I-Arterial Hypertension Kwabesetyhini

Isifo somngcipheko we-arterial kubasetyhini

V.S. Chistov

I-MGMU yokuqala im. Sechenova

Uxinzelelo lwe-arterial to date - esinye sezifo eziqhelekileyo: ukuxilongwa "kweengxaki
Uva malunga nomntu omnye kwabayishumi namhlanje.
Esi sifo sinokuthula, iminyaka emininzi ukutshabalalisa imithambo yegazi kunye nentliziyo, kwaye kungabikho oqeqeshiwe
Unyango olusesikweni, kukhokelela ekuhlaselweni kwentliziyo, i-angina pectoris, ubuthathaka bentliziyo yesisu, ukuphuhliswa kwentliziyo
Ukungakwazi, ukuphazamiseka, ukungaboni, ukungaphumeleli kwezintso ... olu luhlu lungagcinwa kakhulu, lude kakhulu.
Ngethamsanqa, namhlanje kuninzi amathuba amaninzi nje ekunciphiseni uxinzelelo lwegazi oluphezulu, kodwa kwakhona
Ukuyigcina ixesha elide kwizinga elifanelekileyo - kuyimfuneko kuphela ukupasa uviwo ngexesha
Yaye uyifumene nesifo.
Kubalulekile ukwazi: ngokuba namhlanje umntu omdala weshumi unokunyanzeliswa, kodwa
Isiqingatha sabantu siyazi ngeengxaki zabo. Kwaye baninzi abantu abafumana unyango olufanelekileyo: abanye
Izigulane azibonanga iimfuno zonyango ngeemeko zempilo ezilungileyo, abanye abazi malunga nobukho bwanamhlanje
Amachiza asebenzayo kunye nokunyamezela ngokupheleleyo ukunciphisa uxinzelelo lwegazi. Okwangoku, ukunyanga
I-artertension ye-arterial iyimfuneko-nangona isifo sifana nesifo, singakhokelela kakhulu
Imiphumo ebuhlungu. Musa ukubeka umngcipheko kwimpilo yakho, kunye nobomi bakho.
Iziphumo zengcinezelo yomsindo kwibafazi
Ukwanda kwenyuka kwixinzelelo legazi (oko kukuthi, isifo sengxinzelelo segazi ngaphandle kwezinto ezinobungozi)
I-70% yamatyala ibangela ukubetha kwabasetyhini. Ukuthelekisa, kwindoda ene-AH ngaphandle kwezinto ezinobungozi, iphela
Isibethi ku-30% kuphela.
Ukuphumelela kwonyango elingafihliyo kumadoda kunye nabasetyhini kuyafana. Nangona kunjalo, ngokudala, ukusebenza
Ulwaphulo olusakhulayo lwabafazi luyehla, olubangelwa ziziganeko zokuhamba emva kwexesha (malunga nezantsi nje).
Okwangoku, iingxaki zesifo somfutho wegazi ophezulu ziindawo ezi-1, ukuba sithetha ngokufa kwabesifazane
Lwabantu. Ubukhulu bexinzelelo lwegazi lwe-systolic kwabasetyhini ngowona wesibini kubaluleke kakhulu
Ukuphuhliswa kwesifo senhliziyo (CHD).
I-IHD ne-AH kwabasetyhini
Ibhinqa elivela kwindoda liyaziwayo kuphela ngeempawu zesondo zesiseko kunye neesekondari, kodwa kunye nokwahlukana kuphawuliwe
IiHormones, iigenjini, indlela yokuphila-konke oku, ngokuqinisekileyo, kuboniswa kwizikolo ezahlukahlukeneyo, ukhuseleko kunye
Ukusebenza kwonyango.
Kwiminyaka emininzi, kwakukho uluvo lokuba umngcipheko wokuphuhlisa isifo senhliziyo yabasetyhini uncinci kakhulu kunelo
Amadoda. Enyanisweni, oku akunjalo, ingozi kwizesini zombini iyafana, ngaphezu koko, kwiminyaka yakutshanje kubekho umendo
Ukwanda kokufa okuvela kwisifo senhliziyo kuya kubafazi.
Ukuze kulungiswe le ngxaki, kuyimfuneko, ngokungenani ubuncinci, ukuchonga iingxaki ezisemngciphekweni ze-cardiovascular
Izifo kubafazi, kunye nokukhangela iindlela zokuzilungisa. Yonke into engozi yobomi benhliziyo
Izifo zinokwahlukana ngamaqela amabini: ezithile (ezithile zezesondo ezithile, kwimeko yethu
Abasetyhini), abangaboniyo (abaqhelekileyo kubasetyhini kunye namadoda).
Izinto ezingabalulekanga ziquka ubudala, ukubonakaliswa kwangaphambili kweempawu zesifo senhliziyo
Izihlobo, ukutshaya, isifo sikashukela, ukukhuluphala, ukuhlala kwindlela yokuphila, ukunyamezela kwe-glucose tolerance,
Ukwandiswa kwe-OXC, i-LDL ye-cholesterol, yehla kwizinga le-cholesterol * i-HDL. Nangona kunjalo ukuba le miba ayinasiphelo, ku
Izinto ezikhethileyo zempembelelo yazo ekubunjweni kwesifo se-cardiovascular system kwinkqubo yabasetyhini kunye namadoda ahluke.
Ngokubhekiselele kwimimiselo ethile, ingaquka ukuphazamiseka kwemithi ngexesha lokukhulelwa,
Ukunquma, ukukhulelwa kwe-hormone, i-hysterovariectomy.
Kuboniswe ukuba abafazi abanesisu kakhulu bawela kwiqela leengozi yokwanda kwezifo zentliziyo: ingozi
Ukwandisa ama-4. Iinkqubo ezidlala indima kule nkqubo azikwazanga, kodwa ubudlelwane phakathi kokunyanya nokugqithisa
Uxinzelelo lwegazi luchanekile.
Ngokubhekiselele kwindlela yokuphila, kuboniswe ukuba ukungabikho komsebenzi okwenziwe rhoqo kubangela ingozi eyongeziweyo
Isiganeko nokuphuhliswa kwezifo zentliziyo kabini. Kungakhathaliseki ubunzima beenguqu ngokubhekiselele kwimvelaphi yenyama
Ukuqhelanisa ukusebenza komqondiso wexinzelelo lwegazi kubonakala. Kukholelwa ukuba ifuthe elihle
Imithwalo yempahla ehambelana neendlela ezikhoyo kunye neendlela ezichanekileyo ezibangela ukunciphisa
Uxinzelelo lwegazi, ukubonelela i-myocardium nge-oksijini, ngaphezu koko, ukuzivocavoca kunempembelelo
Izinto zokuvala zifaka isandla ekuphuculeni umthamo we-lipid wegazi.
Ngelishwa, ezweni lethu, uxinzelelo lwegazi oluphezulu phakathi kwabasetyhini luye lwasasazeka kwaye lubonwa ngo-41.1%.
Uxinzelelo lwe-arterial kwi-women of ages of different
Ngexesha lokuqala, ukungafani kwinqanaba lexinzelelo lwegazi, kuxhomekeke kwisini, kunokuthi
Iminyaka emithandathu ubudala. Ixabiso eliphezulu legazi legazi liyabonwa kwiimantombazana ezineminyaka eli-6 ukuya ku-6
Ixesha lokubhaliweyo. Kodwa ukususela kumzuzwana wobushushu kunye nokufika kokuqala kwesikhashana, unokubona amaninzi
Uxinzelelo lwegazi oluphantsi kwabasetyhini. Emva kokufika kwesisu, zonke iintlukwano ziyafa, kunye
Abasetyhini babhekana nomngcipheko ophezulu wokuphuhlisa izifo zengqondo, uxinzelelo lwengqondo oluthelekiswa
Amadoda.
Ukwanda koxinzelelo lwengcinezelo phakathi kwabasetyhini abasebancinci kuphantsi, kodwa emva kokumisa umva kwengozi
Kwaye ukukhula kwesi sifo kwanda kakhulu. Nangona kunjalo, akusiwo onke amabhinqa anegazi eliphezulu
Iyahambelana ngexesha kunye nokuqala kokuvuswa kwesondo. Kwiminyaka yakutshanje, ukwanda kwenycinezelo yegazi kuphawulwe kwaye
Phakathi kwabasetyhini abasetyhini, kubandakanywa nabafazi abakhulelwe. E-Russia, i-hypertensive syndrome ingabonwa kwi-15-30% yabasetyhini abakhulelweyo,
Eyona nto ibangela iingxaki ezinzulu kuphela ngexesha lokukhulelwa nokubeletha, kodwa kunento engalunganga
Impembelelo kwixesha elide lokugxekwa kwabasetyhini. Ngokuqhelekileyo kwenzeka ukuba ixinzelelo lwengcinezelo luvela ngexesha
Ukukhulelwa ... kwaye uhlala nomfazi ngonaphakade.
Uxinzelelo lwe-arterial in women and contraceptive oral
Ukuthatha izithintelo zokukhulelwa ngomlomo ngenye yezizathu eziphambili zokuphuhliswa komfutho wegazi ophezulu
Bafazi. Kuboniswa ukuba abafazi abathabatha la mayeza, kunye nomfutho wexinzelelo ophezulu, badibanisa amaxesha amathathu
Ngokuqhelekileyo amabhinqa angathathi isixhobo esinjalo. Ukongeza, ii-agent zomlomo zomzimba ziyakwazi
Ukuhamba kwinqanaba le-blood pressure. Ingozi yokuxinzeleleka kwengozi yenyango kwi-admission
Izalathisi zomlomo zomzimba zonyuka zinyuka kwabasetyhini abangaphezu kweminyaka engama-35 ubudala ukuba umfazi utshaya kunye / okanye ukuba
Ukunyanya.
Indlela yokukhusela ukunyusa uxinzelelo lwegazi kwabasetyhini abathwala iipilisi zokulawula
Amalungiselelo omlomo: ubunzima, umthamo wokujikeleza kwegazi ukwanda, ukungabikho kwe-insulin kubonakala,
Kukho ukulibazisa kumzimba we-sodium.
Ukwenziwa komgangatho wexinzelelo lwegazi kubonakala kwiiveki ezimbalwa emva kokuphela kweyeza. Kodwa ukuba
Nangona ibhinqa elisemvelaphi yokuthatha i-contraceptive sele sele iqulunqe ingozi yegazi, ukuba ingozi yemiphumo
Ukukhulelwa okunokwenzeka kuya kuba phezulu kunomngcipheko wokunyuka kwe-AH, ngoko kuyacetyiswa ukuba uqhubeke nokuthatha i-contraceptive
Unyango lwangexesha elilodwa kunye neziyobisi ezichasayo.
Umngcipheko wokuphuhlisa umfutho wegazi ophezulu unyuke xa:
- kukho umxhesho wegazi ophezulu kwingxelo yentsapho - kukho ukunyameka - ukukhubazeka kweengtso - ibhinqa lingaphezu kweminyaka engama-35 ubudala - umfazi uthatha i-contraceptive ixesha elide - ukuba uxinzelelo lwegazi luyanda ngexesha lokukhulelwa kwangaphambili.

Uxinzelelo lweengcinezelo kubasetyhini ngethuba lokumisa umva kunye nesikhokhelo sithuba
Ukwanda kwexinzelelo lwegazi ngexesha lokutshatyalaliswa komzimba kuthinteka kwizinto ezininzi - oku kuncitshiswa
Umsebenzi wokwenyama, nokwanda komzimba, kunye nokusetyenziswa kotywala, ityuwa.
Ngexesha lokuhamba emva kokuphuma kwimizimba, ingozi yokuphuhlisa izifo zengqondo zanda. Oku kungenxa yokuhlengahlengiswa
Inkqubo ye-endocrine ngeli xesha, kunye nokusilela kwintsebenziswano ye-estrogens, enenzuzo
Isifo senhliziyo.
Ukungabikho kwe-estrogen kunokukhokelela ekwandiseni ukuphumelela kwengcindezelo ye-angiotensin II, utshintsho kwi-lipid
I-blood spectrum echasene nemvelaphi yokwanda kwe-cholesterol, i-lipoproteids ephantsi kakhulu kwaye iphantsi kweqondo, ukuhla
Inani leepoprostin eziphezulu.
Phakathi kwezigulane ezingaphantsi kweminyaka engama-40 ubudala ukusuka kwingcinezelo yengozi, abafazi banamaxesha amaninzi kunabesilisa, kodwa ngeminyaka engama-45 ukuya ku -55 imeko
Utshintsho, kunye nenani labasetyhini abanexinzelelo lwengcinezelo luqala ukunqoba.
Ngako oko, ingqalelo ngoku ihlawulwa ngokukhawuleza ukukhangela iziyobisi ezikhuselekileyo nezichanekileyo kunyango
Isifo esiphezulu sisifo se-postmenopausal women - kungekhona nje ukunciphisa uxinzelelo lwegazi, kodwa kwakhona
Ngenjongo yokulungisa ukubonakaliswa kwe-climacteric, okuza kunika enye indlela yokwelashwa kwe-hormone.
Unyango lwexinzelelo lwengcinezelo kubasetyhini
Namhlanje, ingxaki ephuthumayo kukubonakaliswa kobudlelwane phakathi kwegazi lokutya kunye nezifo ezahlukahlukeneyo
Ukuphuhliswa kwindlela edibeneyo yokudibanisa kunye nonyango (Oganov RG, 2007; uAnikin SG, 2009; Yakushin SS,
2010).
Nangona kunjalo, phantse zonke iingcali zanamhlanje zivuma ukuba kunyango lwexinzelelo lwegazi
Kukhethwa ukunikezela unyango lwe-antihypergene.
Indawo ebalulekileyo kumaqhinga okuqhuba abafazi abaneengxaki zengxinzelelo yonyango inikwe kwiyeza ezingekho phantsi kweziyobisi.
Ngoko, umzekelo, ukutya okuphantsi kweekhalori kubasetyhini abanokukhuluphala kungakhokelela ekulahlekeni kwindleko, kodwa nakhona
Ukunciphisa uxinzelelo lwegazi, ngaphezu koko, ukutya kuya kuba nempembelelo emihle kwizinto ezinobungozi ezifana nesifo sikashukela,
Ukuxhathisa kwe-Insulin, hypertrophy ye-myocardial ye- ventricle engasekhohlo, i-hyperlipidemia.
Musa ukuthobela indima yomsebenzi wokwenyama: ukuhamba, ukubhukuda, ukusebenzisa, ukusebenzisa
I-Gymnastics njalo njalo kuya kukunceda ukunciphisa ingozi yokubonakala, ukuphuhliswa komfutho wegazi ophezulu.
Ngokufanayo kunye neyeza ezingekho gciwane kufuneka kubonelele iziyobisi ezingamachiza.
Ngaphambi kokuphonononga izidakamizwa ezikhethiweyo namhlanje, kuyafaneleka ukuthetha ithemba lokusebenza
I-Hormone yonyango yokuguqula indawo ngenjongo yempembelelo enokubakho kwixinzelelo legazi, ayifanelekanga. Ngaphezu koko, ku
Kwezinye iimeko (malunga ne-9%), kwakungekho ukuhla kwehla, kodwa ukwanda kwexinzelelo lwegazi
IHormone yonyango.
Ukongezelela, kufuneka kuqatshelwe ukuba nangona kuninzi olubanzi, ukhetho oluninzi lwezidakamizwa ezichasayo,
Namhlanje ukusebenza kwonyango loxinzelelo lwegazi luhlala kwinqanaba eliphantsi. Ukongeza, idatha,
Ezifunyenwe ekufundweni kwamadoda, azikwazi ukudluliselwa kubafazi ngokuzenzekelayo (Podzolkov NM, 2009;
Tkacheva ON, 2010). Ngako oko, ukubaluleka okukhulu yingxaki yonyango olwahlukileyo
Uxinzelelo lweengcinezelo kubasetyhini kunye nokuvavanya kobuchule beendlela ezingasebenzi, eziza kuphucula ukuxela,
Umgangatho wonyango lwangexesha elide. Siyabulela ukuphuhliswa kwe-algorithm, kuya kubakho ukuba kube yedwa unyango
Bafazi.
Kuze kube yimhla, ngesifo somfutho wegazi, abafazi banqunywe nayiphi na isicatshulwa esichaphazelekayo (kunye
Ukungabikho kokuchasene) kweqela ngalinye ngendlela yokuhlanganiswa okanye i-monotherapy. Ukuqinisa i-hypotensive
Umphumo uvame ukushicilelwa i-hypothiazide (i-hydrochlorothiazide). Ngokuqhelekileyo ukunyanga ingcinezelo yentsholongwane yabasetyhini
Sebenzisa i-diuretics: i-arifon-retard, i-arifon, i-cardioselective beta-adrenoblockers (lokren (betaxolol), i-atenolol,
Ngaphantsi kwexesha i-bisoprolol).
Ukuba sithetha nge- ACE inhibitors, ke i-moexipril isetyenziswa rhoqo, ngezinye izikhathi i-fosinopril (monopril).
Ngokumalunga nabaphikisi be-calcium ngendlela ye-dihydropyridine amalungiselelo okuthatha ixesha elide (ukuthunjwa, i-norvask,
Kordafleks-retard), ngoko ukufumana kwabo kunokwenzeka, kodwa kufuneka kukhunjulwe ukuba ezinye izigulana zingakhula
Ngeenyawo zabo, okanye ziyakwazi ukubizwa ngakumbi.

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3. Kobalava Zh.D., Tolkacheva VV, Moryleva О.N. Impawu zonyango kunye nokunyangwa kwengozi yokhuseleko lomzimba kubasetyhini.
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4. Kuban Izaziso zonyango zenzululwazi Iinkqubo zesigulane kunye nezisebenzayo zesimo senhliziyo esisetyhini kwabasetyhini abanegazi eliphezulu. 2011;
5. iProtevich EA, 2006; Tkacheva ON, 2010; Oganov RG, 2007; Anikin SG, 2009; Yakushin SS, 2010.