Ruzhinji rwevanhu vanopfuura makore makumi matanhatu nemasere vane hypertension (high blood pressure), iyo inonyanya kukonzerwa nechirwere , chirwere chemarita (CAD), kushaya mwoyo , uye zvirwere zvepfungwa.
Zvakakosha zvakafanana kuti vanhu vakuru uye vaduku vane dambudziko rekuwedzera kwehutano hwavo. Asi vanhu vazhinji vakwegura vanotarisana nematambudziko maviri anokosha pakuwana kukwana kwehutano hwekudzivirira ropa: kutanga, vazhinji vavo vane systolic hypertension.
Chechipiri, vanhu vakwegura kakawanda vanowanzoomerwa nekurapa chirwere chinopesana nehutachiona.
Systolic Hypertension in Vakwegura
Vanhu vazhinji vakwegura vane hypertension zvikuru vane zvikwata mu systolic yavo yeropa, nepo diastolic yavo inoramba ichigara yakakwana kana inenge yakazara. Izvi ndezvokuti sezvo isu takura, mishonga yedu yeropa inowanzova "yakashata," saka systolic ropa rinomanikidza (kumanikidzwa mumagetsi apo mwoyo wemisungo iri kurova) inokwira kumusoro. A systolic blood pressure ye 140 mm Hg inofungidzirwa kuti ndiyo yakagadziriswa yakakwana.
Uyezve, kune vanhu vanopfuura makore makumi matanhatu nematanhatu, chirwere chepamusoro che systolic cheropa chinowedzera hutano hwehutano kupfuura huwandu hwakanyanya hwemaastolic. (Kusiyana ndeyechokwadi kune vanhu vaduku.) Mukati, systolic hypertension inopfuura kudarika dambudziko rako rekurwadziwa kwepfungwa uye kurohwa. Saka kurapa systolic dambudziko rekurwisana kunokosha.
Asi kubata chirwere cheshutta kunogona kupa chinetso chakakosha: kureva, pakuderedza systolic yeropa, zvakakosha kuti panguva imwe chete kuderedze diastolic yeropa rakawandisa.
Izvi ndezvokuti kune vanhu vakwegura vane CAD, kuderedza diastolic kudzvinyiriri pasi pemakumi matanhatu kana 65 mm Hg yakabatanidzwa nekuwedzera kwekurwadziwa kwemoyo nekurova.
Saka kunyengedza mukurapa systolic hypertension ndiko kuderedza systolic kudzvinyirira kusvika pasi pe 140 mm Hg - kana pedyo ne 140 mm Hg sezvinobvira - nekuchengetedza diastolic kudzvinyirira pamusoro pe 60 kana 65 mm Hg.
Hypertension Therapy in Vakwegura Vanhu
Kufanana nemumwe munhu ane hypertension, danho rokutanga mukurapa kukwirira kweropa muvanhu vakwegura ndokuisa mararamiro ehupenyu anokwanisa kuderedza ropa rako, kusanganisira kushaya kurasikirwa, kuregererwa kwemunyu, kuvhenekera, uye kusvuta kusvuta.
Kana ropa rako rinoramba richisimudzwa mushure memwedzi kana mbiri yekuchinja mararamiro ako, chiremba wako angangodaro akarayira zvinodhaka remishonga.
Muvanhu vakwegura, kushandiswa kwemishonga inopesana nehutachiona zvakachengeteka kunogona kuoma. Kwete kungofanirwa kutarisirwa kutorwa kunodzivisa kuderedza diastolic kudzvinyirira zvakanyanya, asi vamwe vanhu vakwegura, kunyanya avo avo zvikuru vane systolic hypertension, vanogona kukudziridza hutano hwe hyperension (kuwira muropa kumanikidzwa pavanomira) pamwe nemishonga yeropa ropa. Postprandial hypotension (kuwa muropa reropa kamwe mushure mekudya) kunogona kuonekwawo kuvanhu vakwegura vane mishonga yeupempa. Kutengesa - chero zvingave zvichiita kuti zvive - zvinogona kutungamirira kumatope nekuwa, uye zvinofanira kudziviswa.
Saka zita remutambo nderekufamba zvishoma nezvishoma kuitira kuti usadzivisa migumisiro. Paunotanga kushandisa ropa kumishonga kuvanhu vakuru, chirwere chimwe chete chinofanira kushandiswa, uye chinofanira kutanga pamushandi wepasi-kazhinji, pane imwe nhamba inenge inenge hafu yeiyo inogona kushandiswa mune murwere muduku.
Mishonga inowanzotanga ne thiazide diuretic , refu-acting calcium blocker, kana kuti ACE inhibitor. Kana mushonga wacho uchibvumira pasina migumisiro yechipfuva, muyero unogona kuwedzerwa mushure mamavhiki mashomanana kana zvichidiwa. Kana iyo yepamusoro yebazi ichi ichiri kusati iite zvakanaka ropa rekudzivirira, vazhinji vanachiremba vachazobva vaenda kumishonga yakasiyana , panzvimbo yekuwedzera mishonga yechipiri. Kusanganiswa kwezvinodhaka zvinodhaka zvinowanzoshandiswa chete kana kuedza kwakasiyana kwekurapa zvinodhaka kusinganzwisisiki.
Mushure mokunge kushanduka kupi mune zverapi - kuwedzerwa chirwere chechirwere, kushandura kune mishonga yakasiyana, kana kuwedzera mishonga yechipiri - chiremba wako anofanira kunyatsotarisa kuti inonzi hypotension.
Izvi zvinoitwa nekuyera ropa rako apo iwe uri kurara pasi, uye ipapo iwe paunenge uchisimuka, uchitsvaga doro guru mukudzvinyirira. Zvinokosha nguva dzose kuti utaurire chiremba wako pamusoro pehutano chero upi zvaunogona kuwana kana iwe ukasimuka, kana mushure mekudya.
Chinangwa ndechokuti zvishoma nezvishoma uise ropa rako pasi kuti rive nehuwandu hwemashoko, kupfuura vhiki kana mwedzi (pane mumazuva) uchichengetedza panguva ino kuti urege kudzikisa ropa rako rakawandisa. Kuzadzisa chinangwa ichi kazhinji kunotora miedzo yakawanda nemumwe chete kana kupfuura mishonga uye zvimwe zvigadziriswa kuenzanisa.
Summary
Kana iwe uri munhu akwegura, mikana yakanaka kuti une hypertension. Kunyange zvazvo kuwedzera kwehutano kwakakosha, uye apo kuchirapa kunogona kuunza matambudziko, ichiri chiitiko icho nekutarisira nekushivirira (pane iwe pamwe chete nechiremba wako), pane mukana wakanaka kwazvo wehuwandu hwepfungwa yako huchaiswa pasi pasina zvinokonzera migumisiro, uye njodzi yako yekutambudzika kwemwoyo yematambudziko ichaderedzwa zvikuru.
Sources:
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Chobanian AV. Clinical practice. Isolated systolic hypertension kune vakwegura. N Engl J Med 2007; 357: 789.