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فشار خون در بارداری

حدود ۲۵% خانم هایی که برای نخستین بار حامله شده اند در سه ماهه آخر حاملگی دچار کمی افزایش فشار خون می شوند که در صورت موجود نبودن اختلال کلیوی و دیده نشدن پروتئین در آزمایش ادرار نیاز به درمان دارویی ضد فشار خون ندارند و فقط باید تحت نظر قرار بگیرند. در بیماری پِرِه اکلاپسی (pre-eclampsia) که در برخی موارد در مراحل انتهایی حاملگی روی می دهد و با فشار خون بالا، وجود پروتئین در ادرار و ورم (اِدِم) شناخته می شوند و برای مادر و جنین خطرناک است، باید فشار خون در بارداری و ادرار بیمار به طور مرتب کنترل شود و تحت درمان قرار بگیرد. در صورت عدم تشخیص و درمان فشار خون در بارداری ، ممکن است بیماری خطرناکی موسوم به اکلامپسی (eclampsia) یا مسمومیت حاملگی ایجاد شود که با تشنج همراه است و می تواند منجر به مرگ مادر و جنین شود. در این مورد از فشار خون در بارداری بیمار باید در بیمارستان تحت درمان قرار گیرد.

توصیه های فشار خون

- درصورتی که مبتلا به آنژین صدری هستید، باید میزان کلسترول خون شما اندازه گیری شود و درصورت لزوم از داروهای کاهش دهنده کلسترول استفاده کنید. مصرف داروهای کاهش دهنده چربی خون در افرادی که سابقه سکته قلبی دارند، مقدار کلسترول خون را پایین می آورد و احتمال بروز سکته قلبی دوباره را کاهش می دهد. در این موارد، داروهای فشار خون بازدارنده ACE و بتابلاکرها مفیدتر هستند زیرا علاوه بر کاهش فشار خون، موجب آرام تر شدن قلب و پیشگیری از بروز صدمات بیشتر به قلب می شوند. معمولاً در درمان این موارد از فشار خون استفاده از مقادیر کم آسپیرین هم  به وسیله پزشک توصیه می شود.

- افراد مسن، کودکان، خانم های باردار و افراد مبتلا به برخی بیماری های دیگر و یا افرادی که از سایر داروها استفاده می کنند به توجه ویژه برای کنترل فشار خون نیاز دارند.

- فشار خون دیاستولیک تقریبا۵% خانم های مسن، چاق و دارای سابقه فشار خون بالا که از قرص های ضدباری استفاده می کنند به بیش از ۹ میلی متر جیوه می رسد. این قرصها به ندرت فشار خون را به حدی افزایش می دهند که نیاز به درمان داشته باشد.

- مواد حاوی کافئین از قبیل قهوه ، چای ، نوشابه‌های کولا و شکلات، سبب افزایش فشارخون می‌شوند و باید در حد اعتدال مصرف شوند.

- برای کنرل فشارخون از مصرف غذاهای سرخ کرده یا غذاهایی که در درجه ی حرارت‌های بسیار بالا و یا با مدت زمان طولانی تهیه می ‌شوند، و عدم استفاده ی چند باره از روغن‌های آشپزی اجتناب کنید .

- استفاده از گوشت سفید به جای گوشت‌های قرمز برای کنترل فشارخون.

- کنترل استرس ، زیرا یکی از عوامل بالا بردن فشار خون که بسیار سریع هم عمل می‌ کند، استرس و عصبانیت است.

- استراحت به میزان کافی هر روز زیرا کار کردن بی ‌وقفه بیشترین فشار را بر سلامتی فرد وارد خواهد کرد .

- انجام ورزش‌هایی مثل پیاده ‌روی، شنا، دوچرخه سواری برای پایین آوردن فشار خون مفید هستند بنابراین حداقل ۳ بار در هفته و هر بار حداقل ۳۰ دقیقه باید ورزش کرد .

فشار خون و دیابت

فشار خون در افراد مبتلا به دیابت بیش از سایر افراد دیده می شود و در نتیجه، خطر بروز آسیب های کلیوی و چشمی و بیماری های عروق قلب و سکته مغزی در این افراد بیشتر است. در بیماران مبتلا به فشار خون ، کنترل مرتب قند خون و رساندن سطح کلسترول به حد طبیعی ضرورت دارد. مشاهده شده است که داروهای بازدارنده ACE بهتر از سایر داروها موجب پیشگیری از آسیب های کلیوی و چشمی بیماران دیابتی می شود. رساندن فشار خون بیماران مبتلا به دیابت به زیر ۸۵/۱۴۰ بسیار مفید است. اگر چه در افرادی که به دیابت مبتلا نیستند درمان پرفشاری خون باید از فشار بالاتر ۹۰/۱۶۰ شروع شود، در افراد دیابتی درمان مزبور را باید از فشار خون بالاتر از ۸۵/۱۴۰ یا ۸۵/۱۳۰ آغاز نمود.

عوارض‌ فشار خون

سکته مغزی ، حمله قلبی ، نارسایی احتقانی قلب و ورم‌ ریه ، نارسایی‌ کلیه و آسیب چشمی و مشکل بینایی از عوارض اصلی فشار خون بالا هستند.

مطالب مرتبط :

استرس و فشار خون بالا

کاهش فشار خون با ترک سیگار

کاهش فشار خون با تغذیه

توصیه های مهم برای کاهش فشار خون

کاهش فشار خون بالا با کنترل وزن

چگونگی کنترل فشار خون

فشار خون و راههای کنترل آن

درمان فشار خون بالا

منبع : راهنمای پزشکی خانواده- فشار خون

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