Meta pazjent tinqaralu l-pressjoni dan jigi moghti zewg valuri, dik ta' fuq (systolic) u dik ta' taht (diastolic). Il-pressjoni ta' fuq tirreferi ghall-pressjoni fl-arterji waqt li l-qalb tkun qed timbotta d-demm 'il barra, u dik ta' taht ghall-pressjoni fl-arterji waqt li l-qalb tkun qed tirrilassa. Sa xi zmien ilu konna iktar naghmlu enfasi fuq il-pressjoni ta' taht, pero fil-fatt hu important li t-tnejn li huma jkunu taht kontroll.
Pressjoni tad-demm gholja tpoggi lil persuna f'riskju ta kumplikazzjonijiet, fis-sens li jekk din tithalla fuq livell gholi twassal biex l-arterji tad-demm jidjiequ bi process li jissejjah aterosklerosi. Arterji dojoq jikkawzaw "ghatx ta ossignu" fil-partijiet li jissuplixxu, u dan iwassal ghal kumplikazzjonijet bhal attakki tal-qalb jew puplesiji.
Fost il-kawzi tal-pressjoni gholja nsibu bosta, pero f'95% tal-kazi din ma tinstabx u allura nitkellmu fuq "essential hypertension". Fil-5% fejn ikun hemm kawza din tkun wahda jew bosta minn ansjeta, mard fil-kliewi, fit-tirojde, fl-arterji, fil-glandoli adrenali, u anke certu tip ta' kancer rari li jipproducu ormoni.
Fenomenu interessanti ta' ipertensjoni jissejjah "white coat hypertension" fejn il-pazjent toghliehlu l-pressjoni biss fil-presenza tat-tabib. Jien iltqajt ma' kaz bhal dan f'pazjent li meta kienet tehodlu l-pressjoni n-neputija kienet tkun normali, izda meta dan kien jigi l-klinika il-pressjoni kienet toghla sew. Wara li ghadda z-zmien u l-pazjent sar iktar familjari mieghi, il-pressjoni giet ghan-normal.
Barra mard li jikkawza ipertensjoni insibu kundizzjonijiet li huma assocjati ma' pressjoini tad-demm gholja. Hawnjekk irridu nsemmu t-tipjip u l-obesita.
Pressjoni oghla minn 160/85 tista titqies bhala gholja. Madankollu dan il-valur ivarja minn zmien ghal zmien minhabba li r-ricerka dejjem ghaddejja. Perezempju fl-imghoddi kienu jigu accettati valuri hafna oghla, sa anke 190/110.
Fattur iehor li jrid jitqies hu l-istat generali ta sahha tal-individwu. Ghall-ezempju, f'xi hadd li jbati mid-dijabete u x-xaham fid-demm irid isir kontroll strett tal-pressjoni halli din qatt ma taqbez 160/85. Mentri f'xi hadd ta' eta' zghira li ma jbati minn ebda mard valur madwar 160/85 hu accettabli.
Biex wiehed jitqies li jkollu pressjoni gholja, din trid tinstablu gholja ghal tliet darbiet konsekuttivi, u trid tghaddi gimgha bejn kull misurament. Dan ifisser li jekk persuna tinstabilha pressjoni ta 180/100 darba biss, din il-persuna ma titqiesx li tbati bl-ipertensjoni. Fil-prattika difficli li l-affarijiet isiru hekk. Dan ghaliex issib min jinkwieta hafna u jekk tghidlu li ghandu pressjoni gholja pero jkollu jistenna gimghatejn sakemm "tinqatalu", dan iktar jinkwieta u jkompli jgholli l-pressjoni! Hemm ukoll min jitlef l-interess u ma jergax jigi ghal "follow up", biex ma nsemmux dawk li jmorru ghand tabib iehor l-ghada.
Mod tajjeb kif tista' ssir dijanjosi ta' ipertensjoni minghajr ma l-pazjent jallarma ruhu hu l-uzu ta' djarju, fejn l-individwu jzomm rekord tal-pressjoni tieghu matul medda ta' zmien. B'hekk it-tabib ikun jista' jara kif tkun il-pressjoni l-maggor parti tal-hin.
Wara li xi hadd jinstab li jbati minn ipertensjoni dan irid isirulu xi testijiet. Dawn jinkludu ECG, X-Ray tas-sider, u check up komplut tad-demm. Dan isir biex jekk kun hemm xi kawza ghall-pressjoni gholja, din tinstab, kif ukoll biex jigi zvelat jekk il-pressjoni gholja kellhiex effetti negattivi fuq il-gisem.
Dr A. Cordina
Referenzi
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