उच्च रक्तचाप
uchch raktachap
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| vivaran | uchch raktachap ko hi 'haee blad preshar' ya haiparateanshan ke nam se jana jata hai. |
| any nam | haee blad preshar / haiparateanshan / haee bi.pi. |
| avastha | uchch raktachap ko sistolik raktachap 140mm Hg ke barabar ya usase adhik aur/ya dayastolik raktachap 90mm Hg ke barabar ya usase adhik ke roop mean paribhashit kiya jata hai. |
| sanbandhit lekh | madhumeh, anidra, apasphit shira |
| any janakari | vishv mean paanch mean ek vayask ka raktachap badha hai. yah sthiti strok aur hriday rog se hone vali adhi mrityu ka karan hai. prativarsh vishvabhar mean uchch raktachap ki jatilataoan ke karan nau dashamalav char miliyan logoan ki mrityu ho jati hai. uchch raktachap ka nidan, upachar evan niyantran vishvabhar mean ek mahatvapoorn svasthy prathamikata hai. |
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uchch raktachap ya haee blad preshar (aangrezi: High Blood Pressure/ Highpertension) ka hi doosara nam haiparateanshan (haee blad preshar) hai. hamare sharir mean rakt nasoan mean lagatar dau data rahata hai aur rakt ke madhyam se hi sharir ke sabhi aangoan tak oorja aur poshan ke lie zaroori aauksijan, glookoj, vitamins, minarals adi pahuanchate haian. raktachap us dabav ko kahate haian, jo rakt pravah ki vajah se nasoan ki divaroan par p data hai. samanyat: yah is bat par nirbhar karata hai ki hriday kitani gati se rakt ko panp kar raha hai aur rakt ko nasoan mean pravahit hone mean kitane avarodhoan ka samana karana p d raha hai. chikitsakoan ke anusar 130/80 mmHg se jyada rakt ka dabav haiparateanshan ya haee blad preshar ki shreni mean ata hai.
parichay
uchch raktachap ko uchch ya badhe hue raktachap se bhi jana jata hai. is sthiti mean rakt vahikaoan mean lagatar dabav badh jata hai. rakt hriday se sharir ke sabhi bhagoan mean rakt vahikaoan ke madhyam se pravahit hota hai. har bar hriday dh dakata hai, yah dhamaniyoan ke madhyam se rakt ko sharir mean pahuanchata hai. raktachap rakt vahikaoan (dhamaniyoan) ki divaroan ke khilaf rakt ke dabav se nirmit hota hai, kyoanki ise hriday se panp kiya jata hai. yadi rakt vahikaoan mean dabav adhik hota hai, to hriday ko rakt panp mean adhik kam karana p data hai. yadi ise aniyantrit chho d diya jae, to uchch raktachap hridayaghat, hriday ki maansapeshiyoan mean vriddhi aur hriday viphalata utpann kar sakata hai. rakt vahikaoan mean uchch dabav ke karan soojan (dhamanivisphar) aur halke dhabbe vikasit ho sakate haian, jisase avarodhak (klag) aur tootan ki sanbhavana adhik hoti hai. rakt vahikaoan mean dabav ke karan mastishk mean rakt ka risav bhi ho sakata hai. isake karan strok ho sakata hai. uchch raktachap ke karan gurde ki viphalata, aandhapan, rakt vahikaoan ka tootana aur sanjnanatmak hani bhi ho sakati hai.
raktachap ko napana
raktachap markari [1] raktachapamapi ki milimitar[2] mean mapa jata hai tatha amataur par ek nanbar ko doosare nanbar se tiryak (ek ke niche doosare ko) likha jata hai. raktachap ko do map mean mapa jata hai. pahala uchch nanbar sistolik raktachap hai- jise ‘jab hriday mean sankuchan ya dh dakan badh jati hai tab rakt vahikaoan mean uchch davab hota hai’ se paribhashit kiya jata hai. doosara nimn nanbar dayastolik raktachap hai- jise ‘jab hriday ki maansapeshiyoan ko aram milata hai, tab rakt vahikaoan mean nimn davab hota hai’ se paribhashit kiya jata hai. samanyat: raktachap ko sistolik raktachap 120mm Hg aur dayastolik raktachap 140mm Hg se paribhashit kiya jata hai.
uchch raktachap ko sistolik raktachap 140mm Hg ke barabar ya usase adhik aur/ya dayastolik raktachap 90mm Hg ke barabar ya usase adhik ke roop mean paribhashit kiya jata hai.
vishv mean paanch mean ek vayask ka raktachap badha hai. yah sthiti strok aur hriday rog se hone vali adhi mrityu ka karan hai. prati varsh vishv bhar mean uchch raktachap ki jatilataoan ke karan nau dashamalav char miliyan logoan ki mrityu ho jati hai. uchch raktachap ka nidan, upachar evan niyantran vishvabhar mean ek mahatvapoorn svasthy prathamikata hai.
lakshan
uchch raktachap se pi dit adhikaansh logoan mean koee lakshan nahian hote haian. isalie ise saileant kilar ke nam se bhi jana jata hai. kabhi-kabhi uchch raktachap ke karan siradard, saans ki takaliph, chakkar ana, sine mean dard, hriday ki dh dakan badhana aur nak bahana jaise lakshan ho sakate haian. in lakshanoan ko najaraandazakarana khataranak ho sakata hai, lekin uchch raktachap ko soochit karane ke lie inaka ashray liya ja sakata hai. uchch raktachap ganbhir chetavani sanket hai, jo ki yah darshata hai, ki jivan shaili mean badalav mahatvapoorn hai.
karan
uchch raktachap ko prathamik uchch raktachap tatha dvitiyak uchch raktachap do roopoan mean vargikrit kiya gaya hai.
prathamik ya moolabhoot uchch raktachap
jab aantarnihit karan ko nirdharit nahian kiya ja sakata hai. is prakar ke uchch raktachap ko "prathamik moolabhoot raktachap" kaha jata hai. yah uchch raktachap ke vayask mamaloan mean 90-95% paya jata hai. yah kuchh jokhim vale karakoan se ju da hai. yah paryavaran ya anuvanshik karanoan ke parinamasvaroop vikasit ho sakata hai. motapa, madhumeh aur hriday rog mean anuvanshik ghatak bhi hote hai tatha ye uchch raktachap mean yogadan dete hai.
dvitiyak uchch raktachap
jab uchch raktachap ke karan ko pratyaksh pahachan liya jata hai. is sthiti ko madhyamik uchch raktachap kaha jata hai. uchch raktachap ke lagabhag 2-10 pratishat mamale nimnalikhit karan se hote haian -
- rinal pairenkaima rog (2.5-6%),
- sanvahani karan (.2-4%),
- eandokrain karan (1-2%)
- eksojanas/bahirjat (ster aauyad lena, maukhik garbhanirodhak ka upayog),
- eandojanas/aantarjat (prathamik haipareldostiroism, kashiang siandrom, phiyokromosaitoma, kanjenital edrenal hyaparaplasiya,
- drags evan t aauksis (alkohal, koken, gair-sterayadal eanti-inphlomaitri drags (eneseaeedi), nikotin, dikanjesteant kanteniang efedarine, likoris ya efedarine kanteniang harbal remediz).
- any karanoan mean garbhavastha ke karan uchch raktachap, aaubsatraktiv slip epaniya shamil haian.
zokhim ke karan
uchch raktachap vikasit hone vale zokhim ke karak nimnalikhit haian-
gair-parivartaniy zokhim ke karak
- parivarik itihas- uchch raktachap parivar mean pahale se chala a raha haian.
- badhati umr - umr ke sath uchch raktachap ka khatara badh jata hai.
- liang- yuva aur madhyam ayu varg ke purushoan mean uchch raktachap behad samany hai, jabaki adhe se zyada mahilaean rajonivritti ke bad hone vale parivartan ke karan jivan mean uchch raktachap se pi dit hoti hai.
parivartaniy zokhim ke karak
- sharirik gatividhiyoan mean kami.
- asvasthyakar ahar. atyadhik namak aur vasa yukt ahar ka sevan tatha paryapt matra mean phal v sabjiyaan n khana.
- atyadhik vazan aur motapa.
- zyada aur atyadhik alkohal ka upabhog.
- sanbhavit yogadan ke karak. kharab tanav prabandhan, dhoomrapan aur paisiv shmokiang (nishkriy dhoomrapan) yani sekeand haiand shmokiang, slip epaniya.
- poorv-uchch raktachap[3] bhavishy mean uchch raktachap ke vikas ke zokhim ko badhata hai.
- madhumeh - madhumeh se pi dit lagabhag sath pratishat logoan ko uchch raktachap bhi hota hai.
nidan
sabhi vayaskoan ko apane raktachap ke star ke bare mean janakari rakhani chahie. aise kee prakar ke divais hote haian, jinaka upayog raktachap mapane ke lie kiya jata haian. ye ilektr aaunik, markari aur enar aauid divais hote haian. dablyoo ech o kifayati evan vishvasaniy ilektr aaunik upakaranoan ka upayog karane ki sifarish karata hai, jinamean hath se ridiangs chayan karane ka vikalp hota hai. jab baitariyaan band ho jati haian, tab ardh-svachalit upakaran hath se ridiang lene mean saksham hota haian.
dablyoo ech o sifarish karata hai, ki ilektr aaunik upakaranoan[4] ke paksh mean markari divais ko charanabaddh tarike se samapt kiya jana chahie. ainar aauid upakaran jaise ki rudhiradabamapi/raktachapamapi (sphigamomainomitar) ka upayog kiya ja sakata hai. yah upakaran jaanch ke sahi parinam pradarshit kar raha hai, isaki jaanch ke lie har chhah mahinoan mean chikitsak ya any upakaran par raktachap ki jaanch ki jani chahie tatha donoan parinamoan ki tulana ki jani chahie. upayogakartaoan ko in upakaranoan se raktachap mapane ke lie prashikshit kiya jana chahie.
raktachap prabandhan
sabhi vayaskoan ko apane raktachap ki niyamit jaanch rakhani chahie. yadi raktachap adhik hai, to unhean svasthy karyakartta ki salah leni chahie. kuchh logoan ke lie jivan shaili badalav raktachap niyantrit karane ke lie paryapt haian. doosaroan ke lie ye jivan shaili badalav aparyapt haian tatha unhean raktachap ko niyantrit karane ke lie chikitsak dvara prastavit dava ki avashyakata hoti hai.
jivan shaili upay
- namak mean kami. pratidin paanch gram se kam namak ka sevan[5] karana.
- alkohal ka simit sevan.
- phal aur sabjiyoan evan kam vasa yukt ahar ka adhik upabhog.
- vazan kam karana tatha ise banae rakhana.
- niyamit vyayam. uchch raktachap se pi dit rogiyoan ke lie saptah mean paanch se sat din kam se kam tis minat madhyam-tivr gatishil erobik vyayam[6] karana.
- dhoomrapan aur any tanbakoo utpadoan ka upabhog chho dana.
- uchch raktachap ko rokane ke lie ahar drishtikon[7]- dieesech ahar yojana ke lie vishesh ahar ki avashyakata nahian hai. isake bajay yah dainik evan saptahik poshan sanbandhi lakshy pradan karata hai. isalie is ahar yojana ki sifarish ki jati hai.
- phal v sabjiyoan aur sabut anaj khana.
- isamean vasa rahit ya kam vasa vale deyari utpad, machhali, murgi/poltri, phaliyaan, meva aur vanaspati tel shamil haian.
- santript vasa se bharapoor ahar jaise ki vasayukt maans, kul vasa[8] yukt dugdh utpadoan aur nariyal, pam karnel[9]evan ta d jaise tr aaupikal aauyal se bachav.
- sharkara- mithe pey padarthoan evan mithaeeyoan ka kam se kam matra mean upabhog.
- poteshiyam, kailshiyam, maignishiyam, resha aur protin se bharapoor ahar ka upabhog.
- sodiyam ka kam upabhog.
rokatham ke upay
- prathamik rokatham-
har vyakti uchch raktachap ke vikas ki sanbhavana aur isake pratikool parinam ko kam karane ke lie paanch thos kadam apana sakata hai. ise prathamik rokatham kaha jata hai. isamean shamil hai-
svasth ahar
- shishuoan aur yuvaoan ke lie uchit poshan par zor
- svasth jivan shaili ko protsahit karana;
- pratidin paanch gram se kam namak (ek chammach se kam) khana;
- din mean paanch bar phal evan sabjiyoan ka sevan karana.
- santript aur kul vasa (total phait) ka sevan kam karana.
alkohal ke prabhav se bachav
alkohal ke hanikarak upayog se bachean tatha alkohal ki ek nirdharit matra se zyada n piyean.
sharirik gatividhi
- niyamit sharirik gatividhiyaan karean tatha bachchoan aur yuvaoan ko pratidin kam se kam tis minat saptah mean paanch din sharirik gatividhiyaan karane ke lie protsahit karana.
- sharir ke samany vazan ko banaean rakhana- adhikatam prati paanch kilo vazan kam karana, do se das aank tak sistolik raktachap ko kam kar sakata hai.
tanbakoo chho dana
tanbakoo upayog chho dana aur tanbakoo utpadoan ke sanpark se bachav.
svasth upay
svasth upayoan jaise ki dhyan, uchit sharirik vyayam aur sakaratmak samajik sanpark ke madhyam se tanav prabandhan karana.
- dvitiyak rokatham-
dvitiyak rokatham ka lakshy pi dit vyakti mean uchch raktachap ka pata lagana aur use niyantran karana hai, jisake phalasvaroop jatilataoan ka zokhim kam ho jata hai.
raktachap ki niyamit jaanch se rog ka jaldi pata lagana
yadi uchch raktachap ka jaldi pata lag jata hai, to hridayaghat (hart ataik), hriday viphalata (hart phel), strok aur kidani viphalata ke zokhim ko kam kiya ja sakata hai. sv-dekhabhal uchch raktachap ka shighr pata lagane, dava aur svasth vyavahar apanane, behatar niyantran evan jab avashyak hoan, tab chikitsa salah maangane ke mahatv ke bare mean jagarook karane mean madad kar sakata hai. sv-dekhabhal sabhi ke lie mahatvapoorn hai, lekin yah visheshakar aise logoan ke lie mahatvapoorn hai, jinake pas bhaugolik, bhautik ya arthik karanoan ki vazah se svasthy sevaoan tak simit pahuanch hai.
upachar
upachar ka uddeshy 140/90 mmHg se kam raktachap prapti honi chahie tatha adarsh raktachap 120/80 mmHg hai. rogiyoan, parivaroan aur samudayoan ki shiksha ke madhyam se rogi anupalana yatha davaee khane, ahar sanhita ka palan karane evan any jivan shaili badalav mean sudhar kiya jana chahie.
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tika tippani aur sandarbh
bahari k diyaan
sanbandhit lekh
varnamala kramanusar lekh khoj
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