保健 - 第89期 - page 16

心血管疾病追蹤
14
ᑌΥᏐࠥ͜ᏀᖹdΪϤ160/100mmHg ˸ɪٙɚeɧ
ॴ৷АᏀεცᏐ͜ᑌΥ ط ᐕfԟ䟕ᑌΥ͜ᖹ݊щϞ
஝ ۆ ճkϞdவɰ݊㠗εɽۨᑗґ޼Ӻٙഐ ؈ fͦ
ۃ ᑗґɪ੬͜˲ᐕࣖʮႩ༰λٙ݊л҇ኒᕐд̋
ACEIא ARBdνል˙̔ϖ౷лeऎઠԭeτ௹ፕe
ል˾˖ഃf
ڐ ϋԸٙɽۨᑗґ޼ӺɦᗇྼdACEIא ARBၾඑܶ
ҤኒᑌΥᏐ͜dՉࠥᏀᐕࣖһλf਷lz࿁㋮Ӎվၾ
ऄಣή̻ᑌΥٙఊ˪ል˙ႡኒЪəŘಂᑗґᝈ࿀d
ᗇྼࠥᏀᆽྼܘ တจf
Ң਷ίɪ˰ ߏ 50ϋ˾І ࡇ ٙል˙ࠥᏀ˪d˸ʿ˸ ܝ
޼Ⴁٙޜ ീࠥᏀ˪d̏ԯ0 ໮ࠥᏀ˪ே݊˸ᕐдމ ਿ
ᓾᑌΥՉ˼ࠥᏀᖹٙఊ˪ል˙Ⴁኒdᐕࣖɰ༰တจf
Ш݊ϞԬ৷АᏀઃ٫ᎇจ፯኿Շ၇ࠥᏀᖹᑌΥᏐ͜d
Չഐ؈ ᐕࣖڢ Шʔ౤৷dਓˀᏐ ۍ ᄣεfԷνϞɛ
ਗ਼ ACEIၾARB ᑌΥᏐ͜d༈אՇᗳᖹၾ࠴ ˼ա᜗ڜ
ထኒᑌΥᏐ͜fഐ ؈ ั௺೯͛ଟ׼ᜑᄣεdϾː໘
А၍ԫ΁Ԩ͊ಯˇfɰϞɛᎇจਗ਼ΝᗳᖹٙʔΝۜ
၇፹Ⴌή̋ίɓৎdν˾˖̋߅९ԭ א τ௹ၪdऄ
ಣή̵̻̋୽ή̻fν ࠑהۃ d̵୽ή̻Ϊঐீཀ
А໘܈ღ݂͜˸ ط ᐕ໘А၍षdϾऄಣή̻ஷཀܶ
ҤඑᕎɿආɝА၍୚ ߤ lz੽Ͼᓒੵ̮մА၍d༺Ց
ࠥᏀͦٙf༊ซऄಣή̻ࠥᏀ ܝ А૰ɽε ݴ ɝ̮մ
А၍d̵୽ή̻ٙ໘А၍ᓒੵᄣ̋໘А ݴ ٙЪ͜৉
ڢ ɽɽۂ ࢮə෗kᐼʘd͊຾ᗇྼٙࠥᏀᖹᑌΥ˙
ࣩdʔ̙ᎇจԴ͜f
Ң਷৷АᏀܸیપᑥٙࠥᏀᖹᑌΥ˙ࣩj 1.㺷㹼ᗳл
҇ኒ+ ɚ૫䈃֛ᗳඑܶҤኒi2.㺷㹼ᗳл҇ኒ+ACEI
א ARBi 3. ɚ૫䈃֛ᗳඑܶҤኒ+ƺ ڜ ထኒi4. ɚ૫
䈃֛ᗳඑܶҤኒ+ACEI אARBf
服藥時間的藝術
މ ԴАᏀί 24ʃࣛlz̻ᖢ༺ᅺd఻˷ ה Ϟอۨ޼Ⴁ
ٙࠥᏀᖹேՈϞ ڗ ࣖࠥᏀЪ͜fШਕ̀ ء จٙ݊d
ͦ ੬ۃٙ͜ڗ ࣖࠥᏀᖹ€ܼ̍છᙑ˪dᇠᙑ˪ೌɓ
ঐί 24ʃࣛlzѩፅࠥᏀfεᅰࠥᏀᖹί24 ʃࣛٙ௰
ܝ 4~6ʃ̸̛ࣛ͟׵Аᖹዢ ܓ ٙɨࠥϾࠥᏀషܓ ᐵ
ʃfΪϤd஢εᑗґਖ਼࢕ܔ ᙄdɭ؂͜ 2 ࠴ ኒඎא 2
၇˸ɪٙࠥᏀᖹdѩᏐ ܔ ᙄձོᎸՉʱϣ؂͜fԷ
ν ߕ ਷ٙཬո׌৷АᏀ ط ᐕٙਖ਼࢕΍ᗆఱ ܔ ᙄਗ਼ऄ
ಣή̻ʱ މ Ϙૉ؂͜Շϣٙ፬ ج Դεᅰઃ٫ٙАᏀ
༺ᅺfਖ਼࢕ ܔࡁᙄʱϣ؂ᖹٙࣛග֝ίАᏀʺ৷ۃ
ٙ 2~4ʃࣛf߰ʔٝАᏀ׼ᜑʺ৷ٙࢤ ࠽ ࣛගdۆ̙
ஷཀᏨ಻ 24ʃࣛਗ࿒АᏀٙഐ ؈ Ըሜ዆؂ᖹࣛගf
ϞԬઃ٫ցගАᏀˀ৷׵ͣ˂d א¨ોࢤ©€уὋો
࡝፴ԸࣛٙАᏀ৷ܘd਷̮ኪ٫၈މ Morning Surged
ોගऎᄟତ൥׼ᜑdۆ ࠥᏀᖹ̙׳ίցග؂͜fν
਷̮Ϟਖ਼࢕ܔ ᙄ߰Ϟ¨ોࢤ©ତ൥٫̙ίցග11ࣛ؂
͜ऄಣή̻dϣ˚ὋોАᏀε̙༺ᅺf݂ࠥᏀᖹ؂
ٙࣛ͜ග̙ΪɛϾମdʔᏐႬɝցගʔঐࠥ͜Ꮐᖹ
ٙ¨ຫਜ©f
ࠥᏀᖹۜ၇ᐿεdᏐ͜ɦɽϞᑺӺdϞٙ৷АᏀઃ
٫੬ึਪj¨ԟɓ၇ࠥᏀᖹ௰λk©Ϋഈ݊jӚϞ௰
λd߂Ϟһλf௰ቇΥ׵આࠥᏀٙdఱ݊௰λٙࠥ
Ꮐᖹfவఱ݊Ң਷৷АᏀܸ הی੶ሜٙࠥᏀ طᐕ̀
඲ࡈ ᜗ʷf
Refining the Art of Controlling Hypertension
High blood pressure (BP) maybe due to steroids, tri-cyclic anti-depressants, excessive licorice or slimming drugs, etc., take note!
Refrain from smoking, drinking and excessive salt; treat “obstructive sleep apnea”, presenting, e.g., as loud snoring. Except for
emergencies, rapid BP reduction, e.g., by short-acting drugs may cause dizziness: failure to accommodate the low BP promptly. Be
patient, as BP control usually takes 10 days. Diuretics are useful adjuncts; thiazides are preferable to Lasix (Furosemide) with short
actions. As “sustained action” pills may not last for 24 hrs, better take divided doses daily. For those with “morning surge” of BP, try
taking drugs at 11 pm. Strategic combinations are often required, e.g., our State Guidelines stipulate: (1) Thiazide + dihydropyridine
(DHP) calcium antagonists (2) Thiazide + ACEI (angiotensin-converting enzyme inhibitors) or ARB (angiotensin-II receptor blockers) (3)
DHP calcium antagonists + beta-blockers (4) DHP calcium antagonists + ACEI or ARB. There is no “best” anti-hypertensive drug; only
“better” ones!