Chirwere cheBP vakadzi

Chirwere cheBP vakadzi

VS Tchistov

First MGMU IM Sechenov

Chirwere cheBP ndiyo nhasi - mumwe rakajairika zvirwere: chirwere kuti "Arterial
neBP "kunzwa nhasi pamusoro mumwe nedzevakuru gumi.
The chirwere anogona chinyararire kwemakore akawanda kuparadza ropa midziyo uye mwoyo, uye pasina anokwanisa
nenguva kurapwa, kuchaita kuti mwoyo kurwiswa, angina, mwoyo tsandanyama simba, kuti mwoyo
kukundikana, sitiroko, upofu, itsvo kukundikana ... mazita ichi aigona kuenda refu chaizvo nguva.
Sezvineiwo, nhasi pane yakawanda mikana kwete kuderedza BP, asiwo
kuhuchengeta kwenguva refu nguva optimum pamwero - unofanira chete zvakaitika rokuongorora munguva
uye kuona chirwere.
Zvakakosha kuziva: nhasi, munhu mukuru wose chegumi munhu ane BP, asi
Chete hafu yevanhu kuziva dambudziko. Uye vanhu kunyange vashoma vanogamuchira kurapwa: Vamwe
Varwere havaoni kudikanwa kunorapwa utano hwakanaka, vamwe havazivi nezvokuvapo ano
zvikuru inoshanda uye zvakanaka akashivirira zvinodhaka kuti BP. Zvichakadai, zvirape
neBP zvinokosha - kunyange kana hosha iri asymptomatic, zvinogona kutungamirira chaizvo
migumisiro inosuruvarisa. Regai kuisa utano hwavo uye kunyange upenyu hwavo.
Migumisiro neBP vakadzi
Isolated yakawedzera BP (kureva, BP pasina concomitant zvinokonzera njodzi) muna
70% nyaya kunotungamirira sitiroko vakadzi. Enzanisa nevanhu neBP pasina concomitant ngozi zvinokonzera kumigumo
Kurohwa chete muna 30% nyaya.
Kubudirira antihypertensive kurapa mune varume nevakadzi zvakafanana. Zvisinei, pamwe zera, kubudirira
antihypertensive kurapa vakadzi ipfupi, iyo anokonzerwa peculiarities kuti kubereka (pamusoro pazasi).
To musi, BP yematambudziko zvitore nzvimbo yokutanga, kana isu kutaura pamusoro vakadzi nzufu
kwevanhu. Kukosha systolic BP vakadzi ndicho chechipiri chinokosha ngozi
zviri nechirwere chemwoyo (CHD).
Ischemic mwoyo chirwere uye BP vakadzi
Mumwe mukadzi kubva murume haasi chete nesekondari zvepabonde maitiro, asiwo akacherekedza kusiyana
mahormone, majini, mararamiro - ichi zvose, Chokwadi, zvinoratidzwa weboka siyana zvirwere, kuchengeteka uye
kubudirira kurapwa.
Kwemakore akawanda kwakanga vaidavira kuti nengozi nechirwere chemwoyo vakadzi zviri kudzika kudarika
varume. Chokwadi hakusi, muna aroorane, njodzi ndiwo chete, uyezve, pane katsika achangopfuura makore
yakawedzera kufa kubva zvemwoyo chirwere vakadzi.
Kuti vagadzirise dambudziko iri, unofanira, pane kushoma, kuziva chikuru zvinokonzera ngozi zvemwoyo
chirwere vakadzi, uyewo Teererai kutsvaka nzira kururamiswa yavo. Conventionally, zvose zvinokonzera ngozi zvemwoyo
zvirwere zvinogona mapoka mapoka maviri: maduramazwi (zvakananga pasi, kana ichi nokuda
vakadzi), asiri yakananga (general uye vakadzi uye vanhu).
Vasiri chaizvo zvinhu zvinosanganisira zera, vachiri kuratidza zviratidzo zvemwoyo mu
hama, kusvuta, chirwere cheshuga, kufutisa, a ndakagara mararamiro, havachanyatsogoni shuga shiviriro,
kuwedzera zvachose remafuta akawandisa, LDL remafuta akawandisa, richikwidibira HDL remafuta akawandisa *. Pasinei chokwadi kuti izvi zvinhu hazvisi dzakananga
zvinoitwa simba ravo pamusoro paumbwe zvokurwara pakati kumwoyo vakadzi nevarume, pane misiyano.
Panyaya chaizvo unhu, ipapo ivo vanogona kunzi metabolic abnormalities panguva pamuviri,
kubereka, hormone pamuviri, gisterovariektomiyu.
Rakaratidza kuti vakadzi kufutisa uyewo kuwira mukuru mukana zvemwoyo chirwere: njodzi
It yakawedzera 4 nguva. Zvigadziriswe kuti nezvaanoita izvi zvichigere kuzivikanwa, asi ukama pakati kufutisa uye
BP iri chaizvo.
Kana mararamiro, hatina akaratidza kuti kushaya dzose kurovedza muviri kunowedzera ngozi
kuti chidzoke uye kukura zvemwoyo chirwere nepakati. Pasinei uremu kuchinja panguva panyama
Basa iri dzakaona normalization kuti BP. Zvinofungidzirwa kuti kunobatsirawo
mumuviri mabasa chokuita raivapo zvisina kunanga uye yakananga zvigadziriswe kuti pave rutapudzo
BP, myocardial okisijeni kugovera, mukuwedzera, kushandisa sei zvinobatsira
kweropa zvinoita, pave kuvandudzika ropa lipid chakarondedzera.
Zvinosuruvarisa kwedu nyika neBP pakati pavakadzi kwakapararira uye rinowanikwa muna 41,1%.
Chirwere cheBP vakadzi vemazera akasiyana
Kokutanga pamusoro kusiyana BP siyana maererano vakadzi vanogona kutaura
makore matanhatu. Higher BP kuchengetwa vasikana makore matanhatu uye kukwira
yokuyaruka. Asi pashure pakuyaruka uye pamberi kubereka anogona kutaurwa
pasi BP vakadzi. Mushure kubereka, kusiyana zvose kunyangarika, uye
vakadzi vanotarisana wakakwirira pangozi zvemwoyo chirwere, BP, zvichienzaniswa
varume.
Kuwanda neBP pakati vasikana hakusi zvakakwirira, asi pashure kubereka, mukana
uye kuva chirwere inowedzerawo yekudyidzana. Asi kwete mukadzi wose ane cheBP
It rinobatana kutanga kurara involution. Mumakore achangopfuura, BP kuwedzera, uye manotsi
pakati pavakadzi vaduku, kusanganisira vakadzi vane pamuviri. It zvinogona kuonekwa 15-30% yevakadzi nepamuviri muRussia vane chirwere cheBP urwere
inotungamira kuna zvakakomba matambudziko, maari hamuna chete panguva nepamuviri uye pakusununguka, asi anewo kunaka
nezvainoita kwenguva fungidziro vakadzi. Kakawanda zvinoitika kuti BP kunoitika munguva
pamuviri ... uye anoramba mukadzi nokusingaperi.
NeBP vakadzi uye nemumuromo nhumbu
Use nomumukanwa nhumbu ndiyo imwe huru zvinokonzera neBP kukura mune
vakadzi. Kwakaratidza kuti vakadzi kutora zvinodhaka izvi, vane chirwere cheBP chiso 2-3 nguva
kakawanda kupfuura vakadzi hamutongogamuchiri mari yakadaro. Uyezve, nemumuromo pamuviri vamiririri vaikwanisa
kare kuchengetwa achiipa chirwere cheBP. Ngozi neBP pa rubvumo
kudzivirira pamuviri dzaiita yomuchipatara kunowedzera vakadzi makore 35, kana ari mukadzi anosvuta mabhokisi, uye / kana pamberi
kufutisa.
Aronga nomazviri cheBP vakadzi vanotora pamuviri
zvokuudzwa zvinodhaka: wakawedzera body mass, vhoriyamu ropa, pane insulin irambe,
yavaibvisa akacherekedza kunonoka mumuviri.
Normalization ropa nevezera kwakacherechedzwa pashure pemavhiki mashomanana pashure kuguma supplementation. asi kana
Mukadzi pamusoro pakanyorwa nhumbu kwakasimbiswa BP, kana mukana zvinozoitika
zvichibvira pamuviri kuchapfuura pangozi kuchiita BP, Zvinokurudzirwa kuramba uchiwana pamuviri ne
mawa kurapwa pamwe antihypertensive zvinodhaka.
The pangozi yokuita neBP inowedzera kana:
- vane nhoroondo neBP mhuri - pane kufutisa - pane chirwere cheitsvo - mukadzi anopfuura makore 35 okuberekwa - Mukadzi anotora nhumbu kwenguva refu - kana, panguva yapfuura pamuviri neBP akanga akakwidziridzwa.

NeBP vakadzi panguva kubereka uye postmenopause
Dzichiwedzera BP panguva kubereka kunokanganisa zvinhu zvizhinji - kuderera uku
kurovedza muviri, uye muviri kufuta, uye vakawedzera doro uye munyu.
Panguva kubereka kunowedzera mukana zvemwoyo chirwere. Izvi nokuda kugadzirisa
kwemakemikari anobudiswa gadziriro iyi uyewo wakareruka inonzi estrogen usage kungotaurwa chaizvo kunobatsira
cardio vascular hurongwa.
Inonzi estrogen kukanganisika kungaita kuti vawedzere kunyatsoshanda pressor angiotensin II, kuchinja lipid
chakarondedzera ropa pamusoro pakanyorwa yakawedzera zvachose remafuta akawandisa, lipoproteins yakaderera chaizvo uye vakaderera arambe achirema kuderedza
uwandu kumusoro arambe achirema lipoproteins.
Pavarwere vaduku nemakore 40 vane chirwere cheBP chirwere, vakadzi vanotambura nezvahwo pane vanhu, asi mumakore 45-55 zvinhu
It Anochinja, uye uwandu kwevakadzi vane chirwere cheBP anotanga zvipararire.
Saka, zvakawanda hanya zvino rwakabhadharwa kuna kutsvaka mishonga ine ngozi uye inobudirira nokuda pakurapa
neBP vakadzi postmenopausal - kwete chete kuderedza BP, asiwo
nechinangwa rakasungwa kuenda kumwedzi kuratidzwa, iyo ichapa rinogona kutsiva kemikari yokutsiva mishonga.
Mabatirwo neBP vakadzi
Nhasi, chinonyanya rokukurumidzira dambudziko ndiko kuziva ukama pakati neBP uye siyana nezvirwere nechinangwa
kukudziridza Zvakanyanya Kunaka Panguva Yepamuviri nzwisisika yokusvika kudzivirira uye kurapwa (Oganov RG, 2007; SG Anikin, 2009; Jakushin SS,
2010).
Asi zvinenge zvose nyanzvi ano vanobvuma kuti nokurapa neBP
zvinganaka basa antigipergenzivnuyu kurapa.
Nzvimbo inokosha mazano revakadzi neBP anopiwa non-pharmacological kurapwa.
Saka, Somuenzaniso, pasi-mafuta Kudya vakadzi vane kufutisa kungaita kwete chete uremu, asiwo
yakaderera BP, mukuwedzera, zvokudya chokwadi kukanganisa zvinokonzera njodzi zvakadai sechirwere cheshuga,
insulin irambe, myocardial hypertrophy kuti ventricle kuruboshwe, hyperlipidemia.
Usarerutsa basa kurovedza muviri: vanhuwo muchifamba, kushambira, rinotenda pamusoro simulators, kuchirapa muviri
jimunasitikisi zvichingodaro kuchakubatsira kuderedza panowanikwa nengozi neBP kukura.
In kufanana asiri pharmacological kurapa vanofanira kupiwa mishonga antihypertensive.
Asati pokuongorora kupfuura vaifarira mishonga nhasi ndiko kutaura kuti tariro nokuda kubudirira
kemikari yokutsiva mushonga kuti zvinobvira kunobatsira BP, havana anoruramiswa. Uyezve,
zvimwe zviitiko (anenge 9%) Akaratidza kuva kuderera uye kuwedzera BP panguva
kemikari chitsividzo mushonga.
Uyezve, zvinofanira kucherechedzwa kuti pasinei zvakanaka kwazvo, zvakasiyana-siyana pakusarudza antihypertensive zvinodhaka,
Nhasi kubudirira kurapa neBP anoramba panguva kumbonyanya yakaderera chechetere. Uyezve, data,
vakanga vawana muzvidzidzo varume, vakadzi vapiwa uchatamisa hazvibviri (Podzolkov NM, 2009;
Tkachev ON, 2010). Somugumisiro, zvikuru ndiye dambudziko kusiyaniswa mishonga kuti arterial
neBP vakadzi, uyewo kunyatsoongorora ari dzichipfekeka vasiri invasive nzira zvichavandudza fungidziro,
unhu-yakareba mishonga. Kuburikidza kukura algorithm achagona individualize kurapwa
vakadzi.
To zuva, ari chirwere cheBP vakadzi basa chero antihypertensive mumiririri (nokuti
hapana contraindications) mumwe boka muchimiro mubatanidzwa kana oga. Kuti dzikurukure hypotensive
maratidzirwo Kazhinji ushandiswe hydrochlorothiazide (gwaro-rohlortiazid). Kazhinji kurapa neBP vakadzi
kushandiswa diuretics: arifon kutadzisa, arifon, cardioselective Beta-blockers (lokren (betaxolol), atenolol,
zvishoma bisoprolol).
Kana isu nezvazvo ACE FIs, izvozvo unowanzoshandiswa moexipril, dzimwe nguva - fosinopril (monopril).
Kana ari karusiyamu antagonist muchimiro kuramba-kwebhuku kugadzirirwa dihydropyridine (plendil, Norvasc,
kordafleks kutadzisa), kugamuchirwa kwavo ingangodaro, asi zvinofanira kurangarirwa kuti vamwe varwere kuonekwe edema
netsoka dzavo, kana kuti vanogona kuva raidudzwa.

1. Ageev FT, Fomin IV, Mareev Y. and said. Kupararira neBP iri European chikamu Russian
Federation. Izvi zvidzidzo ZERA, 2003;
2. Shlyakhto EV Belousov yb, Kirichenko AA and said. chirwere cheBP vakadzi postmenopausal. Cardiology. 2003;
3. Kobalava Railway, Tolkachev VV Moryleva ON Clinical zvinhu uye Mabatirwo neBP vakadzi.
Heart. 2004;
4. Kuban Research Medical Gazette Clinical uye dzichipfekeka zviri kumwoyo vakadzi vane BP. 2011;
5. Prokhorovich TEKSTO, 2006; Tkachev ON, 2010; Oganov RG, 2007; Anikin SG, 2009; Jakushin SS 2010.