Kuwedzera kweropa kunowanzoonekwa kune vakwegura vakuru kana vachienzaniswa nemapoka emadzinza madiki, asi haafaniri kutarisirwa sechinhu chinowanzoita chekukwegura. Mishonga yakaoma yakaoma uye isinganzwisisiki patinenge takura. Izvi zvinokonzera kuwedzera kwechirwere chechiropa, kunyange zvazvo diastolic yeropa rega inowanzosimbiswa kune vanhu pakati pemakore makumi mashanu nemakumi matanhatu. "Kuda kwepfungwa" ndiwo musiyano pakati pe systolic uye diastolic yeropa.
Ngozi yehutano yehutano inowedzera sezvo kuwedzera kwepfungwa kunowedzera.
Systolic hypertension kune vakwegura yaimbove yakashandiswa kuzivikanwa se "systolic yeropa," iyo inoratidzwa ne systolic yeropa yepamusoro kupfuura 160 mm Hg ne diastolic yeropa yepasi inopfuura 90 mm Hg Systolic hypertension ndiyo inonyanya kukonzera kuwedzera kwehutano mune varwere vanopfuura makore makumi mashanu, iyo inokosha nokuti inonyanya kuisa mukana wehutano hwepfungwa uye kushungurudzika kuenzaniswa nedzimwe mhando dzehutano hwepamusoro hwehutano.Iyo inobatanidzawo nehuwandu hwekufa kubva pamagariro evanhu. vane arteriyiti isinganzwisisiki, nyanzvi dzose dzinobvuma kuti zvakakosha kuti urambe uine chinangwa chekugara kweropa mukati mevakwegura.
Kukosha kweRopa Kushushikana Muropa muVakuru
Pane zvinhu zvakasiyana-siyana kune vakwegura kana kuti kukwegura kwevanhu vanoita kuti ropa rekudzivirira rinonyanya kukosha:
- Kuwedzereka kwengozi yemitambo yemwoyo yakaenzaniswa nevarwere vaduku vane zvimwe zvinokonzera ngozi.
- Systolic blood pressure inogona kunge iri yakakwirira, ine systolic yakanyanya yehuwandu hwehutachiona yakanyanya kuwanda muhuwandu hwevanhu.
- Vakura vakwegura vane huwandu hwakawanda hwehumwe hutano hunofanirwa kubvunzwa kana ukasarudza ropa rakanaka remishonga yemishonga.
- Hypertension inokanganisa kugunun'una zvisina kunaka kunyange pakati pevanhu vakuru vakura. Ikoko kunoratidzikawo kuva nehukama pakati pehutano hwepamusoro uye kuora mwoyo. Ongororo dzakawanda dzakaratidza kuti varwere vanorapwa nemishonga inorwisa antihypertensive vane njodzi yakaderera yekukura kwekushaya njere, kuora mwoyo, uye atrophy yeuropi. Kubvira kwenguva refu kurapwa kwehuwandu hweropa kunowedzera kukanganisa kweAlzheimer's dementia uye vascular dementia.
High blood pressure ndiyo inonyanya kukosha chinokonzera zvirwere zvevascular zvemarudzi ose uye nekuda kwekufa. Ongororo dzakawanda dzakaratidza kuti varwere vane chirwere chepamusoro chekutapisa kweropa vaiva nenhamba shoma shoro yekurohwa, kufa nekurohwa, kurwadziwa kwemwoyo, mamwe matambudziko emwoyo, kufa kwezviitiko zvepfungwa, uye zvose-zvinokonzera kufa. Kuongororwa kwe "nhamba inodiwa kurapa," iyo inoratidza kuti vanhu vazhinji vanofanirwa kutarisirwa sei kuti munhu mumwe chete abatsirwe kurapwa, inoratidza kuti vanhu vashoma vanopfuura zana vanoda kurapwa nekuda kwekudzivirira kweropa kuitira kuti munhu mumwe kuve nemigumisiro yakakomba seuropwa kana kushaya mwoyo. NNT ndiyo chiyero chemari yekuwana mari / kubatsirwa kwekurapa. INNT inobatanidza neropa rekurapa muvanhu vakuru vakakuudza kuti kurapa kweropa kunonyanya kushandiswa kwenguva refu, sezvo kurapwa kunogona kudzivirira zviitiko zvakawanda zvinotambudza zvakakosha kurapa uye zvinogona kukonzera kurasikirwa kukuru kwekusununguka.
Chii Chinofanira Kuitwa Nevanhu Vakwegura Vane Hypertension Kuvandudza Nhamba Yadzo?
Upenyu huri kuchinja hunoderedza kudzvinyirira kweropa, asi hazvisi pachena kana vachideredza zviitiko izvi. DASH (Dietary Approaches to Stop Hypertension) kudya kunoshanda mukuderedza systolic ropa muvanhu vakwegura, sezvo zvichiita vangave vakanyanya kugamuchira migumisiro ye sodium (munyu) mukudya kwavo. Vashandi vakwegura vakashanda vanobatsirwa nemararamiro emwoyo uye mamwe mararamiro emararamiro, kusanganisira fodya nekuguma kwekushandisa doro, zvinoshanda kumarudzi ose emakore.
Kurapa kweropa rega muvanhu vakwegura vanofanira kutora mamwe mamiriro ezvinhu kuti afungisise:
- Kuisa ropa mukati mezvirwere kunoratidzika kuva kukosha kupfuura kushandiswa kwekamwe boka remishonga.
- Kurapa nemishonga inopesana nemishonga inoderedza ngozi yekuwedzera kuwedzera kwehupfumi hwepamu ne 94 muzana.
- Kuora mwoyo, iyo inowanzoguma nemigumisiro yepamusoro yeropa, yakaratidzwa kuti yakaderedzwa ne 42 muzana kune vakwegura vakwegura vane ropa repamusoro rinorapwa nemishonga kana vachienzanisa nevaya vaiva nehuwandu hwemhepo iyo isati yambobata.
- Kuwedzera kweropa kunogona kukonzera chirwere chepfungwa, asi kuongorora kukuru kwakaratidza kuti kuderedzwa kwehutano weropa kwaive kwakanakisisa kudarika kuchinja kwezvokudya mukuderedza dambudziko.
Kunetseka Kweropa Rakanaka Target for the Elderly
Kunyange zvazvo mazano evanhu vemazuva ano anoratidza chirongwa chemuviri wezvinokonzerwa neropa pasi pe 140 mm Hg systolic uye diastolic ropa rinopfuura 90 mm Hg, chinangwa chevatana vakwegura chinofanira kuva systolic ropa rinopfuura 150 mm Hg uye diastolic ropa pasi pe 90 mm Hg. Kune vakwegura varwere vane chirwere cheshuga kana chirwere chisingaperi chepfungwa, chinangwa chekuderedzwa kweropa kunofanira kuva systolic ropa rinodarika 140 mm Hg. Vakura vakwegura avo vasina kukodzera uye vane hutano vanogona kutarisa chinangwa chekutema ropa pasi pe 140 mm Hg.
Chirongwa chekurapa kwekuda kweropa chinosvika mune makumi manomwe chete kubva muzana yevakwegura vanotora mishonga yehutano hwehutano, asi zvidzidzo zvakaratidza zvikomborero zvakakura nekurapa, kunyange apo chinangwa chekuda kweropa chinangwa hachiwaniki. Aya mazano anobatanidza kuderedzwa kwehutano hwemadziviriro maviri uye kushamiswa kwechirwere kunoderera uye 4.4 kubva muzana kuderedza mwoyo kusakundikana.
Vanhu Vose Vakwegura Vanofanira Kuve Nekodzero Dzedze Ropa Rinobatwa Nemishonga Here?
Kunyange zvazvo kuchinja mumararamiro ehupenyu, kufanana nekurashikirwa, kuperesa munyu, uye kurovedza muviri, zvinobatsira, muhupenyu chaihwo zvinoratidzika kuti kuchinja mararamiro hazviwanzoitwa nguva dzose nenzira yekubvumira varwere vakwegura kuona zvikomborero. Maitiro ekuchinja mararamiro haasi nyore nyore nyore kune vakwegura uye anogonawo kudhura, apo vashandi vezvokudya zvinovaka muviri, maitiro ekurapa, uye yekufambisa mari, pakati pezvimwe zvikonzero, vanofungidzirwa.
Zvakakosha kuvarwere vose vane ropa rekurwisana kuti vararame hupenyu hwakanaka, asi hapana humwe humwe uchapupu hwekuti matanho aya ane simba guru mukuderedza dambudziko rekurapa sequelae kunokwidzivirira kweropa kune vanhu vakwegura. Kutsvakurudza kunoratidza kuti kushandiswa kwemishonga yepamusoro yemishonga yemvura kunonyanya kubudirira pakuderedza mamiriro emwoyo.
Nenzira yakawanda, vanhu vane ngozi dzakawanda dzehutano hwehutano hwepfungwa, pasinei nezera ravo, vanofanira kurapwa nemishonga kuti vasangane nechinangwa cheropa. Pane imwe nguva, paive nekugamuchirwa kwechikonzero chekuregeredza kurapwa kwevarwere vaiva nemakore anopfuura 79, asi uchapupu hunoratidza zvakajeka kuti migumisiro, kusanganisira kurohwa, mwoyo yehutachiona, uye mwoyo kusakundikana, zvakanyanya kuipa kune varwere vasina kubatwa , kunyange mumakore gumi nemapfumbamwe ehupenyu.
Best Antihypertensive Drug For An Elderly With High Blood Pressure
Muzhinji, mishonga imwechete yakakurudzirwa kuti vanhu vakawanda vagone kukodzera kune munhu akwegura. IWO ALLHAT kuedzwa (Antihypertensive uye Lipid-Kuchechera Kurapa Kudzivirira Heart Attack) yakaratidza kuti alpha-blockers yakabatanidzwa nehuwandu hwehutano hwemwoyo yakadai sekushaya mwoyo nekuenzaniswa nemamwe madhigiriji emishonga. Zvisinei, kune vazhinji vakwegura vakwegura vane imwe mamiriro ezvinhu ehutano, nyanzvi dzinoita seinobvumirana kuti kurapwa kunofanira kunge kune mumwe nomumwe zvichienderana nezvinodiwa nemurwere.
Zvinetso zvoutano zvakadai sezvirwere zvepuro, gout, chirwere cheshuga, osteoporosis, uye kukanganiswa kwemoyo kuchaita kuti zvakasarudzwa kusarudzwa kwezvinodhaka zvinoshandiswa kudzora ropa, kunyanya apo imwe mamiriro ezvinhu anogona kutarisirwa nemishonga imwechete inoshandiswa nehutachiona. Maitiro akawanda emishonga kune vakwegura vakwegura vanoda mazano evakadzi kubva kunechiremba kuti aone kuti ropa rinoshandiswa sei nemishonga rinosangana nezvinodiwa nemunhu.
Kuwedzera kweropa kunogona kuva kwakaoma kutonga kune munhu akwegura uye zvinodarika zvinodhaka zvinowanzonyorerwa. Izvi zvinogona kuguma ne "orthostatic hypotension," kana kudonha kwemazipa eropa paunofamba uchibva panzvimbo yakatarisa kana wakagara panzvimbo yekumire. Zvinonyanya kukosha kuyera ropa revanhu vakura kana ivo vakamira kuti vave nechokwadi kuti hazviitiki uye zvinokonzera kupera kana chirwere. Orthostatic hypotension iyi inonyanya kuisa mungozi kune vakwegura uye nokuti varwere vakwegura kazhinji vanotora mhando dzakawanda dzemishonga, vanogonawo kubatana uye kuwedzera rudzi urwu rwemagetsi.
IAmerican Geriatrics Society inokurudzira kuongororwa kwezvirema kune vanhu vakwegura kuti vaone chero njodzi dzinobatanidza nechisimba chekuita ropa, kusanganisira ngozi dzekuwa uye kuneta. Nyanzvi dzakawanda dzinobvumiranawo kuti kuderedza ropa kushandiswa nemishonga kune vakwegura vakwegura kunofanira kuitika zvishoma nezvishoma, uye zvishoma nezvishoma kuwedzera. Kunyange zvazvo ropa rinotungamira mirayiridzo ikozvino rinotanga kutanga madhigirii maviri akasiyana apo kubuda kwekutanga kweropa kunopfuura 20 mm Hg pamusoro pezvinangwa, mumwe mushonga unofanira kutanga uchitanga zvishoma usati wawedzera mishonga yakasiyana.
Zvimwe Zvokufungisisa
Apo patinenge takura, tinorasikirwa nekunzwisisika kwekutora, saka vanhu vakwegura vanogona kudarika zvokudya zvavo vasingazivi kuti vari kuwedzera dambudziko ravo. Kurara kwepabhesi kunobatanidzwa nekukura kwehuwandu hwehutano, saka zvinonzwisisika kutaura kurara kusina kujairika masikati kana kunzwa kwokuneta mukumuka apo uri kuona chiremba wako.
Sekugara kwehuwandu hwevanhu, isu ticharamba tichiramba tichiona nhamba inokura yevanhu vanogara mu 9 th kana gumi nemakore gumi ehupenyu. Muvanhu vanopfuura makore makumi matanhatu, kusvika kuzana makumi mapfumbamwe (80%) vachagadziriswa nehuwandu hwehutano. Vakwegura vakuru vanogona kuwedzera nekuvandudza hupenyu hwavo nekuderedza dambudziko rekurohwa, kurwadziwa kwemoyo, kukanganisa kwemwoyo, nekufa kuburikidza nekudzora ropa. Sangano re Joint National Commission (JNC8) rakapa huchapupu huri nani huripo mune zvavanorayira zvekutarisira dambudziko rekuwedzera kwehutano.
Shoko Rinobva
Kurapa kwekumanikidzwa kweropa kunogona kuwedzera upenyu hwako uye kuderedza njodzi huru dzezviitiko zvakashata sekurohwa kana kushaya mwoyo. Vakuru vakwegura vanobatsirwa kupfuura vaduku vaduku kuburikidza nekurapwa kwehutachiona. Ivo vanogona kunge vane mamwe mararamiro uye vanogona kuva nehuwandu hwehuwandu hwemishonga inorambidza mishonga. Kana uri munhu akwegura ane hypertension, unofanirwa kubvunza chiremba wehutano uyo ane ruzivo pamusoro pemishonga. Mutungamiri wehutano hwakanaka huchavawo nokunzwisisa kwakakwana kwezvinetso zvinoshanda zvinouya nekukwegura uye dzakawanda zvinokonzera matambudziko ehutano evanhu vakawanda vakwegura.
> Sources:
> American Academy of Family Physicians. (2014). JNC 8 Mirayiridzo yekutungamirirwa kweHypertension muVakuru. Ndiye Chiremba weNzara , 90 (7), 503-504.
> Franklin SS, Gustin W 4th, Wong ND, et al. Hemodynamic mararamiro ekuchinja-kufanana nemakore muropa. The Framingham Heart Study. Circulation 1997; 96: 308.
> James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS , Ortiz E. 2014 Evidence-Based Guideline yekutungamirirwa kweHurumende yeHurumende yeVanhu Vakuru Kubva Kubva Panhengo dzeNhengo Dzakanyorerwa kuChishanu yeZimbabwe National Committee (JNC 8). JAMA. 2014; 311 (5): 507-520. doi: 10.1001 / jama.2013.284427
> Mahajan R. Joint National Committee 8 ripoti: Rinosiyana sei neJNC 7. International Journal of Applied and Basic Medical Research . 2014; 4 (2): 61-62. doi: 10.4103 / 2229-516X.136773.
> Patel MD, A. (2015, February 20). PaHypertension Muvakwegura: An Epidemiologic Shift - American College of Cardiology. Kudzorerwa kubva ku http://www.acc.org/latest-in-cardiology/articles/2015/02/19/14/55/on-hypertension-in-the-elderly