Ke koko kiʻekiʻe - nā mākua

ʻO ke kaomi koko ke ana o ka ikaika i hoʻokau ʻia i nā paia o kou aʻa i ke kolo ʻana o kou puʻuwai i ke koko i kou kino. ʻO ka hypertension ka manawa i hoʻohana ʻia e wehewehe i ke koko kiʻekiʻe.

Hiki i ke kahe koko kiʻekiʻe i hana ʻole ʻia ke alakaʻi i nā pilikia lapaʻau. Hoʻopili kēia i ka maʻi puʻuwai, hahau, holo pono ʻole ʻana o ka puʻuwai, nā pilikia o ka maka, a me nā pilikia olakino ʻē aʻe.

Hāʻawi ʻia nā heluhelu kaomi koko ma ke ʻano he ʻelua helu. Kapa ʻia ka helu kiʻekiʻe he systolic pressure pressure. Kapa ʻia ka helu lalo i ke kaomi koko diastolic. ʻO kahi laʻana, 120 ma luna o 80 (kākau ʻia ma 120/80 mm Hg).

Hiki ke kiʻekiʻe a hoʻokahi a ʻelua paha o kēia mau helu. (Kahakaha: pili kēia mau helu i ka poʻe ʻaʻole e lawe i nā lāʻau no ke kaomi koko a ʻaʻole maʻi.)

• ʻO ke kaomi koko maʻamau ke haʻahaʻa kou kaomi koko ma mua o 120/80 mm Hg i ka hapa nui o ka manawa.
• ʻO ke kiʻekiʻe o ke koko (hypertension) ke kiʻekiʻe a hoʻokahi a ʻelua paha o kāu mau kahe koko ma mua o 130/80 mm Hg ka hapa nui o ka manawa.
• Inā ka helu kiʻekiʻe o ke kiʻekiʻe o ke koko ma waena o 120 a me 130 mm Hg, a ʻo ka helu o ke kaomi o ke kō ma lalo o 80 mm Hg, ua kapa ʻia ia he kiʻekiʻe ke koko.

Inā loaʻa iā ʻoe ka pilikia o ka puʻuwai a i ʻole ka puʻuwai, a i ʻole he maʻi hahau ʻoe, makemake paha kāu kauka i kou kaomi koko e ʻoi aku ka haʻahaʻa ma mua o ka poʻe i loaʻa ʻole kēia mau ʻano.

Hiki i nā kumu he nui ke hoʻololi i ke koko, me:

• ʻO ka nui o ka wai a me ka paʻakai i kou kino
• ʻO ke kūlana o kou puʻupaʻa, ʻōnaehana ʻōnaehana, a i ʻole nā ​​kīʻaha koko
• Nā pae hormonone ou

E haʻi ʻia aku paha ʻoe i kou kiʻekiʻe o ke kahe o ke koko i kou wā ʻelemakule. ʻO kēia no ka lilo o nā kīʻaha koko i ke koʻikoʻi i kou mau makahiki. Ke hiki mai kēlā, piʻi aʻe kou kaomi koko. Hoʻonui ka piʻi kiʻekiʻe o ke koko i kou manawa e loaʻa ai ka maʻi hahau, puʻuwai puʻuwai, puʻuwai puʻuwai, maʻi ʻōpū, a i ʻole make mua.

Loaʻa iā ʻoe kahi kiʻekiʻe o ke kaomi kiʻekiʻe inā ʻoe:

• ʻAmelika ʻAmelika
• Ua momona
• Hoʻoluhi pinepine a hopohopo paha
• Inu nui loa i ka waiʻona (ʻoi aku ma mua o 1 inu i kēlā me kēia lā no nā wahine a ʻoi aku ma mua o 2 inu i kēlā me kēia lā no nā kāne)
• ʻAi nui ka paʻakai
• Loaʻa i kahi moʻolelo ʻohana o ke koko kiʻekiʻe
• Loaʻa diabetes
• Puhi

ʻO ka hapa nui o ka manawa, ʻaʻohe kumu o ke kahe kiʻekiʻe i loaʻa. Kapa ʻia kēia he hypertension nui.

ʻO ke kahe kiʻekiʻe e hoʻokumu ʻia e kekahi ʻano olakino a lāʻau lapaʻau paha āu e lawe nei i kapa ʻia he hypertension lua. ʻO ke kiʻekiʻe kiʻekiʻe kiʻekiʻe ma muli o:

• Maʻi maʻi ʻōniʻoniʻo
• Nā maʻi o ka adrenal gland (e like me pheochromocytoma a i ʻole Cushing syndrome)
• Hyperparathyroidism
• Hapai a preeclampsia paha
• ʻO nā lāʻau e like me nā lāʻau kaohi hānau, nā papaʻaiʻai, kekahi mau lāʻau anuanu, nā lāʻau migraine, corticosteroids, kekahi antipsychotics, a me kekahi mau lāʻau i hoʻohana ʻia e mālama ai i ka maʻi ʻaʻai.
• Piha ʻaʻa e hāʻawi i ke koko i ka puʻupaʻa (stenosis artery renal)
• Apne hiamoe ākea (OSA)

ʻO ka hapanui o ka manawa, ʻaʻohe ʻōuli. No ka hapanui o ka poʻe, loaʻa ke koko kiʻekiʻe ke hele lākou i ko lākou lawelawe mālama ola a i ʻole ua nānā ʻia ma kahi ʻē.

Ma muli o ka loaʻa ʻole o nā ʻōuli, hiki i nā kānaka ke hoʻomohala i nā maʻi puʻuwai a me nā pilikia o ka puʻuwai me ka ʻike ʻole o ke koko kiʻekiʻe.

ʻO ka hypertension malignant kahi ʻano weliweli o ke koko kiʻekiʻe loa. Pākuʻi ʻia paha nā ʻōuli:

• ʻEha poʻo poʻo
• ʻO Nusea a me ka luaʻi
• Huikau
• Hoʻololi ka hihiʻo
• Nā Nosebleeds

ʻO ke kuhi ʻana i ke koko kiʻekiʻe ma mua e hiki ke kōkua i ka pale ʻana i ka maʻi puʻuwai, ka hahau ʻana, nā pilikia o ka maka, a me nā maʻi puʻupuʻu mau.

E ana ana kāu mea hāʻawi i kou kaomi koko i nā manawa he nui ma mua o ka hōʻoia ʻana iā ʻoe me ke koko kiʻekiʻe. He mea maʻamau kāu mau kaomi koko e ʻokoʻa e pili ana i ka manawa o ka lā.

ʻO nā mākua āpau ma mua o 18 mau makahiki e nānā i ko lākou kahe koko i kēlā me kēia makahiki. Pono paha e ana hou pinepine ʻia no ka poʻe me ka mōʻaukala o ka heluhelu ʻana i ke koko kiʻekiʻe a i ʻole nā ​​mea me nā mea pilikia no ke kahe kiʻekiʻe.

ʻO nā heluhelu kaomi koko i lawe ʻia ma ka home he ana maikaʻi paha ia o kāu kaomi koko o kēia manawa ma mua o nā mea i lawe ʻia ma ke keʻena o kāu mea lawelawe.

• E hōʻoia i ka loaʻa ʻana o kahi mea maikaʻi maikaʻi, pono ke nānā pono i ke kaomi koko. Pono e loaʻa i kahi cuff nui a me kahi heluhelu heluhelu.
• E hoʻomaʻamaʻa me kāu mea lawelawe e ʻike pono i ka lawe pololei ʻana i kou kaomi koko.
• Pono ʻoe e hoʻomaha a noho i mau minuke ma mua o ka heluhelu ʻana.
• Lawe i kāu mea nānā home i kāu mau koho i hiki ai i kāu mea hāʻawi ke hōʻoia ke holo pono nei.

E hana ana kāu mea hāʻawi i kahi hoʻokolohua kino e nānā i nā hōʻailona o ka maʻi puʻuwai, hōʻino i nā maka, a me nā hoʻololi ʻē aʻe i kou kino.

E hoʻokolohua ʻia paha e nānā no:

• Pae kiʻekiʻe kolesterol
• ʻO ka maʻi puʻuwai, e hoʻohana ana i nā hoʻokolohua e like me ka echocardiogram a i ʻole ka electrocardiogram
• ʻO ka maʻi kīnā, e hoʻohana ana i nā hoʻāʻo e like me ka pan metabolic panel maʻamau a me ka urinalysis a i ʻole ultrasound o nā puʻupaʻa

ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i kou kaomi koko i mea e loaʻa ai iā ʻoe kahi haʻahaʻa o nā pilikia olakino i hoʻokumu ʻia e ke koko kiʻekiʻe. Pono ʻoe a me kāu mea e hāʻawi i kahi pahuhopu kahe koko no ʻoe.

Ke noʻonoʻo e pili ana i ka lāʻau maikaʻi loa no ke kiʻekiʻe o ke koko, pono ʻoe a me kāu mea lawelawe i ka noʻonoʻo i nā kumu ʻē aʻe e like me:

• Kou makahiki
• Nā lāʻau āu e lawe ai
• ʻO kou makaʻu i nā hopena ʻaoʻao mai nā lāʻau hiki
• Nā kūlana olakino ʻē aʻe i loaʻa iā ʻoe, e like me ka mōʻaukala o ka maʻi puʻuwai, hahau, pilikia ʻōpala, a i ʻole ka maʻi diabetes

Inā kū kou kahe koko ma waena o 120/80 a me 130/80 mm Hg, ua hoʻokiʻekiʻe ʻoe i ke kaomi koko.

• E paipai kāu mea hāʻawi i nā loli nohona e hoʻoliʻiliʻi i kou kaomi koko i kahi pae maʻamau.
• ʻAʻole hoʻohana pinepine ʻia nā lāʻau i kēia manawa.

Inā ʻoi aku ke kiʻekiʻe o kou kahe koko ma mua o 130/80, akā ʻoi aku ka haʻahaʻa ma mua o 140/90 mm Hg, loaʻa iā ʻoe ka pae 1 ke koko kiʻekiʻe. Ke noʻonoʻo nei e pili ana i ka lāʻau maikaʻi loa, pono ʻoe a me kāu mea lawelawe e noʻonoʻo.

• Inā ʻaʻohe ou maʻi ʻē aʻe a i ʻole nā ​​kumu weliweli, hiki i kāu mea hāʻawi ke paipai i nā loli nohona a hana hou i nā ana ma hope o kekahi mau mahina.
• Inā kū mau ke kaomi koko ma luna o 130/80, akā ma lalo o 140/90 mm Hg, hiki i kāu mea hāʻawi ke paipai i nā lāʻau e mālama i ke koko kiʻekiʻe.
• Inā loaʻa ʻoe i nā maʻi ʻē aʻe a i ʻole nā ​​kumu weliweli, e hoʻomaka paha kāu mea hoʻolako i nā lāʻau i ka manawa like e like me ka loli o ka nohona.

Inā ʻoi aku ke kiʻekiʻe o kou kaʻe koko ma mua o 140/90 mm Hg, loaʻa iā ʻoe ka pae 2 kiʻekiʻe o ke koko. E hoʻomaka paha kāu mea hāʻawi iā ʻoe ma nā lāʻau a koi i nā loli nohona.

Ma mua o ka hoʻoholo hope loa ʻana i ke kahe kiʻekiʻe a i ʻole ke koko kiʻekiʻe, pono i kāu mea lawelawe e noi iā ʻoe e ana ʻia kou kaomi koko ma ka home, ma kāu kauka lāʻau, a ma kahi ʻē aʻe ma kahi o kā lākou keʻena a i ʻole kahi haukapila.

NA OLELO OLA

Hiki iā ʻoe ke hana i nā mea he nui e kāohi ai i kou kaomi koko, me:

• ʻAi i kahi papaʻai olakino puʻuwai, me ka potassium a me ka fiber.
• Inu nui i ka wai.
• E kiʻi ma kahi o 40 mau minuke o ka hoʻomeamea a hoʻoikaika kino aerobic ma ka liʻiliʻi he 3 a 4 mau lā o ka pule.
• Inā puhi ʻoe, haʻalele.
• E kaupalena i ka nui o ka waiʻona āu e inu ai i 1 inu i kēlā lā i kēia lā no nā wahine, a me 2 i ka lā no nā kāne a ʻoi aku paha.
• Palena i ka nui o ka sodium (paʻakai) āu e ʻai ai. Kūpono no ka mea ma lalo o 1,500 mg i kēlā me kēia lā.
• E hōʻemi i ke koʻikoʻi. E hoʻāʻo e hōʻalo i nā mea e hoʻonāukiuki ai iā ʻoe, a hoʻāʻo i ka noʻonoʻo a yoga paha i ka hoʻopau kaumaha ʻana.
• Noho ma ke kaupaona kino olakino.

Hiki i kāu mea hāʻawi ke kōkua iā ʻoe e ʻike i nā papahana no ka lilo ʻana o ka paona, ka hoʻōki ʻana i ka puhipaka, a me ka hoʻoikaika kino.

Hiki iā ʻoe ke kiʻi i kahi kuhikuhi i kahi kauka, hiki iā ia ke kōkua iā ʻoe e hoʻolālā i kahi papaʻai olakino nāu.

Pehea ka haʻahaʻa o kou kahe ʻana o ke koko a ma ka pae hea ʻoe e pono ai e hoʻomaka i ka hoʻoponopono ʻana e like me ka nui o kāu makahiki a me nā pilikia olakino āu.

NA LAAU LAPAAU NO KA HYPERTENSION

ʻO ka hapa nui o ka manawa, e hoʻāʻo kāu mea hāʻawi i nā loli nohona, a nānā i kou kahe koko i ʻelua a ʻoi mau manawa. E hoʻomaka paha nā lāʻau inā loaʻa i kāu heluhelu ʻana i ke kaomi koko ma luna a ma luna paha o kēia mau pae.

• ʻO ka helu kiʻekiʻe (systolic pressure) o 130 a ʻoi
• Helu lalo (kaomi diastolic) o 80 a ʻoi

Inā loaʻa ʻoe i ka maʻi diabetes, nā pilikia puʻuwai, a i ʻole ka mōʻaukala o ka hahau ʻana, hoʻomaka ʻia nā lāʻau i ka heluhelu ʻana i ke kaomi haʻahaʻa. ʻO nā pahuhopu kaomi koko e hoʻohana pinepine ʻia no ka poʻe me kēia pilikia olakino ma lalo o 120 a 130/80 mm Hg.

Nui a hewahewa nā lāʻau e mālama ai i ke koko kiʻekiʻe.

• ʻO ka manawa pinepine, ʻaʻole lawa paha ka lāʻau kaomi koko hoʻokahi e kāohi ai i kou kahe koko, a pono ʻoe e ʻai i ʻelua a ʻoi paha lāʻau.
• He mea nui ia e lawe i nā lāʻau i kuhikuhi ʻia iā ʻoe.
• Inā loaʻa iā ʻoe nā hopena ʻaoʻao, hiki i kāu kauka ke pani i kahi lāʻau ʻokoʻa.

ʻO ka hapa nui o ka manawa, hiki ke kaʻi ʻia ke koko kiʻekiʻe me ka lāʻau a me nā loli nohona.

Ke kaohi maikaʻi ʻole ke kaomi koko, makaʻu ʻoe no:

• Kahe mai ka aorta, ke kīʻaha koko nui e hāʻawi i ke koko i ka ʻōpū, pelvis, a me nā wāwae
• Maʻi maʻi ʻōniʻoniʻo
• Ka hōʻeha puʻuwai a me ka puʻuwai ʻole
• Hāʻawi ke koko maikaʻi ʻole i nā wāwae
• Nā pilikia me kāu hihi
• Hahau

Inā loaʻa ʻoe i ke koko kiʻekiʻe, loaʻa iā ʻoe nā māka maʻamau me kāu mea hāʻawi.

ʻOiai inā ʻaʻole ʻoe i ʻike ʻia me ke koko kiʻekiʻe, he mea nui ia e nānā i kou kahe o ke koko i kāu nānā pinepine ʻana, keu hoʻi inā he ʻokoko a kiʻekiʻe paha kekahi o kou ʻohana.

Kāhea koke aku i kāu mea nāna e mālama inā hōʻike ka home i ke kiʻekiʻe o kou kahe koko.

Hiki i ka hapa nui o ka poʻe ke pale i ke kahe o ke koko kiʻekiʻe mai ka hopena ʻana i nā loli nohona i hoʻolālā ʻia e lawe i ke koko i lalo.

Hypertension; HBP

• Nā mea kāohi ACE
• Angioplasty a me stent - puʻuwai - hoʻokuʻu
• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• ʻO ka aspirin a me ka maʻi puʻuwai
• ʻO ka pata, ka margarine, a me nā aila kuke
• ʻO Cholesterol a me ka nohona
• Ke kaohi nei i kou kiʻekiʻe o ke koko
• Mālama ka maka diabetes
• Diabetes - pale i ka hōʻeha puʻuwai a me ka hahau
• Diabetes - ke mālama nei i kou mau wāwae
• Nā hōʻoia diabetes a me nā hōʻoia
• Ua wehewehe ʻia nā momona momona
• ʻLelo aʻoaʻo ʻai wikiwiki
• Puʻuwai puʻuwai - hoʻokuʻu
• Maʻi maʻi puʻuwai - nā mea weliweli
• Hewa ka puʻuwai - hoʻokuʻu
• Hewa ka puʻuwai - nā wai a me nā diuretics
• Ka maikaʻi ʻole o ka naʻau - ka nānā ʻana i ka home
• Hewa ka puʻuwai - he aha e nīnau aku ai i kāu kauka
• Ke koko kiʻekiʻe - he aha e nīnau aku ai i kāu kauka
• Pehea e heluhelu ai i nā lepili ʻai
• Imibrable cardioverter defibrillator - hoʻokuʻu
• Wehe i nā puʻupaʻa - hoʻokuʻu
• Papaʻai paʻakai haʻahaʻa
• Papaʻai Mediterranean
• ʻAno 2 diabetes - he aha e nīnau aku ai i kāu kauka

• Ke nānā nei i ke kahe o ke koko
• Hypertension i hoʻomaʻamaʻa ʻole ʻia
• Hoʻololi ka nohona
• ʻO kaʻai DASH
• Nā hoʻāʻo koko kiʻekiʻe
• ʻIke kaomi koko
• Kaomi koko

ʻAhahui Diabetes ʻAmelika. 10. Ka maʻi Cardiovascular a me ka mālama ʻana i nā pilikia: nā kūlana o ka mālama olakino ma diabetes-2020. Mālama Diabetes. 2020; 43 (Hōʻawi 1): S111-S134. PMID: 31862753 pubmed.ncbi.nlm.nih.gov/31862753/.

Arnett DK, Blumenthal RS, Albert MA, et al. ʻO 2019 ACC / AHA kulekele e pili ana i ka pale mua ʻana i ka maʻi maʻi ʻōpū: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force on Clinical Practice Alakaʻi. Kaapuni. 2019; 140 (11); e596-e646. PMID: 30879355 pubmed.ncbi.nlm.nih.gov/30879355/.

James PA, Oparil S, Carter BL, et al. ʻO ka papa kuhikuhi e pili ana i ka hōʻike 2014 no ka mālama ʻana i ke kiʻekiʻe o ke koko kiʻekiʻe i nā mākua: hōʻike mai nā lālā o ka papa i koho ʻia i ka ʻewalu hui komite nui (JNC 8). JAMA. 2014; 311 (5): 507-520. PMID: 24352797 pubmed.ncbi.nlm.nih.gov/24352797/.

Meschia JF, Bushnell C, Boden-Albala B, et al; ʻAha ʻAha ʻAha ʻAmelika Hui Pū ʻIa; ʻAha Kūkā ma ka hanai maʻi Cardiovascular a me ka hahau; ʻAha Kūkā ma ka Cardiology Clinical; Ka ʻaha kūkā ma nā genomics a me ka biology translational; ʻAha Kūkākūkā Nā ʻōkuhi no ka pale mua ʻana i ka hahau: kahi ʻōlelo no ka poʻe ʻoihana ola kino mai ka American Heart Association / American Stroke Association. Hahau. 2014; 45 (12): 3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

ʻO Victor RG. ʻO ke kiʻekiʻe hypertension: nā hana a me ka hōʻailona. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: kahi puke o ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 46.

ʻO Victor RG, Libby P. Pūnaehana hypertension: hoʻokele. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: kahi puke o ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 47.

Weber MA, Schiffrin EL, White WB, et al. Nā kulekele hana lapaʻau no ka mālama ʻana i ke kiʻekiʻe ma ke kaiāulu: kahi ʻōlelo e ka American Society of Hypertension a me ka International Society of Hypertension. ʻO J Clin Hypertens (Greenwich). 2014; 16 (1): 14-26. PMID: 24341872 pubmed.ncbi.nlm.nih.gov/24341872/.

Whelton PK, Carey RM, Aronow WS, et al.2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA alakaʻi no ka pale ʻana, ʻike, loiloi, a me ka mālama ʻana i ke kiʻekiʻe o ke koko i nā mākua Pūʻulu Hana ʻAhahui Puʻuwai e pili ana i nā ʻōkuhi hoʻomaʻamaʻa lapaʻau. ʻO J Am Coll Cardiol. 2018; 71 (19): e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535.

Xie X, Atkins E, Lv J, et al. Nā hopena o ka hoʻohaʻahaʻa ʻana i ke koko e hoʻohaʻahaʻa nei i nā hopena o ka maʻi puʻuwai a me ke kōpaʻa: ka loiloi ʻōnaehana hou a me ka meta-analysis. Lancet. 2016; 387 (10017): 435-443. PMID: 26559744 pubmed.ncbi.nlm.nih.gov/26559744/.