Huong dan day du ve tang huyet ap: nguyen nhan, dieu tri va phong ngua

Tang huyet ap, thuong duoc biet den la huyet ap cao, la mot benh man tinh trong do ap luc trong dong mach tang lien tuc. Theo To chuc Y te The gioi, benh anh huong den khoang 1,28 ty nguoi truong thanh tu 30–79 tuoi tren toan the gioi, va gan mot nua khong biet ve tinh trang cua minh. No thuong duoc goi la "ke giet nguoi tham lang" vi thuong khong gay trieu chung cho den khi co ton thuong co quan nghiem trong.

Huyet ap la luc ma mau tuan hoan tac dong len thanh dong mach. No duoc bieu thi bang ap luc tam thu tren tam truong. Gia tri binh thuong la duoi 120/80 mmHg. De chan doan chinh xac, can do nhieu lan trong it nhat hai lan kham khac nhau. Theo doi huyet ap luu dong 24 gio (ABPM) duoc coi la tieu chuan vang.

Binh thuong: duoi 120/80 mmHg. Binh thuong cao: 130–139/85–89 mmHg. Tang huyet ap do 1: 140–159/90–99 mmHg. Do 2: 160–179/100–109 mmHg. Do 3: ≥180/≥110 mmHg. Con tang huyet ap cap xay ra khi huyet ap vuot qua 180/120 mmHg.

Tang huyet ap nguyen phat (vo can) chiem 90–95% truong hop. Cac yeu to nguy co bao gom: tuoi tac, tien su gia dinh, beo phi, an nhieu muoi, it van dong, uong nhieu ruou va hut thuoc. Tang huyet ap thu phat (5–10%) co the do benh than, roi loan noi tiet hoac thuoc nhu NSAIDs, thuoc tranh thai va corticosteroid.

Che do an DASH co the giam huyet ap tam thu 8–14 mmHg. Han che natri duoi 2.300 mg/ngay giam huyet ap 5–6 mmHg. Tap the duc hieu khi deu dan — it nhat 150 phut/tuan — giam huyet ap 5–8 mmHg. Giam can 5–10% mang lai hieu qua lam sang co y nghia. Bo thuoc la va han che ruou cung rat quan trong.

Nam nhom thuoc dau tay: Thuoc uc che ACE (ramipril, enalapril, lisinopril) — tac dung phu thuong gap: ho khan. Thuoc chen thu the ARB (losartan, valsartan, telmisartan). Thuoc chen kenh calci (amlodipin, nifedipin). Thuoc loi tieu thiazid (hydrochlorothiazid, indapamid). Thuoc chen beta (bisoprolol, metoprolol).

Dot quy: tang huyet ap la yeu to nguy co quan trong nhat, tang nguy co 3–4 lan. Nhoi mau co tim va suy tim. Benh than man. Benh vong mac do tang huyet ap. Kiem soat hieu qua giam nguy co dot quy 35–40%.

Roi loan tang huyet ap anh huong 5–10% thai ky. Thuoc ha huyet ap uu tien la labetalol, nifedipin (phong thich keo dai) va methyldopa. Thuoc uc che ACE va ARB tuyet doi chong chi dinh trong thai ky.

Cac thuoc chinh bao gom ramipril, enalapril, lisinopril, losartan, valsartan, amlodipin, hydrochlorothiazid, indapamid, bisoprolol va spironolacton. Tim hieu cac tinh trang lien quan tren PillsCard: suy tim, benh than man, dai thao duong typ 2.