Hypertension chinhu chikuru chinodzivirirwa muzvirwere nekufa muUnited States iyo inobatsira kushaya chirwere, chirwere chepfungwa, uye kurwisa kwemwoyo. Zvakakosha kuti uzvione pakutanga nekuzvibata, kuitira kuti udzivirire zvinetso zvakakomba. Sangano reNational National Commission rekudzivirira, Kuongorora, Kuongorora, uye Kuchengetedzwa kweHurumende yeHurumende yepamusoro yakabudisa mazano kubva pauchapupu hwezvesayenzi.
Chii chinonzi JNC 8?
Iwe ungangodaro wakanzwa kuti pane mazano kune vatungamiri vehutano hwepamusoro yevanhu vakuru. Iyi mitungamiri yakabudiswa ne8th Joint National Committee yekudzivirira, Kuziva, Kuongorora, uye Kurapa kweHurumende yeHurumende, iyo inozivikanwa seJNC 8. Mitemo yakagadzirwa mushure mekomiti yeyanyanzvi yakagadzira uchapupu hwose hwehuzivi huripo uye yakagadziridzwa kuti ipe mazano kuvanachiremba kwehutungamiri hwehuwandu hwehutachiona. JNC 8 inorayira zvibvumirano zvekurapa kukwirira kweropa, zvinangwa zveropa, uye uchapupu-based medication therapy.
Ropa Rakamanikidzwa Zvigaro uye Target
Zvidzidzo zvinoratidza kuti kuderedza ropa mukati mevanhu vakuru vane hypertension ne 10 mm Hg kunogona kuderedza dambudziko rekufa kubva mumoyo wehutachiona uye kuparadzaniswa ne25% kusvika 40%. Uchapupu hunoratidza kuti vanhu vakuru vari vaduku vezera remakore makumi matanhatu nematanhatu vanofanira kutanga mishonga apo systolic yeropa rekuverenga (nhamba yepamusoro) inokwana 140 mm Hg kana yakakwirira kana apo diastolic yeropa rekuverenga iri 90 mm Hg kana kupfuura.
Muvanhu vakuru vanopfuura makore makumi matanhatu, chirwere chinofanira kutanga kana systolic kukwira 150 mm Hg kana yakakwirira uye kana diastolic inokwana 90 mm Hg kana kupfuura. Varwere vanotanga kurapwa vanofanira kushandisa nhamba idzi sevari vavariro dzavo. Vanhu vane chirwere cheshuga kana chirwere chisingagumi vanofanira kushandisawo zvinangwa izvi kubvira JNC 8 isina kuwana humwe uchapupu hwokuti kuchengetedza ropa rezasi kuderedza zvirwere zvehutano mumapoka aya maviri.
Mishonga Zvinokurudzirwa kune Initial Treatment
JNC 8 yakashandura mazano ekurapa kwekutanga kurapwa kwehuwandu hwehutachiona, kubva pamakirasi mashanu emishonga kusvika kune makirasi anokurudzirwa 4. JNC 8 yakanatswa kurapa mazano kumakira mana emishonga:
- Angiotensin inoshandura enzyme inhibitors (ACEI)
- Angiotensin receptor blockers (ARB)
- Diuretics
- Calcium channel blockers (CCB)
JNC 8 yakaongorora zvakare uchapupu hunonyatsotarisa kuti huongororwe mazano ekurapa kwezvikamu zvishoma zvichienderana nehutano uye kuvapo kwechirwere cheshuga kana chirwere chisingaperi chepfungwa. Pane humwe humwe humwe humwe humwe humwe humwe humwe humwe hutano hwakasiyana-siyana hunoenderana nekusarudzwa kune mamwe masangano evanhu vane ropa rinodhaka.
- Gavhuna kwete nhamba yevanhu (kana vasina chirwere cheshuga) inofanira kutanga kurapwa neACEI, ARB, CCB, kana thiazide-type diuretic (kureva, hydrochlorothiazide)
- Kazhinji vanhu vemazuva mashoma (kana vasina chirwere cheshuga) vanofanira kushandisa CCB kana thiazide-type diuretic yekutanga kurapwa kwehuwandu hwehutachiona.
- Varwere vane chirwere chisingaperi chepfungwa pamusoro pemakore gumi nemasere vanofanira kushandisa ACEI kana ARB senzira yekutanga yekurapa kana kuwedzerwa-kurapa sezvo ichi chave chiratidzwa kugadzirisa migumisiro yeutsvo. Izvi zvinoshanda kune vanhu vemavara uye vasiri vanhu vemavara.
Nguva yekuwedzera Dose kana kuwedzera Drug Drug
JNC 8 inokurudzira kuwedzera kwekutanga kwechirwere chemishonga kana kuwedzerwa kwechipiri chemishonga kubva kune imwe yezvikurudziro zvemishonga zvinokurudzirwa zvekundika kwako kana iwe usingakwanise kusvika kuwedzerwa kweropa rako pane imwe mwedzi. Kana kuwedzerwa kwedza kana kuwedzerwa kwemishonga mitsva hakuderedze ropa rako kuchinangwa chako chinangwa, ipapo chiremba wako anofanira kuwedzera chechitatu chemishonga kubva kune imwe yezvikwata zvinorayirwa. Zvisinei, ACEIs uye ARB hazvifaniri kushandiswa pamwechete. Vamwe varwere vangada kuwedzera kwechirwere kubva kune rimwe kirasi.
Mamwe Makirasi eAnhypertension Drugs
Pane nguva apo varwere vane chimwe chikonzero chokutora mishonga kubva kuchikoro chisina kutaurwa zvakananga munyaya dzeJNC 8.
Semuenzaniso, beta-blockers dzakaratidzwa kuti dzivandudze kupona kune varwere vane mwoyo wekukundikana, saka vari sarudzo yakanaka yekuderedza ropa mukati mevarwere vane congestive moyo kusakundikana. Varwere vane hutano hwe prostatic hypertrophy vanowanzotora kirasi yemishonga inonzi "alpha blockers" kuderedza zviratidzo zvavo. Iyi mishonga yakatanga kusimbiswa kuti iite chirwere chepamusoro cheropa, asi inosunungura prostate uye mushumba wechipfuva, zvichiita kuti urini iyerere zvakasununguka. Alpha-blockers isarudzo yakanaka yekurapwa kwehutano hwepfungwa mune varume neBPH.