IHypertension "J Curve"
"Chiremba wangu akatanga kundibata nokundipa kweropa mwedzi mitanhatu yapfuura, uye kuverenga kwangu kwakabva 155/90 kusvikira 120/70, iyo yandakafunga yakanga yakanaka. Saka vhiki yapfuura ndakashamisika apo chiremba wangu akaratidza kunetseka kuti akanga aita kuti ropa rangu rive rakanyanya kuderera, uye rakaderedza chirwere changu chemishonga yeropa. Mubvunzo wangu ndewokuti chii chaanotora? Too down? Icho chiri chinhu chaicho, kana ndinofanira kuzviwana chiremba mutsva here? "- Sidney weOregon
Sezvazvinoitika, Sidney, chiremba wako anoita seari kutosvika pane zvisizvo zvehupupuri huchangobva kuitika maererano nerapi yehutachiona. Pane humwe humwe hunoratidza kuti ropa rinotaridzirwa rakanaka mumunhu asina kutariswa (120/70 somuenzaniso), zvingave zvakanyanyisa kune munhu ane ropa rekurapa.
Hypertension, kana kuwedzerwa kweropa, chirwere chakanyanya kufanana nehutano, kuti, kana isingateereri, inogona kutungamirira kune myocardial infarction (kurwisa kwemoyo) , kushaya mwoyo , kurwara, uye zvirwere zvepfungwa. Kana iwe une hypertension zvakakosha iwe iwe nachiremba wako kutora matanho anodiwa kuti udzikise zvakakwana ropa rako, kusati kwasvibiswa kukanganiswa kunoitwa pamwoyo wako, uropi kana tsutsvo.
Chikamu ichocho che equation chakajeka. Iyo nharo inoratidzirwa mukurapa kwoutano hwehutachiona hunofanirwa kushandiswa sei.
Ndezvipi Zvakanaka Kurapa Zvinangwa?
Kwemakore mazhinji, nyanzvi dzehutano hwepfungwa dzakange dzichida kutaura kuti, "Kana zvasvika pakunetseka kweropa, pasi pfupi iri nani." Mashoko aya aigara ari chimwe chinhu chokunyanyisa, sezvo kuderedza kuwedzera kweropa kusvika kune zvakaderera mazinga, pachena, zvinogona kutungamirira kuchena kwemusoro kana kunyange syncope .
Asi kupa huwandu hwekupera, "yepamusoro zviri nani" yakaratidza kuva nzira inonzwisisika, nokuti muhuwandu hwevanhu inenge ichokwadi zvechokwadi - yakaderera ropa, inoderedza dambudziko rehutano hwepfungwa kana hwepfungwa.
Izvo zvave zvichingofungidzirwa kuti mutemo iwoyo unofanirwa kushandiswa kune vane huwandu hwehutachiona hwehutano mukurapa.
Mushure mezvose, zvidzidzo zvisingaverengeki zvakaratidza kuti kana iwe uchideredza ropa mukati mevarwere vane hypertension, zvibereko zvavo zvinovandudza zvikuru. Saka vanachiremba vakanzwa vakasununguka kuderedza kusimba kwavo kweropa zvakanyanya sezvavaikwanisika, chero bedzi varwere vavo vakanga vasina zviratidzo zvekudzivirira kana kuti orthostasis .
Ichi ndicho chikonzero zvinangwa zvehutano hwehutano hwehutachiona hunoratidzirwa se "shoma pane" kukosha (zvakadai se, systolic blood pressure pasi pe 140 mm Hg), panzvimbo yekuti mararamiro akadai (se, systolic pressure pakati pe 130 - 140 mm Hg) .
Izvo zvave zvichive mumakore achangopfuura kuti iyi "yepamusoro yepamusoro" paradigm yakauya pasi pemubvunzo wakakomba. Iko zvino inoratidzika kuti inogona kuve yakakwanisa kuderedza kushanda kweropa pasi pasi pekukosha kwakakwana, uye zvinogona kuunza kukuvadza mukuita kudaro.
Dambudziko Ropa "J Curve"
Zvimwe zvitsvakurudzo zvitsva zvakaratidza kuti zvikwereti zvemakiriniki kune varwere vanobatwa nehutano hwepamusoro zvinogona kutevera "J curve," apo zvibereko zvinoita sezviri nani mukati mehutano hwemhando yeropa. Kana ropa rinodzvinyirirwa panguva yekurapa riri pamusoro kana kuti pasi apa zvakanakisisa zvakasiyana, zvipatara zvinowedzera kuipa. Kana iJ curve hypothesis ndeyechokwadi, saka "pasi iri nani" paradigm inhema - uye vanachiremba vachafanira kunyanya kuchenjerera pamusoro pekuti vari kure zvakadini kuderedza zvirwere zvevarwere vavo.
Chimwe chezvidzidzo zvakakosha zvakagadzira chirevo ichi chakabudiswa muna 2014 mu Journal of the American College of Cardiology. Vatsvakurudzi vanobva kuSouth California Kaiser Group vakatsanangura vanenge vanenge mamiriyoni miviri varwere vakabatwa nehutano hwehutano, uye vakafananidza nhamo dzavo dzeropa mukurapa kumigumisiro yavo yezvipatara. Vakawana kuti iyo yakakwana systolic yeropa yepamusoro apo ichirapa yakanga iri pakati pe 130 - 139 mm Hg, uye zvakanakisisa diastolic yeropa raiva pakati pe 60 - 79 mm Hg. Kuwedzerwa kwehutano kwezvinokonzerwa neropa zvakange zviri pamusoro kana pasi pematunhu aya zvakabatanidzwa nemigumisiro yakaipa.
Pfungwa yeJ curve inogona kunge inonyanya kukosha, uye ikozvino yakagamuchirwa zvikuru, kune vakwegura vakwegura vane shungu dzekudzivirira hutachiona hwehutachiona. Imwe mirayiridzo yemazuva ano inokurudzira kuchenjerera mukuderedza ropa rinoderera zvikuru muvarwere ava, uye vanachiremba vakawanda vava kunyatsochenjerera nezvekurapa varwere vavo vane hutano hwehutano hwakanyanya zvehasha.
Kunyange zvakadaro, zvinofanira kuonekwa kuti zvidzidzo zvakawanda zvakakundikana kuziva J curve yevasati vakura vakarapwa nehuwandu hwehutachiona, uye mubvunzo unoramba uine kukakavadzana pakati pezvenyanzvi. Asi nyanzvi dzakawanda dzave dzakawanda zvakanyanya pakuratidza "pasi pasi zviri nani" pfungwa, uye nyanzvi dzakawanda uye dzakawanda dziri kuuya kuzogamuchira kuti J jveve ndeyechokwadi.
Saka, Sidney, kukurudzira kwachiremba wako kuti udzoke pahutano hwako hwehutano hwehutano hunoenderana nehuchapupu huchangobva kuitika. Tichazofanira kungomirira uye kuona kana panyanzvi mazano anogadzira mitungamiri yekurapa achazopedzisira atora naye.
Sources:
Sim JJ, Shi J, Kovesdy CP, et al. Kukanganisa kwekuwana ropa kumanikidziro pamusoro pekufa kwekutadza uye kuguma-sted-stal renal disease pakati pevanhu vakawanda, vane hutano hwakasiyana-siyana. Am Coll Cardiol. 2014; 64 (6): 588-97 (ISSN: 1558-3597)
Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH / ESC Zvinyorwa zvekutungamirirwa kwehutano hwehutachiona: Task Force yekutungamirirwa kwehutano hwehutano hweEuropean Society of Hypertension (ESH) uye yeEuropean Society of Cardiology (ESC). J Hypertens 2013; 31: 1281.
James PA, Oparil S, Carter BL, uye al. 2014 uchapupu hunotungamirirwa nehutungamiri hwehuwandu hwehutano hwevanhu kune vanhu vakuru: nhuyo inobva kune nhengo dzemapoka akasarudzwa kuEighth Joint National Committee (JNC 8). JAMA 2014; 311: 507.