Arterial hypertension i loko o nā wāhine

Arterial hypertension i loko o nā wāhine

makou Tchistov

First MGMU IM Sechenov

Arterial hypertension mea i keia la - kekahi o ka loa e like me ka maʻi:ʻike, o "Arterial
hypertension "lohe i keia la ma kahi o kekahi i ka umi makua.
Ka maʻi hiki hāmau no na makahiki, e luku aku i ka ipu koko a me ka naau, a ma ka wa e kaawale aku o ka palapala hōʻoia no
'eleu lapaʻau, e alakai i ka naau kaua, angina, naau Muscle nawaliwali, i ka naau
ole, he hahauʻana, makapo, hakuʻala hoʻokō 'ole' ... keia papa ke hele aku ma luna o ka lōʻihi loa manawa.
Mea pōmaikaʻi, i kēia lā, aia nō i ka loaʻa mai o ka manawa,ʻaʻole pono e ho'ēmi i kiʻekiʻe ke koko, aka, no hoi
malama ia no ka manawa lōʻihi ma ka kaʻoi loa kiʻekiʻe - 'oe wale nō pono i kekahi, nana i ka manawa
a, e huai ae i ka maʻi.
He mea pono e ike: i keia la, o kela umi o ka makua kanaka kiʻekiʻe ke koko, akā,
Wale kekahi hapa o na kanaka, ua ike e pili ana i ka pilikia. A hiki poʻeʻuʻuku kanaka ka poe i lawe kupono lapaʻau: kekahi
Nā mea maʻi mai e ike i ka pono no ka iapaau ana i loko o maikai ola, 'ē aʻe mai i ike e pili ana i ke ola ana o kēia
loa pono a me ka pono tolerated ai 'no ka hakumakuma ke koko. Ia manawa, e hoola
hypertension mea pono - a hiki ina ka maʻi i asymptomatic, ka mea hiki ke alakai i ka loa
kaumaha hopena. Mai aa aku i ko lakou ola, a hiki i ko lākou ola.
Ka hopena o ka hypertension i loko o na wahine
Kaʻawale, a mahuahua nui ke koko, ( 'o ia hoʻi, hypertension me concomitant kamepiula kumumea) i loko o
70% o nā hihia hiki aku ai i ka hahau i na wahine. No ka nane, i loko o nā kānaka hypertension me concomitant'Ākena Makaʻu welau
hahau ana wale nō i loko o 30% o ka hihia.
I ka laulā o ka antihypertensive Inc i loko o nā kānaka a me nā wāhine i ka ia. Eia naʻe, a me na makahiki, i ka laulā o
antihypertensive Inc i loko o nā wāhine ua hoemi, a ua kauoha ia e ka 'o menopause (e pili ana i lalo nei).
I ka lā, hypertension complications noho mua wahi, ina ua kamailio e pili ana i na wahine i ka make
heluna kanaka. Ka waiwai o systolic ke koko, i loko o nā wāhine o ka lua o ka mea nui kamepiula ololi
o coronary naau maʻi (CHD).
Ischemic naʻau mai a me ka hypertension i loko o nā wāhine
A wahine mai ke kanaka mea ole wale ka iniiaiie a me ka kiʻekiʻe 'īnea iʻano, akā, no hoi ia oko ao ma ka
hormones, nā'ōewe, I Aloha Hawaii - i keia, o ka papa, lewa i loko o ka papa o nā maʻi, ka maluhia a me ka
i ka laulā o ka lapaau.
No na makahiki ka mea i manaoio aku i ka pilikia o ka coronary naau maʻi i loko o nā wāhine mea me ka nui loa haʻahaʻa ma mua ia o ka
kanaka. I mea mea mea ole, i loko o nā sexes, na ka pilikia i ka ia, eia hoi, he mea i ka welelau o loko o nā makahiki, e
māhuahua make nei mai ka mea'ōnaehana mānowai koko maʻi i loko o nā wāhine.
E hoʻoponopono i kēia pilikia, e pono, ma ka palena iki, kuhikuhi i ka papa kuhikuhiE kamepiula kumumea no ka mea'ōnaehana mānowai koko
maʻi i loko o nā wāhine, e like me ka pono i malama ai i ka huli 'ana no kāu kiʻina hana o lākou e hooponopono. Conventionally, a pau kamepiula kumumea no ka mea'ōnaehana mānowai koko
maʻi hiki ke maheleia i mau pūʻulu: i ka hana i ho'ākāka '(i ho'ākāka' ia ma ka papahele, ma keia hihia no
wahine), ole-manaʻo (mau, a no ka wahine, a no na kanaka).
No ka 'ole-ho'ākāka aʻe nā makahiki, he kakahiaka hoike ana o symptoms o ka mea'ōnaehana mānowai koko ka maʻi i loko o
hoahanau, pūnuku puhi, mimikō, obesity, he sedentary Aloha Hawaii, hoʻopōʻino monakō koko ioeeiiaiey,
mahuahua ma ka huina naʻokoko, LDL naʻokoko, hookuu iho HDL naʻokoko *. I loko nō o ka mea i kēia mau kumumea mea i ho'ākāka 'ia i loko o
hiʻona o ko lākou mau keiki ma luna o ka ho okumu ana o ka pathology o ka mea'ōnaehana mānowai koko'ōnaehana i loko o na wahine a me na kanaka, he poe oko ao.
Me ka pili ana i ka mea i ho'ākāka 'ano, a laila ka mea, hiki e wahi metabolic abnormalities i hāpai keiki,
menopause, hormonal contraception, gisterovariektomiyu.
Ua hoao iho la i na wahine me ka obesity i hāʻule i loko o ka pilikia kiʻekiʻe o nā mea'ōnaehana mānowai koko maʻi: kamepiula
Ua hoomahuahua ae la lakou ma ka 4 manawa. Maomeka i pāʻani i ke kūlana i loko o kēia kaʻina hana ka mea,ʻaʻole iʻike, akā, i ka pilina ma waena o obesity, a
ke koko, Ua ponoia mai la.
Like no ka I Aloha Hawaii, ua ua hoao aku au ia ia i ka nele o ka pololei, physical hana maoli i ke kamepiula
ka muli a me ka hooulu ana o ka mea'ōnaehana mānowai koko mai ma ka hapalua. Nānā 'ole o ka mea kaumaha hou iloko physical
ha awina ua malama normalization o ke koko,. Ua Ua manaoio ia he maikaʻi ia
physical nā hana pili i ke kanawai a me kaʻauhau'ēʻaʻe kauoha maomeka e hoʻonui ai i ka ka ho'ēmiʻana
ke koko,, myocardial oxygen ma ka hoʻolako ', ma ka hou, hana i ka pono ia ma
koko clotting kumumea, he hoʻonui i ka hana o ke koko lipid pae.
Eia naʻe, i loko o ko mākou aupuni hypertension iwaena o na wahine Ua laha a ia lŘlŘ i ka 41,1%.
Arterial hypertension i loko o na wahine o kekahi mau makahiki
No ka mea mua manawa e pili ana i ka oko o ke koko, pae e like me ka hoohanau hiki ke olelo ma
i ka makahiki o ka eono. Higher ke koko, malamaia ma kaikamahine mai ka eono makahiki, a i
puberty. Akā, ma hope o puberty, a ma mua o ka menopause i e hoomanao hou ia
haahaa ke koko, i loko o nā wāhine. Ma hope o menopause, a pau oko ao nalo, a
na wahine he alo he pilikia oi aku o ka mea'ōnaehana mānowai koko maʻi, hypertension, like me
kanaka.
Ke prevalence o hypertension iwaena o na kaikamahine mea e kiʻekiʻe, akā, ma hope o menopause, o ka pilikia o ka
a me ka ulu i ka maʻi, piʻi pū me ka nui loa. Akā,ʻaʻole nō kēlā wahine kēia mea kiʻekiʻe ke koko,
Ua coincides me ka hoouka kaua o ka moe involution. Ma nā makahiki, ke koko, māhuahua, a me ka memo
iwaena o na kaikamahine, a me na wahine hapai. Ua hiki ke ike i loko o 15-30% o ka hapai wahine i loko o Rusia hypertensive maʻi pale
i hiki aku ai i ka mea complications,ʻaʻole wale nō i loko o ia iho i hāpai keiki, a hānau, akā, no ka mea, o ka io
hopena ma luna o ka lōʻihi-makahiki prognosis i loko o nā wāhine. Loa pinepine ka mea hana i hypertension ia lŘlŘ iloko o
hāpai keiki ... a koe me ka wahine a mau loa aku.
Hypertension i na wahine, a me ka moʻolelo contraceptives
E ho ohana i ka moʻolelo contraceptives o kekahi o na kumu nui kumu o ka hypertension ulu ana i loko o
na wahine. Hoao i na wahine lawe mau ai ', hypertensive maka 2-3 manawa
oi ma mua o nā wāhine pinepine ka mea e oleʻae ia kālā. Eia hou, ku una contraceptive konohiki hiki o
mua malama worsen arterial hypertension. Ka pilikia o ka hypertension i komo
contraceptive ku una konohiki, piʻi pū i loko o nā wāhine ma luna o 35 makahiki, ina he wahine nicotine, a me / ai ole ia, ma ke alo o ka
obesity.
I manaoiaʻano papa hana no ka kiʻekiʻe ke koko, i loko o nā wāhine, ka poe lawe hānau hooponopono
ku una ha ai ': a mahuahua nui kino nuipa a, ke koko ka leo, he mea insulina ia'ku,
paʻakai ia kali hou aku; i loko o ke kino.
Normalization o ke koko, malama ma hope o kekahi mau pule ma hope o ka pauʻana o ka supplementation. akā, inā
i ka wahine ma ke kāʻei kua o contraceptives ua ulu hypertension, ina o ka pilikia o ka hopena
hiki hāpai keiki e kela aku kona nui ma mua o ka pilikia o ka Holomua o hypertension, ka mea, ua? aeiiaiaoaony e hoʻomau lawe contraceptives me
i ka wā hoʻokahi lapaʻau me antihypertensive ai '.
Ka pilikia o ka ulu hypertension, piʻi pū inā:
- i hypertension ohana mōʻaukala - he mea obesity - he mea hakuʻala mai - i kekahi wahine no 35 makahiki - he wahine lawe contraceptives no ka lōʻihi manawa - ina, ma ka māhele ma mua o hāpai keiki ke koko, i ke kiekie.

Hypertension i loko o nā wāhine i menopause a me ka postmenopause
Ma ka mea ulu i loko o ke koko, i menopause e loli ai na mea he nui aʻe - keia emi
physical haʻawina, a me ke kino ke kaupaonaʻana ka waiwai, a ua mahuahua hokii o ka waiʻona a me ka paʻakai.
Ma menopause maoli i ka pilikia o ka mea'ōnaehana mānowai koko maʻi. O ke kumu ho i ka ka kūkuluʻana
endocrine'ōnaehana i loko o kēia wā, a me ka nele maila estrogen hoʻololi kemikala, ina i pono ia ma
cardio vascular nenoaiu.
Estrogen deficiency ke alakai i mahuahua ka hoʻokōʻana pressor angiotensin II, he loli ma ka lipid
pae ana o ke koko ma luna o ke kāʻei kua o ka mahuahua nui o naʻokoko, lipoproteins o loa haʻahaʻa a me ka haahaa nuʻa e ho'ēmi i
ka nui o ka kiʻekiʻe nuʻa lipoproteins.
I waena o nā mea maʻi kaikaina ma mua o 40 makahiki o hypertensive maʻi, na wahine e ae emi o na kanaka pinepine, akā, i loko o 45-55 makahiki i ke kulana
Ua Ua hoʻololi, a me ka helu o hypertensive wahine hoʻomaka i ka lanakila.
Alaila, ua manawa uku a hiki i ka huli 'nui noonoo ana no ka palekana pono a me ka lapaʻauʻia no ka iapaau ana o
hypertension ma postmenopausal wahine - ole wale i ka ho'ēmi i ke koko,, akā, no hoi
no ka mea o ka hooponopono hou ana o menopausal hoike ana, a e kaumaha aku i kekahi koho e hōmona hope Inc.
Lapaʻau o hypertension i loko o na wahine
I keia la, i ka loa ka manaʻo pilikia mea e kuhikuhi i ka pilina ma waena o hypertension a me nā maʻi a me ka AIM o
hoʻomōhala pono ai hulina kokoke i ka Kāohiʻana a me ka hana (Oganov RG, 2007, Anikin SG, 2009; Jakushin SS,
2010).
Akā, Aneane pau kēia mau loea, 'aelike i ka iapaau ana o ka hypertension
kaʻoi loa hāʻawi antigipergenzivnuyu Inc.
ua haawiia mai he nui wahi i loko o nā nā kaʻa mokulele o ka wahine me ka hypertension ole-pharmacological lapaau.
No laila, no ka laʻana, haʻahaʻa-calorieʻai no ka wahine me ka obesity hiki alakai ole wale i ka ke kaupaona poho, akā, no hoi i
lalo ke koko, me ka hou, i kaʻai ikaika lakou aloha ia kamepiula kumumea like me mimikō,
insulina ia'ku, myocardial hypertrophy o ka ventricle hema, hyperlipidemia.
Mai underestimate i ke kūlana o ka physical aayoaeuiinoe: ano o hele, 'auʻau, i hana ia ma simulators, pākōlea kino
gymnastics a no laila, ma luna, e kōkuaʻoe e emi i ka hanana a na ka pilikia o ka hypertension? acaeoey.
Ma ia laua me ka ole-pharmacological Inc E e hoakaka ia antihypertensive ai '.
Mua no ka hoʻoponopono loa i pili ia ai 'keia mea e olelo aku i na manaolana no ka laulā o
hōmona hope Inc i ka hiki maikaʻi 'ole ma luna o ke koko,, i ole hoaponoia mai. no hoi,
kekahi hihia (ma kahi o 9%) hoike ole emi, a māhuahua ma ke koko, i
hōmona hope Inc.
Eia hou, ka mea e e kaulana ia ma naʻe o ke 'ano laulā, e lauwili koho o antihypertensive ai',
I kēia lā i ka laulā o ka iapaau ana o ka hypertension i koe ma ke 'ano haʻahaʻaʻilikai. Eia hou kekahi, aeaiiua,
a i loaa i ka haʻawina o na kanaka, na wahine koho hoolilo mea hiki ole (Podzolkov HI, 2009;
Tkachev ON, 2010). Nolaila, nui o ka pilikia o ka differentiated Inc o arterial
hypertension i loko o nā wāhine, e like me ka loiloi 'ana o ka loiloi ole-invasive i kūpono i e hoʻoikaika prognosis,
kona mea e like loa-makahiki Inc. Ma ka hooulu ana o ka algorithm e e hiki ke aʻoaʻo 'lapaʻau
na wahine.
I ka lā, i loko o arterial hypertension i loko o nā wāhine ia kekahi antihypertensive Agena (no ka
i contraindications) o kēlā me kēia pae i loko o ka palapala o ka hoʻohui pū 'ole wale. E hōʻoi 'i ka hypotensive
ka hopena ua ana hoakaka hydrochlorothiazide (alakai-rohlortiazid). Pinepine i ka iapaau ana o ka hypertension i loko o na wahine
hoʻohana ana o diuretics: arifon retard, arifon, cardioselective Hoʻokolohua-blockers (lokren (betaxolol), atenolol,
emi bisoprolol).
Inā mākou e kamailio e pili ana i ACE nā mea kūpale, ka mea, ua ana hoʻohana moexipril, i kekahi manawa, - fosinopril (monopril).
Like pili ana i ke kalipuna hoa i loko o ka palapala o ka malama aku-kalaʻana hoomakaukau ana o ka dihydropyridine (plendil, Norvasc,
kordafleks retard), kā lākou? eaia Ua loa e hiki, akā, e pono e hoomanao i kekahi nā mea maʻi i hōʻike 'edema
ma ko lākou mau wāwae, a me ke lilo ka mea, oi hai.

1. Ageev Ft, Fomin IV, Mareev Y. ¶ AL. Prevalence o hypertension i loko o ka Europa hapa o ka Lūkini
Hui. Kēia mau haʻawina KA MAKAHIKI, 2003;
2. Shlyakhto EV Belousov YB, Kirichenko AA ¶ AL. Arterial hypertension ma postmenopausal wahine. Cardiology. 2003;
3. Kobalava alahao, Tolkachev VV Moryleva ON Lapaʻau helehelena a me ka hana o ka hypertension i loko o nā wāhine.
Heart. 2004;
4. Kuban Research Lapaʻau Gazette lapaʻau a me ooieoeiiaeuiuo hiʻona o ka mea'ōnaehana mānowai koko'ōnaehana i ka wahine me ka hypertension. 2011;
5. Prokhorovich EA, 2006; Tkachev ON 2010; Oganov RG, 2007; Anikin SG, 2009; Jakushin SS 2010.