esiyingozi impilo.

Ukuhlola kwezinga lokucindezela kwegazi kuyiyingxenye ebalulekile yekunakekelwa kwempilo yomzimba. Ukuthi mangakanani kufanele uhlolwe ingcindezi yakho yegazi kuncike eminyakeni yakho nasempilweni yakho jikelele.

Cela umhlinzeki wakho ukuba akufundele ingcindezi yegazi okungenani eminyakeni emibili uqale eminyakeni engu-18. Uma uneminyaka engu-40 noma ngaphezulu, noma uneminyaka engu-18 kuya kwengu-39 futhi unesongo elikhulu lokucindezela kwegazi okuphezulu, cela ukuhlolwa kwengcindezi yegazi unyaka wonke.

Umhlinzeki wakho wokunakekelwa cishe uzokuncoma ukufundwa okuvamile uma unezinga lokucindezela kwegazi eliphezulu noma ezinye izici ezingozi zesifo senhliziyo.

Abantwana abaneminyaka engu-3 nangaphezulu bangase bahlolwe ingcindezi yegazi njengengxenye yokuhlolwa kwabo kwaminyaka yonke.

Uma ungamboni njalo umhlinzeki wokunakekelwa, ungase ukwazi ukuthola ukuhlolwa kwamahhala kwengcindezi yegazi emcimbini wezempilo noma kwezinye izindawo emphakathini wakho. Imishini yamahhala yokulinganisa ingcindezi yegazi itholakala ezitolo nakwezinye izihlahla zokwelapha. Ubunyani bale mishini kuncike ezintweni eziningi, njengosayizi olufanele we-cuff nokusetshenziswa okulungile kwemishini. Cela umhlinzeki wakho wezempilo iseluleko mayelana nokusebenzisa imishini yokulinganisa ingcindezi yegazi yeningilizi ye-public.

Ukugeleza kwegazi kunqunywa izinto ezimbili: inani legazi elithunyelwa yinhliziyo nobunzima bokuhamba kwegazi ngemithambo yegazi. Ukuba inhliziyo iphumula igazi eliningi futhi imithambo yegazi icishe, ukucindezeleka kwegazi kuphakama kakhulu.

Kunezinhlobo ezimbili eziyinhloko zokucindezeleka kwegazi okuphezulu.

Ukuqina kwegazi okuphezulu kunamakhulu ezimbangela eziyingozi, okuhlanganisa:

• Ubudala. Ingozi yokuba nokuqina kwegazi okuphezulu iyanda ngokwanda kobudala. Kwaze kwaba ngaphambi kweminyaka engama-64, ukuqina kwegazi okuphezulu kuvame kakhulu kubantu besilisa. Abesifazane banesihlahla esikhulu sokuthola ukuqina kwegazi okuphezulu ngemuva kweminyaka engama-65.
• Uhlanga. Ukuqina kwegazi okuphezulu kuvame kakhulu kubantu abamnyama. Kuthuthukela ebudaleni obuqala kubantu abamnyama kunokuba kubantu abamhlope.
• Umlando womndeni. Kunokwenzeka ukuthi uthole ukuqina kwegazi okuphezulu uma unembeleko noma umfowenu onaleli gciwane.
• Ukukhuluphala noma ukukhuluphala ngokweqile. Isisindo esiningi sibangela ukuguquka kwezitho zegazi, izinso nezinye izingxenye zomzimba. Lezi zinguquko zivame ukwandisa ukuqina kwegazi. Ukukhuluphala noma ukuba nokhuluphala ngokweqile futhi kukhuphula ingozi yesifo senhliziyo nezimbangela zalo eziyingozi, njengokuphakama kwe-kolesterol.
• Ukwehluleka kokuzivocavoca. Ukungazivocavoci kungabangela ukwanda kwesisindo. Isisindo esikhulu siyakhuphula ingozi yokuba nokuqina kwegazi okuphezulu. Abantu abangasebenzi ngokomzimba bavame ukuba nezinga eliphezulu lezinga lenhliziyo.
• Ukusetshenziswa kwe-tabha noma ukubhema. Ukubhema, ukukhinyabeza utshaba noma ukubhema kukhuphula ngokushesha ukuqina kwegazi isikhathi esifushane. Ukubhema utshaba kulimala izindonga zezitho zegazi futhi kusheshisa inqubo yokunqabela kwe-arteri. Uma ubhema, cela umhlinzeki wakho wokunakekelwa izindlela zokusiza ukuyeka.
• Usawoti omningi. Usawoti omningi - obizwa nangokuthi yi-sodium - emzimbeni ungabangela ukuba umzimba ugcine amanzi. Lokhu kukhuphula ukuqina kwegazi.
• Amazinga aphansi e-potassium. I-potassium iyasiza ukulinganisa inani lusawoti ezicini zomzimba. Ukulingana okuhle kwe-potassium kubalulekile empilweni enhle yenhliziyo. Amazinga aphansi e-potassium angabangelwa ukushoda kwe-potassium ekudleni noma ezinye izimo zempilo, okuhlanganisa nokuphuza amanzi okwanele.
• Ukusebenzisa utshwala ngokweqile. Ukusetshenziswa kotshwala kuye kwahlanganiswa nokuqina kwegazi okuphezulu, ikakhulukazi kubantu besilisa.
• Ukuqina. Amazinga aphezulu okuqina angabangela ukwanda okwesikhashana kokuphakama kwegazi. Imikhuba ehlobene nokuqina njengokudla okuningi, ukusebenzisa utshaba noma ukusebenzisa utshwala ingabangela ukwanda okwengeziwe kokuphakama kwegazi.
• Ezinye izimo ezingapheli. Ubuhlungu bezinso, isifo sikashukela nokuqeda ubuthongo ezinye zezimo ezingabangela ukuqina kwegazi okuphezulu.
• Ukukhulelwa. Ngezinye izikhathi ukukhulelwa kubangela ukuqina kwegazi okuphezulu.

Ukuqina kwegazi okuphezulu kuvame kakhulu kubantu abadala. Kodwa abantwana bangaba nokuqina kwegazi okuphezulu futhi. Ukuqina kwegazi okuphezulu kubantwana kungabangelwa izinkinga zezinso noma inhliziyo. Kodwa kubantu abaningi abakhula, ukuqina kwegazi okuphezulu kubangelwa imikhuba yokuphila njengokudla okungezona ezempilo nokuntuleka kokuzivocavoca.

Ukucindezela okukhulu odongeni lwe-artery okubangelwa yi-high blood pressure kungalimaza imithambo yegazi namalungu omzimba. Lapho i-blood pressure iphakama kakhulu futhi ihlala ingalawulwa isikhathi eside, ubukhulu bomonakalo buyanda.

I-high blood pressure engalawulwa ingabangela izinkinga ezihlanganisa:

• Ukuboshwa kwenhliziyo noma isifo sobuchopho. Ukuqina nokuqina kwe-arteries ngenxa ye-high blood pressure noma ezinye izinto kungabangela ukuboshwa kwenhliziyo, isifo sobuchopho noma ezinye izinkinga.
• Aneurysm. Ukwanda kwe-blood pressure kungabangela ukuthi umthambo wegazi ubuthakathaka futhi uqine, ukwakha i-aneurysm. Uma i-aneurysm iqhekeka, kungaba yingozi eyingozi ekuphileni.
• Ukwehluleka kwenhliziyo. Uma une-high blood pressure, inhliziyo kumele isebenze nzima ukuze iphonse igazi. Ukuhlupheka kubangela ukuba odonga lekamelo lokupompa lenhliziyo liqine. Lokhu kubizwa ngokuthi i-left ventricular hypertrophy. Ekugcineni, inhliziyo ayikwazi ukupompa igazi elanele ukuhlangabezana nezidingo zomzimba, okubangela ukwehluleka kwenhliziyo.
• Izinkinga zezinso. I-high blood pressure ingabangela imithambo yegazi esinzini ibe mncinci noma ibuthakathaka. Lokhu kungabangela ukulimala kwesinso.
• Izinkinga zamehlo. Ukwanda kwe-blood pressure kungabangela imithambo yegazi ehlangene, ecindezelekile noma eqhekekile emehlweni. Lokhu kungabangela ukulahleka kobona.
• I-Metabolic syndrome. Le syndrome yiqembu lezehlakalo zokuguqulwa komzimba. Ihilela ukwahlukaniswa okungavamile keshukela, okuthiwa i-glucose. I-syndrome ihlanganisa ukwanda komthamo wezingalo, i-triglycerides ephezulu, ukunciphisa i-high-density lipoprotein (HDL noma i-'good') cholesterol, i-high blood pressure kanye namazinga aphezulu eshukela egazini. Lezi zimo zikwenza ube nethuba elikhulu lokukhula isifo sikashukela, isifo senhliziyo nesifo sobuchopho.
• Ukushintsha ngekhono lokukhumbula noma ukuqonda. I-high blood pressure engalawulwa ingathinta ikhono lokucinga, ukukhumbula nokufunda.
• Ukuwohloka kwengqondo. I-arteries ecindezelekile noma evaliwe inganciphisa ukugeleza kwegazi ebuchosheni. Lokhu kungabangela uhlobo oluthile lokuwohloka kwengqondo okuthiwa yi-vascular dementia. Isifo sobuchopho esiphazamisa ukugeleza kwegazi ebuchosheni singabangela i-vascular dementia.

Sawubona. NginguDokotela uLeslie Thomas, ungudokotela wezinkophelo eMayo Clinic. Futhi ngilapha ukuze ngiphendule eminye yemibuzo ebalulekile onayo nge-hypertension.

Iyiphi indlela engcono kakhulu yokulinganisa ingcindezi yami yegazi ekhaya?

Ukulinganisa ingcindezi yakho yegazi ekhaya kuyinqubo elula. Abantu abaningi banezingcindezi yegazi eziphakeme kancane engalweni olunye kunokunye. Ngakho-ke kubalulekile ukulinganisa ingcindezi yegazi engalweni elinamafunde aphezulu. Kungcono ukuqeda ikhofi, ukuzivocavoca nokuphuza utsha, uma uqhuma, okungenani imizuzu engama-30. Ukuze ulungiselele ukulinganisa, kufanele ukhululeke ngezinyawo zakho phansi nezinyawo zingagqunywe, futhi umhlane wakho uxhaswe okungenani imizuzu emihlanu. Izingalo zakho kufanele zixhaswe phezu komphetho oqondile. Ngemva kokupumula imizuzu emihlanu, kuthathwa okungenani izilinganiso ezimbili ngomzuzu owodwa ekuseni ngaphambi kwemithi nakusihlwa ngaphambi kokudla kwakusihlwa. I-monitor yakho yegazi kufanele ihlolwe ukuze ibe ne-calibration efanele unyaka ngamunye.

Yini engabangela ingcindezi yami yegazi ukuba ihluke kakhulu?

Lolu hlobo lokuhlukahluka okusheshayo kwengcindezi yegazi kusuka kwesinye esijwayelekile kuya kwesiphezulu kakhulu ngezinye izikhathi kubizwa ngokuthi ingcindezi yegazi eguquguqukayo. Kulabo abathuthukisa ingcindezi yegazi eguquguqukayo, izinkinga zenhliziyo, izinkinga ze-hormonal, izinkinga ze-neurological, noma ngisho nezimimo zengqondo zingase zibe khona. Ukufumana nokuphatha imbangela yangempela yengcindezi yegazi eguquguqukayo kungathuthukisa kakhulu lesimo.

Kufanele ngikhawulele usawoti ukuze nginciphise ingcindezi yami yegazi?

Kubalulekile ukuqaphela ukuthi abanye abantu abane-high blood pressure base badla ukudla okukhawulelwe kakhulu ku-sodium. Futhi kulabo bantu ukunciphisa okwengeziwe kwe-sodium yokudla ngeke kube usizo noma kunconywe. Kubantu abaningi, ukudla kwe-sodium kuphezulu ngokulinganayo. Ngakho-ke, i-target ephumelelayo okumele uyicabangele kulabo bantu ingaphansi kwama-milligrams angu-1500 ngosuku. Abaningi noma kunjalo, bazosiza nge-target engaphansi kwama-milligrams angu-1000 ngosuku. Ukulandela ukunciphisa i-sodium yokudla, kungathatha isikhathi, ngisho namaviki, ukuze ingcindezi yegazi ithuthuke futhi iqiniseke ezingeni eliphansi. Ngakho-ke kubaluleke kakhulu ukuba uqine ngokunciphisa ukudla kwe-sodium nokubekezela lapho uhlola ukuthuthuka.

Ngingayinciphisela kanjani ingcindezi yami yegazi ngaphandle kwemithi?

Lo mbuzo uvame kakhulu. Abantu abaningi bafuna ukuqeda imithi uma bengakwazi, lapho bezama ukunciphisa ingcindezi yabo yegazi. Izindlela ezimbalwa zibonisiwe ngokwesayensi ukunciphisa ingcindezi yegazi. Eyokuqala, futhi mhlawumbe ebaluleke kunazo zonke, iwukuba usebenze ngokomzimba. Ukunciphisa isisindo nakho kungaba yinto ebalulekile kubantu abaningi abahlukene. Ukulinganisela utshwala, ukunciphisa ukudla kwe-sodium, nokukhulisa ukudla kwe-potassium konke kungasiza.

Iyiphi imithi engcono kakhulu yokuthatha i-hypertension?

Ayikho imithi engcono kakhulu yokwelapha i-hypertension kuwo wonke umuntu. Ngoba izimo zezokwelapha zomuntu ngamunye emlandweni nakwamanye amanje kufanele zicatshangelwe. Ngaphezu kwalokho, wonke umuntu une-physiology ehlukile. Ukulinganisa ukuthi amandla athile e-physiological angase abe khona ukubangela i-hypertension kumuntu kuvumela indlela eqondile yokukhetha imithi. Imithi ye-antihypertensive iqembuke ngeklasi. Iklasi ngayinye yemithi ihluke kwezinye izigaba ngendlela eyanciphise ingcindezi yegazi. Ngokwesibonelo, ama-diuretics, kungakhathaliseki uhlobo, asebenza ukunciphisa okuqukethwe komzimba kwe-salt namanzi. Lokhu kuholela ekunciphiseni i-plasma volume ngaphakathi kwemithambo yegazi futhi ngenxa yalokho ingcindezi yegazi ephansi. Abaphambukisi be-calcium channel banciphise ukuncika okulinganiselwe kwemithambo yegazi. Lokhu kunciphisa i-vasoconstriction futhi kukhuthaza ingcindezi yegazi ephansi. Ezinye izigaba zemithi ye-antihypertensive zisebenza ngezindlela zazo. Ukucabangela izimo zakho zempilo, i-physiology, nokuthi imithi ngayinye isebenza kanjani, udokotela wakho angakuncoma imithi ephephile futhi ephumelelayo kuwe.

Ingabe imithi ethile yegazi ingalimaza izinkophelo zami?

Ukulandela ukulungiswa kwengcindezi yegazi noma ukusethwa kwemithi ethile yegazi, kuyinto evamile ukubona izinguquko kumamaki wokusebenza kwezinkophelo ekuhlolweni kwegazi. Noma kunjalo, izinguquko ezincane kula mamaki, ebonisa izinguquko ezincane ekusebenzeni kokucwecwa kwezinkophelo akufanele kuchazwe njengobufakazi obuphelele bokulimala kwezinkophelo. Udokotela wakho angachaza izinguquko ekuhlolweni kwelebhu ngemva kokushintsha noma yikuphi imithi.

Ngingaba kanjani umlingani ongcono kakhulu eqenjini lami lokwelapha?

Gcina ingxoxo evulekile neqembu lakho lokwelapha ngezinhloso zakho nezintandokazi zakho. Ukuxhumana, ukuthembana nokubambisana kuyizinhlutho eziyisihluthulelo empumelelweni yesikhathi eside yokuphatha ingcindezi yakho yegazi. Unganqikazi ukubuza iqembu lakho lokwelapha noma yimiphi imibuzo noma ukukhathazeka okukona. Ukuba nolwazi kwenza umehluko. Siyabonga ngesikhathi sakho futhi sikufisela okuhle.

Ukuze uthola i-high blood pressure, umhlinzeki wakho wezempilo ukhomba futhi ubuze imibuzo ngomlando wakho wezokwelapha nanoma yiziphi izimpawu. Umhlinzeki wakho ulalela inhliziyo yakho usebenzisa idivayisi ebizwa nge-stethoscope.

Ingcindezi yakho yegazi ihlolwa usebenzisa i-cuff, evame ukufakwa phansi kwengalo yakho. Kubalulekile ukuthi i-cuff ifanele. Uma inkulu kakhulu noma incinci kakhulu, ukufunda kwengcindezi yegazi kungase kuhluke. I-cuff iphefumulelwa usebenzisa i-pump yesandla encane noma umshini.

Ukufunda kwengcindezi yegazi kuqapha ingcindezi emithambekeni lapho inhliziyo ishaya (inombolo ephezulu, ebizwa ngokuthi ingcindezi ye-systolic) naphakathi kokushaya kwenhliziyo (inombolo ephansi, ebizwa ngokuthi ingcindezi ye-diastolic). Ukuqapha ingcindezi yegazi, i-cuff ephumulelwayo ivame ukufakwa phansi kwengalo. Umshini noma i-pump yesandla encane isebenza ukuze iphefumulele i-cuff. Kulesi sithombe, umshini uqopha ukufunda kwengcindezi yegazi. Lokhu kubizwa ngokuthi ukulinganisa kwengcindezi yegazi okuzenzakalelayo.

Isikhathi sokuqala ingcindezi yakho yegazi ihlolwa, kufanele ilinganiswe kuzo zombili izingalo ukuze ubone ukuthi kukhona umehluko yini. Ngemva kwalokho, ingalo enenombolo ephezulu kufanele isetshenziswe.

Ingcindezi yegazi ilinganiswa ngemilimitha ye-mercury (mm Hg). Ukufunda kwengcindezi yegazi kunamanani amabili.

I-high blood pressure (hypertension) itholwa uma ukufunda kwengcindezi yegazi kufana noma kukhulu kunamamilimitha angu-130/80 ye-mercury (mm Hg). Ukuxilongwa kwe-high blood pressure kuvame ukusekelwe ku-average yezilinganiso ezimbili noma ngaphezulu ezithathwe ngezikhathi ezahlukene.

Ingcindezi yegazi iqembuke ngokuthi iphezulu kangakanani. Lokhu kubizwa ngokuthi i-staging. I-staging iyasiza ukuqondisa ukwelashwa.

Ngezinye izikhathi ukufunda kwengcindezi yegazi ephansi kujwayelekile (ngaphansi kwama-80 mm Hg) kodwa inombolo ephezulu iphezulu. Lokhu kubizwa ngokuthi i-isolated systolic hypertension. Luhlobo oluvamile lwe-high blood pressure kubantu abadala kunama-65.

Uma uthola i-high blood pressure, umhlinzeki wakho angakuncoma ukuhlolwa ukuze ahlole imbangela.

Umhlinzeki wakho wezempilo angase akucele ukuthi uqale uqaphe ingcindezi yakho yegazi ekhaya. Ukuqapha ekhaya kuyindlela enhle yokugcina ilingana ingcindezi yakho yegazi. Kusiza ababoneleli bakho ngokunakekela ukwazi ukuthi imithi yakho isebenza yini noma ukuthi isimo sakho siyasibi.

Ama-monitor wegazi ekhaya atholakala ezitolo zasekhaya nase-pharmacy.

Ukuze uthole ukulinganisa kwengcindezi yegazi okuthenjwa kakhulu, i-American Heart Association iphakamisa ukusebenzisa i-monitor ene-cuff ehamba ngaphansi kwengalo yakho ephezulu, uma itholakala.

Amadivayisi aqapha ingcindezi yakho yegazi e-wrist noma eminweni awunconywa yi-American Heart Association ngoba anganikeza imiphumela engathembekile.

• Inombolo ephezulu, ebizwa ngokuthi ingcindezi ye-systolic. Okokuqala, noma inombolo engaphezulu, iqapha ingcindezi emithambekeni lapho inhliziyo ishaya.

• Inombolo ephansi, ebizwa ngokuthi ingcindezi ye-diastolic. Eyesibili, noma inombolo ephansi, iqapha ingcindezi emithambekeni phakathi kokushaya kwenhliziyo.

• I-Stage 1 hypertension. Inombolo ephezulu iphakathi kwama-130 nama-139 mm Hg noma inombolo ephansi iphakathi kwama-80 nama-89 mm Hg.

• I-Stage 2 hypertension. Inombolo ephezulu ingama-140 mm Hg noma ngaphezulu noma inombolo ephansi ingama-90 mm Hg noma ngaphezulu.

• Ukuqapha okuhambahambayo. Ukuhlolwa kwengcindezi yegazi okude kungase kwenziwe ukuze kuhlolwe ingcindezi yegazi ngezikhathi ezithile ngamahora ayisithupha noma ama-24. Lokhu kubizwa ngokuthi ukuqapha kwengcindezi yegazi okuhambahambayo. Noma kunjalo, amadivayisi asetshenziswayo ekuhlolweni awatholakali kuwo wonke amasiko ezempilo. Hlola nomshuwalense wakho ukuze ubone ukuthi ukuqapha kwengcindezi yegazi okuhambahambayo kuyinsizakalo ehlanganisiwe yini.

• Izivivinyo zelebhu. Izivivinyo zegazi nezinina zenziwa ukuze ziqaphe izimo ezingabangela noma zenzise kakhulu i-high blood pressure. Ngokwesibonelo, izivivinyo zenziwa ukuze ziqaphe amazinga akho we-cholesterol nama-sugar egazi. Ungase futhi ube nezivivinyo zelebhu ukuze uhlole ukusebenza kwezinkophelo, isibindi ne-thyroid.

• Electrocardiogram (ECG noma EKG). Lokhu kuhlolwa okusheshayo nokungenazinkinga kuqapha umsebenzi we-electrical wenhliziyo. Kungatshela ukuthi inhliziyo ishaya ngokushesha kangakanani noma kancane kangakanani. Ngesikhathi se-electrocardiogram (ECG), izinzwa ebizwa ngokuthi ama-electrodes afakwa esifubeni futhi ngezinye izikhathi ezingalweni noma ezinyaweni. Izingcingo zixhuma izinzwa kumshini, ophrinta noma obonisa imiphumela.

• Echocardiogram. Lokhu kuhlolwa okungenawo ubuhlungu kusebenzisa amaza omsindo ukudala izithombe eziningi zenhliziyo eshaya. Kubonisa ukuthi igazi lihamba kanjani ngenhliziyo ne-heart valves.

Ukushintsha indlela yakho yokuphila kungakusiza ukulawula nokuphatha igazi eliphezulu. Umhlinzeki wakho wezempilo angakuncoma ukuba wenze izinguquko zendlela yokuphila ezihlanganisa:

Ngezinye izikhathi izinguquko zendlela yokuphila azanele ekuwelapheni igazi eliphezulu. Uma zingasizi, umhlinzeki wakho angakuncoma imithi yokunciphisa igazi lakho.

Uhlobo lwemithi olusetshenziswayo ekuwelapheni i-hypertension kuncike empilweni yakho yonke nokuthi igazi lakho liphezulu kangakanani. Imithi emibili noma ngaphezulu yegazi ivame ukusebenza kangcono kunenye. Kungathatha isikhathi ukuthola imithi noma ukuxuba kwemithi okusebenza kangcono kuwe.

Uma uthatha imithi yegazi, kubalulekile ukwazi amazinga akho egazi okuhloselwe. Kufanele uqondele ezingeni lokuwelapha igazi elingaphansi kuka-130/80 mm Hg uma:

Umgomo wegazi oluhle ungashintsha ngokweminyaka neemeko zempilo, ikakhulukazi uma ungaphezu kweminyaka engama-65.

Imithi esetshenziswayo ekuwelapheni igazi eliphezulu ihlanganisa:

Amaphilisi amanzi (ama-diuretics). Le mithi ikusiza ukususa i-sodium namanzi emzimbeni. Zivame ukuba yimithi yokuqala esetshenziswayo ekuwelapheni igazi eliphezulu.

Kunezinhlobo ezahlukene zama-diuretics, kuhlanganise i-thiazide, i-loop ne-potassium sparing. Eyona umhlinzeki wakho ayincoma kuncike ekulinganisweni kwegazi lakho nezinye izimo zempilo, njengokulima kwesibindi noma ukwehluleka kwenhliziyo. Ama-diuretics avamile ukusetshenziswa ekuwelapheni igazi lihlanganisa i-chlorthalidone, i-hydrochlorothiazide (Microzide) nabanye.

Umphumela oqhelekile we-diuretics ukwanda kokungqongqoza. Ukungqongqoza okuningi kunganciphisa amazinga e-potassium. Ukulingana okuhle kwe-potassium kuyadingeka ukusiza inhliziyo ukuba ishaye kahle. Uma une-potassium ephansi (hypokalemia), umhlinzeki wakho angakuncoma i-diuretic egcina i-potassium enama-triamterene.

Abaphambukisi be-calcium channel. Le mithi ikusiza ukuphumula imisipha yezinsimbi zegazi. Ezinye zihambisa izinga lenhliziyo yakho. Zihlanganisa i-amlodipine (Norvasc), i-diltiazem (Cardizem, Tiazac, nabanye) nabanye. Abaphambukisi be-calcium channel bangasebenza kangcono kubantu abadala nabantu abamnyama kunokwenza abaphambukisi be-angiotensin-converting enzyme (ACE) bodwa.

Ungadli noma uphuze imikhiqizo ye-grapefruit uma uthatha abaphambukisi be-calcium channel. I-grapefruit iyakhulisa amazinga egazi ezinye iziphambukisi ze-calcium channel, okuyingozi. Xoxa nomhlinzeki wakho noma umthengisi wemithi uma ukhathazekile ngokusebenzisana.

Uma unengcindezi ekutholeni umgomo wakho wegazi ngokuxuba kwemithi engaphezulu, umhlinzeki wakho angakubhalela:

Abaphambukisi be-Beta. Le mithi inciphisa umsebenzi enhliziyweni futhi iyandise izinsimbi zegazi. Lokhu kusiza inhliziyo ukuba ishaye kancane nangamandla amancane. Abaphambukisi be-beta bahlanganisa i-atenolol (Tenormin), i-metoprolol (Lopressor, Toprol-XL, Kapspargo sprinkle) nabanye.

Abaphambukisi be-beta abavame ukunconywa njengomuthi owodwa obhalwe. Bangasebenza kangcono uma behlanganiswe nezinye izidakamizwa zegazi.

Abaphambukisi be-Renin. I-Aliskiren (Tekturna) iyanciphisa ukukhiqizwa kwe-renin, i-enzyme eyenziwa yizinkimbinkimbi ezibangela uchungechunge lweziqondiso zekhemikhali ezandisa igazi.

Ngenxa yengozi yezinkinga ezinzima, kuhlanganise nokushaya, akumele uthathe i-aliskiren nge-ACE inhibitors noma i-ARBs.

Thatha njalo imithi yegazi njengoba kunqunyiwe. Ungalokothi uphuthelwe umthamo noma uyeke ngokuzumayo ukuthatha imithi yegazi. Ukumisa ngokuzumayo okukhethekile, njengabaphambukisi be-beta, kungabangela ukwanda okukhulu kwegazi okuthiwa yi-rebound hypertension.

Uma uphuthelwa imithamo ngenxa yebizo, imiphumela emibi noma ukukhohlwa, xoxa nomhlinzeki wakho wokunakekelwa ngezixazululo. Ungashintshi ukwelashwa kwakho ngaphandle kwesiqondiso somhlinzeki wakho.

Ungaba ne-hypertension ehlala njalo uma:

Ukuba ne-hypertension ehlala njalo akusho ukuthi igazi lakho alikaze libe phansi. Uma wena nomhlinzeki wakho ningakwazi ukuthola imbangela, uhlelo lokwelapha oluphumelelayo lungadalwa.

Ukwelapha i-hypertension ehlala njalo kungase kuhlanganise izinyathelo eziningi, kuhlanganise:

Uma unegazi eliphezulu futhi ukhulelwe, xoxa nabhlinzeki bakho wokunakekelwa ukuthi ungalawula kanjani igazi ngesikhathi sokukhulelwa kwakho.

Abacwaningi bebelokhu becwaninga ukusetshenziswa kokushisa ukubhubhisa izinzwa ezithile esibindini ezingase zidlale indima e-hypertension ehlala njalo. Le ndlela ibizwa ngokuthi i-renal denervation. Izifundo zokuqala zibonise inzuzo ethile. Kepha izifundo ezinamandla kakhulu zithole ukuthi ayinciphisi kakhulu igazi kubantu abane-hypertension ehlala njalo. Ucwaningo olwengeziwe luqhubeka ukuze kunqunywe ukuthi iyiphi indima, uma ikhona, le yokwelapha ingaba nayo ekuwelapheni i-hypertension.

• Ukudla ukudla okunempilo yinhliziyo okune-salt encane

• Ukuthola umsebenzi womzimba ojwayelekile

• Ukugcina isisindo esinempilo noma ukulahlekelwa isisindo

• Ukulinganisela utshwala

• Ukungabhemi

• Ukuthola amahora angu-7 kuya kwangu-9 okulala nsuku zonke

• Ungumuntu omdala ophilile oneminyaka engama-65 noma ngaphezulu

• Ungumuntu omdala ophilile oneminyaka engaphansi kwengu-65 onengozi engu-10% noma ngaphezulu yokuthuthukisa isifo senhliziyo eminyakeni eyi-10 ezayo

• Une-chronic kidney disease, isifo sikashukela noma isifo se-coronary artery

• Amaphilisi amanzi (ama-diuretics). Le mithi ikusiza ukususa i-sodium namanzi emzimbeni. Zivame ukuba yimithi yokuqala esetshenziswayo ekuwelapheni igazi eliphezulu.

  Kunezinhlobo ezahlukene zama-diuretics, kuhlanganise i-thiazide, i-loop ne-potassium sparing. Eyona umhlinzeki wakho ayincoma kuncike ekulinganisweni kwegazi lakho nezinye izimo zempilo, njengokulima kwesibindi noma ukwehluleka kwenhliziyo. Ama-diuretics avamile ukusetshenziswa ekuwelapheni igazi lihlanganisa i-chlorthalidone, i-hydrochlorothiazide (Microzide) nabanye.

  Umphumela oqhelekile we-diuretics ukwanda kokungqongqoza. Ukungqongqoza okuningi kunganciphisa amazinga e-potassium. Ukulingana okuhle kwe-potassium kuyadingeka ukusiza inhliziyo ukuba ishaye kahle. Uma une-potassium ephansi (hypokalemia), umhlinzeki wakho angakuncoma i-diuretic egcina i-potassium enama-triamterene.

• Abaphambukisi be-angiotensin-converting enzyme (ACE). Le mithi ikusiza ukuphumula izinsimbi zegazi. Ivimbela ukwakheka kwe-kemikhali yemvelo eyancisa izinsimbi zegazi. Isibonelo sihlanganisa i-lisinopril (Prinivil, Zestril), i-benazepril (Lotensin), i-captopril nabanye.

• Abaphambukisi be-angiotensin II receptor (ARBs). Le mithi iphumula izinsimbi zegazi. Ivimbela isenzo, hhayi ukwakheka, kwe-kemikhali yemvelo eyancisa izinsimbi zegazi. abaphambukisi be-angiotensin II receptor (ARBs) bahlanganisa i-candesartan (Atacand), i-losartan (Cozaar) nabanye.

• Abaphambukisi be-calcium channel. Le mithi ikusiza ukuphumula imisipha yezinsimbi zegazi. Ezinye zihambisa izinga lenhliziyo yakho. Zihlanganisa i-amlodipine (Norvasc), i-diltiazem (Cardizem, Tiazac, nabanye) nabanye. Abaphambukisi be-calcium channel bangasebenza kangcono kubantu abadala nabantu abamnyama kunokwenza abaphambukisi be-angiotensin-converting enzyme (ACE) bodwa.

  Ungadli noma uphuze imikhiqizo ye-grapefruit uma uthatha abaphambukisi be-calcium channel. I-grapefruit iyakhulisa amazinga egazi ezinye iziphambukisi ze-calcium channel, okuyingozi. Xoxa nomhlinzeki wakho noma umthengisi wemithi uma ukhathazekile ngokusebenzisana.

• Abaphambukisi be-Alpha. Le mithi inciphisa izibonakaliso zezinzwa ezinsimbini zegazi. Ikusiza ukunciphisa imiphumela yekhemikhali yemvelo eyancisa izinsimbi zegazi. Abaphambukisi be-alpha bahlanganisa i-doxazosin (Cardura), i-prazosin (Minipress) nabanye.

• Abaphambukisi be-Alpha-beta. Abaphambukisi be-alpha-beta bavimba izibonakaliso zezinzwa ezinsimbini zegazi futhi bahambisa ukushaya kwenhliziyo. Banciphisa inani legazi okumele lipompeke ngezinsimbi. Abaphambukisi be-alpha-beta bahlanganisa i-carvedilol (Coreg) ne-labetalol (Trandate).

• Abaphambukisi be-Beta. Le mithi inciphisa umsebenzi enhliziyweni futhi iyandise izinsimbi zegazi. Lokhu kusiza inhliziyo ukuba ishaye kancane nangamandla amancane. Abaphambukisi be-beta bahlanganisa i-atenolol (Tenormin), i-metoprolol (Lopressor, Toprol-XL, Kapspargo sprinkle) nabanye.

  Abaphambukisi be-beta abavame ukunconywa njengomuthi owodwa obhalwe. Bangasebenza kangcono uma behlanganiswe nezinye izidakamizwa zegazi.

• Abaphambukisi be-Aldosterone. Le mithi ingasetshenziswa ekuwelapheni i-hypertension ehlala njalo. Ivimbela umphumela we-kemikhali yemvelo engabangela ukwakheka kwesoda namanzi emzimbeni. Isibonelo yi-spironolactone (Aldactone) ne-eplerenone (Inspra).

• Abaphambukisi be-Renin. I-Aliskiren (Tekturna) iyanciphisa ukukhiqizwa kwe-renin, i-enzyme eyenziwa yizinkimbinkimbi ezibangela uchungechunge lweziqondiso zekhemikhali ezandisa igazi.

  Ngenxa yengozi yezinkinga ezinzima, kuhlanganise nokushaya, akumele uthathe i-aliskiren nge-ACE inhibitors noma i-ARBs.

• Abaphambukisi be-Vasodilators. Le mithi imisa imisipha ezindongeni ze-artery ukuba ingaqinisi. Lokhu kuvimbela i-arteries ukuba inganciphisi. Isibonelo sihlanganisa i-hydralazine ne-minoxidil.

• Abaphambukisi be-Central-acting. Le mithi ivikela ubuchopho ukuba ungatsheli uhlelo lwezinzwa ukuba lukhulise izinga lenhliziyo futhi lunciphisa izinsimbi zegazi. Isibonelo sihlanganisa i-clonidine (Catapres, Kapvay), i-guanfacine (Intuniv) ne-methyldopa.

• Uthatha okungenani imithi emithathu ehlukene yegazi, kuhlanganise ne-diuretic. Kepha igazi lakho lihlala liphezulu.

• Uthatha imithi emine ehlukene ukulawula igazi eliphezulu. Umhlinzeki wakho wokunakekelwa kufanele ahlole imbangela yesibili engenzeka yegazi eliphezulu.

• Ukushintsha imithi yegazi ukuthola ukuxuba okuhle kakhulu kanye nomthamo.

• Ukubuyekeza yonke imithi yakho, kuhlanganise nalabo abathengwe ngaphandle kwesikripthi.

• Ukubheka igazi ekhaya ukuze ubone ukuthi izikhathi zokwelashwa zibangela igazi eliphezulu yini. Lokhu kubizwa ngokuthi i-hypertension yekhoti elimhlophe.

• Ukudla okunempilo, ukuphatha isisindo nokwenza ezinye izinguquko zendlela yokuphila ezinikeziwe.

Ukuzimisela impilo enempilo kungasiza ekunqobeni nasekulawuleni igazi eliphezulu. Zama lezi zindlela ezilondoloza inhliziyo:

Zama ukuzivocavoca kakhulu. Ukuzivocavoca njalo kugcina umzimba uphilile. Kunganciphisa igazi eliphezulu, kuphazamise ukucindezeleka, kulawule isisindo futhi kunciphisa ingozi yezimo zezempilo ezingapheli. Hlose ukuthola okungenani imizuzu engu-150 ngesonto yomsebenzi we-aerobic ophakathi noma imizuzu engu-75 ngesonto yomsebenzi we-aerobic onamandla, noma ukuhlanganiswa kokubili.

Uma unegazi eliphezulu, ukuqeqeshwa okuqhubekayo okumaphakathi kuya kwaphezulu kunganciphisa ukufunda kwakho kwegazi eliphezulu nge-11 mm Hg kanye nenombolo engezansi nge-5 mm Hg.

• Dla ukudla okunempilo. Dla ukudla okunempilo. Zama ukudla kwe-Dietary Approaches to Stop Hypertension (DASH). Khetha izithelo, imifino, ukudla okugcwele, inyama yenkukhu, izinhlanzi nokudla okune-dairy ephansi. Thola i-potassium eningi emithonjeni yemvelo, engasiza ekuphuculeni igazi eliphezulu. Dla amafutha amaningi ashukela namafutha e-trans.
• Sebenzisa usawoti omncane. Inyama ehlanganisiwe, ukudla okugayiwe, usoso oluthengiswayo, ukudla okugqotshiwe nobunye ubunye obuningi bungaba imithombo efihliwe yesawoti. Hlola imibhalo yokudla ukuthola okuqukethwe kwe-sodium. Khawulela ukudla neziphuzo eziphezulu ku-sodium. Ukungenisa i-sodium engu-1,500 mg ngosuku noma ngaphansi kubhekwa njengokufanele kwabantu abadala abaningi. Kodwa buza umhlinzeki wakho ukuthi yini engcono kuwe.
• Khawulela utshwala. Ngisho noma unempilo, utshwala lungaphakamisa igazi lakho. Uma ukhetha ukuphuza utshwala, yenza kanjalo ngokulinganisela. Kwabantu abadala abaphilile, lokho kusho ukuthi kuze kube yisiphuzo esisodwa ngosuku kwabesifazane, kanye nokuze kube yiziphuzo ezimbili ngosuku kwabesilisa. Isiphuzo esisodwa siilingana ne-ounces eziyi-12 zebhiya, i-ounces eziyi-5 zewayini noma i-ounces eziyi-1.5 ze-liquor engu-80-proof.
• Ungabhemi. Utaba lilimaza izindonga zezinsimbi zegazi futhi likhuphula inqubo yokukhuluphala kwe-arteries. Uma ubhema, cela umhlinzeki wakho wokunakekelwa izindlela zokusiza ukuyeka.
• Gcina isisindo esinempilo. Uma unesisindo esiningi noma une-obesity, ukulahlekelwa isisindo kungasiza ekulawuleni igazi eliphezulu nokunciphisa ingozi yezinkinga. Buza umhlinzeki wakho wezempilo ukuthi yisiphi isisindo esifanele kuwe. Ngokuvamile, igazi liyancipha nge-1 mm Hg nge-2.2 pounds (1 kilogram) yesisindo esilahlekile. Kubantu abanegazi eliphezulu, ukwehla kwegazi kungaba ngaphezulu nge-kilogram ngayinye yesisindo esilahlekile.
• Zama ukuzivocavoca kakhulu. Ukuzivocavoca njalo kugcina umzimba uphilile. Kunganciphisa igazi eliphezulu, kuphazamise ukucindezeleka, kulawule isisindo futhi kunciphisa ingozi yezimo zezempilo ezingapheli. Hlose ukuthola okungenani imizuzu engu-150 ngesonto yomsebenzi we-aerobic ophakathi noma imizuzu engu-75 ngesonto yomsebenzi we-aerobic onamandla, noma ukuhlanganiswa kokubili.

Uma unegazi eliphezulu, ukuqeqeshwa okuqhubekayo okumaphakathi kuya kwaphezulu kunganciphisa ukufunda kwakho kwegazi eliphezulu nge-11 mm Hg kanye nenombolo engezansi nge-5 mm Hg.

• Hlakulela imikhuba emihle yokulala. Ukulala okubi kungandisa ingozi yesifo senhliziyo nezinye izimo ezingapheli. Abantu abadala kufanele baqonde ukuthola amahora angu-7 kuya kwangu-9 okulala nsuku zonke. Abantwana bavame ukudinga okuningi. Lala uvuke ngesikhathi esifanayo nsuku zonke, kufaka phakathi amaviki. Uma unezinkinga zokulala, khuluma nomhlinzeki wakho ngezindlela ezingasiza.
• Lawula ukucindezeleka. Thola izindlela zokusiza ekuphuculeni ukucindezeleka komzwelo. Ukuzivocavoca okuningi, ukuqeqeshwa kwengqondo nokuhlangana nabanye emaqenjini asekelayo zingazindlela zokunciphisa ukucindezeleka.
• Zama ukuphefumula kancane, okujulile. Zama ukuthatha izinyathelo ezibukhali, ezibukhali ukuze ukhululeke. Ezinye izifundo zibonisa ukuthi ukuphefumula okuhamba kancane, okuqondiswe (izinyathelo ezi-5 kuya kwezi-7 ezibukhali ngomzuzu) kuhlanganiswe nezinqubo zengqondo kunganciphisa igazi eliphezulu. Kukhona amadivayisi atholakalayo okuthuthukisa ukuphefumula okuhamba kancane, okujulile. Ngokusho kwe-American Heart Association, ukuphefumula okuqondiswa yi-divayisi kungaba ukukhetha okungekho-drug okufanele ekuphuculeni igazi eliphezulu. Kungaba ukukhetha okuhle uma une-anxiety enegazi eliphezulu noma awukwazi ukubekezelela ukwelashwa okujwayelekile.