ACE inhibitors vs. beta blockers: Ndi mankhwala ati amtundu wa magazi omwe ndi oyenera kwa inu?
Zambiri ZamankhwalaAkuluakulu makumi asanu ndi awiri mphambu asanu aku America ali ndi kuthamanga kwa magazi (kuthamanga kwa magazi), koma kokha 54% a iwo ali ndi magulu awo olamulidwa. Mwamwayi chifukwa cha matenda omwe amapezeka monga kuthamanga kwa magazi, pali mankhwala osiyanasiyana omwe angathandize. Ena mwa iwo ndi ACE inhibitors ndi beta blockers, omwe madokotala ambiri amapereka pamaso pa mtundu wina uliwonse wa mankhwala.
Ngati mulibe chizindikiro, monga anthu ambiri omwe ali ndi kuthamanga kwa magazi, dokotala mwina ayesa choletsa cha ACE poyamba. Ngati kuthamanga kwanu kwa magazi kumatsagana ndi kupweteka pachifuwa kapena nkhawa, beta blocker ikhoza kukhala njira yabwinoko. Madokotala amatha kuperekanso mitundu yonse iwiri ya mankhwala nthawi imodzi munthawi zina.
Kodi mankhwala abwino kwambiri a kuthamanga kwa magazi ndi ati kwa inu? Gwiritsani ntchito bukhuli poyerekeza ACE inhibitors motsutsana ndi beta blockers kukonzekera ulendo wanu wotsatira wa dokotala.
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Kodi ACE inhibitors ndi beta blockers amagwira ntchito bwanji?
ACE inhibitors (angiotensin-converting-enzyme inhibitors) amachepetsa mitsempha yamagazi ndikuchepetsa magazi, omwe amachepetsa kuthamanga kwa magazi ndikuwonjezera magazi kulowa mumtima. Kuti muchite izi, Zoletsa za ACE lepheretsani ma enzyme otembenuza angiotensin kuti asatembenuke angiotensin I kukhala angiotensin II - mahomoni omwe amatseketsa mitsempha yamagazi. Mwa kutsekereza hormone, kuthamanga kwa magazi kwa munthu kumatsitsidwa.
ACE inhibitors nthawi zambiri amapatsidwa ndi madokotala kuti athetse kuthamanga kwa magazi komanso kulephera kwa mtima. Angathandizenso kuchepetsa ngozi zakufa pambuyo povulala kwamtima (myocardial infarction).
Oletsa Beta (beta-adrenergic blocking agents) amaletsa zovuta zama mahomoni opsinjika omwe ali gawo lamanjenje achifundo. Mahomoniwa ndi monga norepinephrine ndi epinephrine (amatchedwanso adrenaline ). Kutsekereza mahomoni amenewa kumathandiza kuti mitsempha ya magazi izisangalala komanso kuti izitulutsa mphamvu. Komanso, beta blockers amatha kuchepetsa kugunda kwa mtima, kutsika kwa magazi, ndikusintha magazi.
Oletsa ma Beta amatha kuchiza kuthamanga kwa magazi limodzi ndi zovuta zina monga kupsinjika kwa mtima, zovuta zamtima, nkhawa, ndi kupweteka pachifuwa.
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| ACE inhibitors motsutsana ndi beta blockers | ||
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| Zoletsa za ACE | Oletsa Beta | |
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| Mankhwala omwe amaperekedwa kawirikawiri |
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| Zotsatira zoyipa |
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| Machenjezo |
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| Kuyanjana |
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Kodi mungatenge ma ACE inhibitors okhala ndi beta blockers?
Dokotala amatha kupereka choletsa cha ACE ndi beta blocker nthawi yomweyo kuti akweze kuthamanga kwa magazi kwa omwe ali pachiwopsezo cha odwala matenda oopsa kapena anthu omwe ali ndi matenda ena monga matenda a mtima kapena mtima wosalimba.
Odwala pafupifupi 75% omwe ali ndi kuthamanga kwa magazi nthawi zambiri amafunikira mankhwala osakanikirana (oposa mankhwala amodzi) kuti akwaniritse zolinga zawo zamagazi, malinga ndi Zolemba za American Society of Hypertension . Mankhwalawa angaphatikizepo kutenga ma ACE inhibitors ndi beta blockers nthawi yomweyo kapena kutenga imodzi ndi mtundu wina wa mankhwala a magazi monga angiotensin receptor blockers (ARBs).
ACE inhibitors ndi beta blockers amagwira ntchito mosiyanasiyana ndikulunjika mbali zosiyanasiyana za thupi. Mwanjira imeneyi, amatha kuthandizana.
Machenjezo
Onse ACE inhibitors ndi beta blockers atha kukhala owopsa kwa amayi apakati. Amatha kuyambitsa chizungulire chifukwa chotsika kwambiri magazi ndipo zimatha kubweretsa zopunduka. Ngati muli ndi pakati kapena mutha kutenga pakati, kucheza ndi dokotala ndiyo njira yabwino kwambiri yodziwira ngati beta blockers kapena ACE inhibitors ali oyenera kwa inu.
ACE inhibitors amakweza potaziyamu wamagazi, chifukwa chake kuyang'anira kudya kwa potaziyamu mukamamwa mankhwala ndikofunikira. Zotsatira zake, kumwa potaziyamu kapena kugwiritsa ntchito cholowa m'malo mwa mchere chomwe chimakhala ndi potaziyamu kumatha kuyambitsa kuchuluka kwa potaziyamu wamagazi (hyperkalemia). Hyperkalemia imatha kubweretsa zovuta zina, zomwe zimawopseza thanzi. Zizindikiro za hyperkalemia zimaphatikizapo kusokonezeka, kugunda kwamtima kosazolowereka, ndi kumva kulira kapena dzanzi m'manja kapena pankhope.
Komabe, ma beta blockers ena amatha kuwonjezera ma triglycerides ndikuchepetsa cholesterol. Izi nthawi zambiri zimakhala zakanthawi koma zimakhudza odwala omwe ali ndi matenda amadzimadzi.
Kuyanjana kwa mankhwala osokoneza bongo
ACE inhibitors ndi beta blockers sangagwire bwino ntchito ngati atatengedwa ndi mankhwala osagwiritsa ntchito anti-inflammatory (NSAIDs) monga ibuprofen, Advil, ndi Aleve. Lankhulani ndi dokotala musanatenge ma NSAID aliwonse mukamamwa ma ACE inhibitors, beta blockers, kapena onse awiri.
Kusintha kuchokera ku beta blockers kupita ku ACE inhibitors
Nthawi zina, dokotala amatha kusintha mankhwala anu a beta blocker kukhala ACE inhibitor kapena mosemphanitsa.
Nthawi yomwe odwala ali ndi vuto lochepa la mtima kapena zovuta zamtima, mwina kuchuluka kwa beta blockers kuyenera kuchepetsedwa, kapena mankhwala ena a kuthamanga kwa magazi monga ACEi atha kugwiritsidwa ntchito, akuti Atif Zafar , MD, director of the University of New Mexico Stroke Program. Pazochitika zina, pomwe odwala ali ndi matenda amitsempha a m'mitsempha (monga stenosis ya mitsempha ya impso), ACEi siyiyamikiridwa pakuwongolera kuthamanga kwa magazi. Mankhwala ena a BP ndi abwino kwa odwalawo.
Ena maphunziro akuwonetsa kuti kusintha kwa beta blockers kupita ku ACE inhibitors kumatha kuthandiza kuchepetsa zizolowezi ndikusintha kuzindikira. Komabe, izi sizitanthauza kuti ma beta blockers ali bwino kuposa ACE inhibitors.
Mankhwala aliwonse amakhala ndi cholinga chake ndipo amatha kukhala bwino pochiza vuto lina kuposa lina. [ACE inhibitors] ndi mankhwala oyamba pomwe oyang'anira beta amagawidwa ngati mankhwala achiwiri pakulamulira BP, Dr. Zafar akuti. Komabe, kwa odwala omwe ali ndi matenda amitsempha yamagazi (CAD), kapena matenda osakhazikika amisala monga comorbid of hypertension, beta blockers ndi ACEI amalimbikitsidwa kusankha mzere woyamba.
Chofunika kwambiri, kukambirana ndi dokotala kapena katswiri wazachipatala ndiyo njira yabwino kwambiri yodziwira ngati kusintha kwa beta blockers kupita ku ACE inhibitors ndiye chisankho choyenera kwa inu malinga ndi yankho lanu kuchipatala ndi zovuta zina zomwe mumakumana nazo.
Zotsatira zoyipa
Monga mankhwala aliwonse, nthawi zonse pamakhala zotheka. Kutenga ma beta blockers, ACE inhibitors, kapena zonsezi zitha kubweretsa zovuta zina zotsatirazi:
| Zotsatira zoyipa za ACE inhibitor vs. beta | |
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| Zotsatira zoyipa za ACE | Zotsatira zoyipa za Beta |
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Mndandanda wazotsatira zake sizokwanira. Katswiri wazachipatala atha kukupatsani mndandanda wathunthu wazotsatira zoyipa zomwe zimakhudzana ndi ACE inhibitors vs. beta blockers.
Ngakhale ndizosowa, ma ACE inhibitors ndi beta blockers amatha kuphatikizidwa ndi zovuta zina. Kutenga zoletsa za ACE zitha kuyambitsa angioedema , chosowa chomwe chimayambitsa kutupa kwa nkhope ziwalo zina za thupi. ACE inhibitors amathanso kuyambitsa impso kulephera kapena kuchepa kwama cell oyera.
Beta blockers adayambitsa mphumu zazikulu. Kwa anthu omwe ali ndi matenda ashuga, ma beta blockers amatha kupangitsa kuti thupi lisawonetse shuga wotsika magazi (monga kunjenjemera ndi kupindika). Kuthamanga kwa magazi ndi kugunda kwa mtima kuyenera kuyang'aniridwa mukamamwa ma beta blockers.
Kodi mankhwala oopsa kwambiri ndi otani?
Ngakhale kulibe mankhwala amodzi omwe angathandize kuthana ndi matenda oopsa, ACE inhibitors ndi beta blockers ndi ena mwa mitundu yotchuka ya mankhwala oopsa. Mankhwala omwe akuyenera kudalira amadalira mbiri ya zamankhwala, zisonyezo, ndi mayankho ake kuchipatala. Katswiri wazachipatala atha kuthandiza kudziwa mankhwala abwino kwambiri oopsa pamlanduwu. Nawu mndandanda wa mankhwala omwe amadziwika kwambiri kuti azitha kulandira kuthamanga kwa magazi:
| ACE inhibitor vs beta blocker mankhwala | |
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| Zoletsa za ACE | Oletsa Beta |
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Mankhwala a kuthamanga kwa magazi amasankhidwa kutengera momwe amachepetsera kuthamanga kwa magazi ndikuchepetsa chiopsezo chamatenda am'mimba, sitiroko, ndi mtima kulephera, malinga ndiZolemba za American Society of Hypertension. Ngati choletsa cha ACE kapena beta blocker sichingakugwiritsireni ntchito, adokotala angakulimbikitseni mtundu wina wa mankhwala oletsa kuthamanga kwa magazi, monga calcium channel blockers, diuretics, alpha blockers, ndi zina zambiri.
Kuphatikiza apo, zosintha m'moyo itha kuthandizira kuthana ndi kuthamanga kwa magazi limodzi ndi mankhwala. Koma koposa zonse, katswiri wazachipatala atha kukuthandizani kudziwa njira yabwino kwambiri yothandizira inu kutengera zomwe mwakumana nazo komanso mbiri yazachipatala.
