{"id":35784,"date":"2023-06-28T23:44:13","date_gmt":"2023-06-28T16:44:13","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35784"},"modified":"2023-06-28T23:44:13","modified_gmt":"2023-06-28T16:44:13","slug":"tang-huyet-ap-tai-sao-tieu-chuan-chan-doan-theo-jnc-7-la-quan-trong-doi-voi-suc-khoe-cua-ban","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/28\/tang-huyet-ap-tai-sao-tieu-chuan-chan-doan-theo-jnc-7-la-quan-trong-doi-voi-suc-khoe-cua-ban\/","title":{"rendered":"T\u0103ng huy\u1ebft \u00e1p: T\u1ea1i sao ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo JNC 7 l\u00e0 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ea1n?"},"content":{"rendered":"<p><strong>T\u0103ng huy\u1ebft \u00e1p theo JNC 7 , t\u0103ng huy\u1ebft \u00e1p l\u00e0 khi huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng (SBP) &gt; 140 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m thu (DBP) &gt; 90 mmHg l\u00e0m b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao v\u00e0 c\u00f3 th\u1ec3 k\u00e8m t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch: v\u00f5ng m\u1ea1c \u2013 n\u00e3o \u2013 tim \u2013 th\u1eadn \u2013 c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn (\u0111\u1ed9ng m\u1ea1ch v\u00e0nh \u2013 \u0111\u1ed9ng m\u1ea1ch n\u00e3o \u2013 \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean). Ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p ch\u1ec9 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh sau khi c\u00f3 k\u1ebft qu\u1ea3 huy\u1ebft \u00e1p cao th\u00f4ng qua \u00edt nh\u1ea5t 3 l\u1ea7n \u0111o v\u1edbi c\u00e1ch \u0111o ch\u00ednh x\u00e1c.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35785 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/a31956fe-b8ac-4624-a52d-1cceb8389798-300x300.jpg\" alt=\"tang-huyet-ap-theo-jnc-7\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/a31956fe-b8ac-4624-a52d-1cceb8389798-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/a31956fe-b8ac-4624-a52d-1cceb8389798-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/a31956fe-b8ac-4624-a52d-1cceb8389798-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/a31956fe-b8ac-4624-a52d-1cceb8389798.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1. C\u00e1c b\u01b0\u1edbc ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p<\/h2>\n<p><strong><br \/>\n<\/strong>B\u01b0\u1edbc 1: x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 th\u1eadt s\u1ef1 b\u1ecb t\u0103ng huy\u1ebft \u00e1p hay kh\u00f4ng? B\u1ec7nh nh\u00e2n c\u00f3 c\u1ea7n ph\u1ea3i \u0111o huy\u1ebft \u00e1p 24 gi\u1edd \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p hay kh\u00f4ng?<strong><em><br \/>\n<\/em><\/strong>D\u1ef1a theo \u0111\u1ecbnh ngh\u0129a m\u00e0 ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p.<br \/>\nV\u1ea5n \u0111\u1ec1 \u0111\u1eb7t ra: khi n\u00e0o th\u00ec ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p b\u1eb1ng \u0111o huy\u1ebft \u00e1p t\u1ea1i nh\u00e0 ho\u1eb7c c\u1ea7n thi\u1ebft ph\u1ea3i \u0111o huy\u1ebft \u00e1p li\u00ean t\u1ee5c 24 gi\u1edd.<\/p>\n<p><strong><em>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 m\u1eafc b\u1ec7nh tim m\u1ea1ch<\/em><\/strong><\/p>\n<ol>\n<li>T\u0103ng huy\u1ebft \u00e1p.<\/li>\n<li>H\u00fat thu\u1ed1c l\u00e1.<\/li>\n<li>B\u00e9o ph\u00ec (BMI &gt; 30 kg\/m<sup>2<\/sup>).<\/li>\n<li>\u00cdt v\u1eadn \u0111\u1ed9ng.<\/li>\n<li>R\u1ed1i lo\u1ea1n lipid m\u00e1u.<\/li>\n<li>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/li>\n<li>R\u1ed1i lo\u1ea1n lipid m\u00e1u.<\/li>\n<li>Microalbuminuria (+) HO\u1eb6C GFR \u01b0\u1edbc \u0111o\u00e1n &lt; 60 mL\/ph\u00fat.<\/li>\n<li>Tu\u1ed5i: nam &gt; 55 v\u00e0 n\u1eef &gt; 65.<\/li>\n<\/ol>\n<p><strong><em><u>B\u01b0\u1edbc 2: N\u1ebfu t\u0103ng huy\u1ebft \u00e1p th\u00ec c\u00f3 ph\u1ea3i b\u1ec7nh nh\u00e2n \u0111ang trong t\u00ecnh tr\u1ea1ng t\u0103ng huy\u1ebft \u00e1p nghi\u00eam tr\u1ecdng hay kh\u00f4ng c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb kh\u1ea5n c\u1ea5p?<\/u><\/em><\/strong><\/p>\n<p>Ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p nghi\u00eam tr\u1ecdng khi SBP &gt; 180 mmHg ho\u1eb7c DBP &gt; 120 mmHg. T\u0103ng huy\u1ebft \u00e1p nghi\u00eam tr\u1ecdng bao g\u1ed3m: t\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p v\u00e0 t\u0103ng huy\u1ebft \u00e1p c\u1ea5p c\u1ee9u (THA c\u1ea5p c\u1ee9u = t\u0103ng huy\u1ebft \u00e1p \u00e1c t\u00ednh).<\/p>\n<p>L\u00fac n\u00e0y v\u1ec1 m\u1eb7t ch\u1ea9n \u0111o\u00e1n ta ph\u1ea3i nhanh ch\u00f3ng \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u n\u1ebfu c\u1ea7n.<\/p>\n<p>(c\u00f3 b\u00e0i ri\u00eang v\u1ec1 x\u1eed tr\u00ed t\u0103ng huy\u1ebft \u00e1p nghi\u00eam tr\u1ecdng)<\/p>\n<p><strong><em><u>B\u01b0\u1edbc 3: N\u1ebfu b\u1ec7nh nh\u00e2n th\u1eadt s\u1ef1 b\u1ecb t\u0103ng huy\u1ebft \u00e1p, b\u1ec7nh nh\u00e2n c\u00f3 ph\u1ea3i l\u00e0 t\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t hay kh\u00f4ng? -\u1ef3 c\u00e1c y\u1ebfu t\u1ed1 g\u1ee3i \u00fd t\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t l\u00e0 g\u00ec? N\u1ebfu l\u00e0 t\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t th\u00ec nguy\u00ean nh\u00e2n l\u00e0 g\u00ec?<\/u><\/em><\/strong><\/p>\n<p>C\u00e1c y\u1ebfu t\u1ed1 gi\u00fap g\u1ee3i \u00fd t\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t tr\u00ean b\u1ec7nh nh\u00e2n:<\/p>\n<ul>\n<li>Kh\u1edfi ph\u00e1t t\u0103ng huy\u1ebft \u00e1p l\u00fac &lt; 25 tu\u1ed5i ho\u1eb7c &gt; 55 tu\u1ed5i.<\/li>\n<li>T\u0103ng huy\u1ebft \u00e1p n\u1eb7ng &gt; 180\/110 mmHg l\u00fac m\u1edbi kh\u1edfi b\u1ec7nh.<\/li>\n<li>Kh\u1edfi ph\u00e1t b\u1ec7nh \u0111\u1ed9t ng\u1ed9t, t\u1eeb huy\u1ebft \u00e1p b\u00ecnh th\u01b0\u01a1ng di\u1ec5n ti\u1ebfn \u0111\u1ebfn THA n\u1eb7ng trong v\u00f2ng &lt; 1 n\u0103m.<\/li>\n<li>T\u0103ng huy\u1ebft \u00e1p kh\u00e1ng tr\u1ecb.<\/li>\n<li>Tr\u01b0\u1edbc kia \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3, nay \u0111\u00e1p \u1ee9ng k\u00e9m.<\/li>\n<li>C\u01a1n t\u0103ng huy\u1ebft \u00e1p k\u00e8m theo h\u1ed3i h\u1ed9p, t\u00e1i nh\u1ee3t, to\u00e1t m\u1ed3 h\u00f4i, run tay.<\/li>\n<li>C\u01a1n y\u1ebfu c\u01a1 tetani.<\/li>\n<li>C\u00f3 tri\u1ec7u ch\u1ee9ng nhi\u1ec1u c\u01a1 quan khi kh\u1edfi b\u1ec7nh.<\/li>\n<li>M\u1ea1ch t\u1ee9 chi kh\u00f4ng c\u00e2n x\u1ee9ng + huy\u1ebft \u00e1p chi tr\u00ean &gt; huy\u1ebft \u00e1p chi d\u01b0\u1edbi.<\/li>\n<li>C\u00f3 \u00e2m th\u1ed5i \u1edf b\u1ee5ng.<\/li>\n<li>Kh\u1ed1i u 2 b\u00ean h\u00f4ng.<\/li>\n<li>B\u1ea5t th\u01b0\u1eddng sinh h\u00f3a: t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft &#8211; h\u1ea1 kali m\u00e1u &#8211; t\u0103ng calci m\u00e1u.<\/li>\n<\/ul>\n<p>C\u00e1ch nguy\u00ean nh\u00e2n g\u00e2y t\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t \u1edf ng\u01b0\u1eddi l\u1edbn:<\/p>\n<ul>\n<li>H\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn.<\/li>\n<li>H\u1eb9p eo \u0110mC.<\/li>\n<li>B\u1ec7nh nhu m\u00f4 th\u1eadn.<\/li>\n<li>H\u1ed9i ch\u1ee9ng Conn.<\/li>\n<li>H\u1ed9i ch\u1ee9ng Cushing.<\/li>\n<li>T\u0103ng s\u1ea3n th\u01b0\u1ee3ng th\u1eadn sinh d\u1ee5c.<\/li>\n<li>U t\u1ee7y th\u01b0\u1ee3ng th\u1eadn.<\/li>\n<li>C\u01b0\u1eddng gi\u00e1p &#8211; nh\u01b0\u1ee3c gi\u00e1p.<\/li>\n<li>Thai k\u00ec.<\/li>\n<li>H\u1ed9i ch\u1ee9ng ng\u01b0ng th\u1edf khi ng\u1ee7.<\/li>\n<li>Thu\u1ed1c ng\u1eeba thai.<\/li>\n<li>H\u1ed9i ch\u1ee9ng t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd<\/li>\n<\/ul>\n<p><strong><em><u>B\u01b0\u1edbc 4: N\u1ebfu b\u1ec7nh nh\u00e2n l\u00e0 t\u0103ng huy\u1ebft \u00e1p nguy\u00ean ph\u00e1t th\u00ec y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh nh\u00e2n g\u00e2y t\u0103ng huy\u1ebft \u00e1p l\u00e0 g\u00ec? V\u00e0 b\u1ec7nh nh\u00e2n t\u0103ng huy\u1ebft \u00e1p giai \u0111o\u1ea1n m\u1ea5y theo JNC VII<\/u><\/em><\/strong><\/p>\n<p><strong><u>Ph\u00e2n \u0111\u00f4 t\u0103ng huy\u1ebft \u00e1p theo JNC VII:<\/u><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"303\"><strong>Ph\u00e2n \u0111\u00f4<\/strong><\/td>\n<td width=\"305\"><strong>SBP (mmHg)<\/strong><\/td>\n<td width=\"307\"><strong>DBP (mmHg)<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"303\">B\u00ecnh th\u01b0\u1eddng (th\u1ecfa c\u1ea3 2 ti\u00eau chu\u1ea9n)<\/td>\n<td width=\"305\">&lt; 120<\/td>\n<td width=\"307\">&lt; 80<\/td>\n<\/tr>\n<tr>\n<td width=\"303\">Ti\u1ec1n THA<\/td>\n<td width=\"305\">&lt; 140<\/td>\n<td width=\"307\">&lt; 90<\/td>\n<\/tr>\n<tr>\n<td width=\"303\">THA giai \u0111o\u1ea1n 1<\/td>\n<td width=\"305\">&lt; 160<\/td>\n<td width=\"307\">&lt; 100<\/td>\n<\/tr>\n<tr>\n<td width=\"303\">THA giai \u0111o\u1ea1n 2<\/td>\n<td width=\"305\">&gt; 160<\/td>\n<td width=\"307\">&gt; 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong><em><u>B\u01b0\u1edbc 5: D\u00f9 l\u00e0 t\u0103n<\/u><\/em><\/strong><strong><em><u>g huy\u1ebft \u00e1p nguy\u00ean ph\u00e1t hay th\u1ee9 ph\u00e1t th\u00ec t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch c\u1ee7a b\u1ec7nh nh\u00e2n hi\u1ec7n c\u00f3 l\u00e0 g\u00ec? T\u1ed5n th\u01b0\u01a1ng d\u01b0\u1edbi l\u00e2m s\u00e0ng hay l\u00e2m s\u00e0ng? B\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh <\/u>b\u1eaft bu\u1ed9c n\u00e0o hay kh\u00f4ng?<\/em><\/strong><\/p>\n<p>Kh\u1ea3o s\u00e1t t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb l\u00e0 \u0111i\u1ec1u b\u1eaft bu\u1ed9c ph\u1ea3i l\u00e0m v\u00ec r\u1eb1ng:<\/p>\n<ul>\n<li>Gi\u00fap ph\u00e2n t\u1ea7ng nguy c\u01a1 tim m\u1ea1ch cao hay th\u1ea5p trong THA -&gt; quy\u1ebft \u0111\u1ecbnh x\u1eed tr\u00ed ban \u0111\u1ea7u c\u00f3 c\u1ea7n d\u00f9ng thu\u1ed1c ngay hay ch\u01b0a. (y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch cao l\u00e0 g\u00ec \u0111\u1ed1i v\u1edbi m\u1ed9t b\u1ec7nh nh\u00e2n THA)<\/li>\n<li>T\u00ecm c\u00e1c <strong>ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c <\/strong>\u0111\u1ec3 bi\u1ebft c\u00e1ch l\u1ef1a ch\u1ecdn thu\u1ed1c ban \u0111\u1ea7u.<\/li>\n<\/ul>\n<p>T\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch c\u00f3 hai d\u1ea1ng: c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u00e0 <strong>bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi l\u00e2m s\u00e0ng<\/strong>. Nh\u01b0 v\u1eady ta s\u1ebd \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n b\u1eb1ng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n bi\u1ebfn ch\u1ee9ng tr\u01b0\u1edbc. N\u1ebfu nh\u01b0 kh\u00f4ng c\u00f3 th\u00ec m\u1edbi t\u00ecm bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi l\u00e2m s\u00e0ng.<\/p>\n<p>\u25a0 <em><u>T\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch bi\u1ec3u hi\u00ean tr\u00ean l\u00e2m s\u00e0ng: (Ngu\u1ed3n: ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tri THA b\u00eanh vi\u00ean<\/u><\/em><\/p>\n<p>115).<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\" width=\"326\"><strong>H\u1ec7 th\u1ed1ng c\u01a1 quan<\/strong><\/td>\n<td width=\"588\"><strong>Bi\u1ec3u hi\u1ec7n<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"326\">C\u00e1c m\u1ea1ch m\u00e1u l\u1edbn<\/td>\n<td width=\"588\">D\u00e3n ph\u00ecnh m\u1ea1ch. M\u1ea3ng x\u01a1 v\u1eefa ti\u1ebfn tri\u1ec3n.<\/p>\n<p>B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" width=\"154\">Tim<\/td>\n<td width=\"172\">C\u1ea5p<\/td>\n<td width=\"588\">Ph\u00f9 ph\u1ed5i c\u1ea5p, NMCT c\u1ea5p.<\/td>\n<\/tr>\n<tr>\n<td width=\"172\">M\u1ea1n<\/td>\n<td width=\"588\">B\u1eb1ng ch\u1ee9ng c\u1ee7a b\u1ec7nh m\u1ea1ch v\u00e0nh tr\u00ean l\u00e2m s\u00e0ng ho\u1eb7c ECG. Ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i tr\u00ean ECG ho\u1eb7c si\u00eau \u00e2m.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" width=\"154\">M\u1ea1ch m\u00e1u n\u00e3o<\/td>\n<td width=\"172\">C\u1ea5p<\/td>\n<td width=\"588\">Xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd. H\u00f4n m\u00ea. \u0110\u1ed9ng kinh. Thay \u0111\u1ed5i tr\u1ea1ng th\u00e1i t\u00e2m th\u1ea7n. TIA. \u0110\u1ed9t qu\u1ef5.<\/td>\n<\/tr>\n<tr>\n<td width=\"172\">M\u1ea1n<\/td>\n<td width=\"588\">TIA. Di ch\u1ee9ng TBMMN.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" width=\"154\">Th\u1eadn<\/td>\n<td width=\"172\">C\u1ea5p<\/td>\n<td width=\"588\">Ti\u1ec3u m\u00e1u, ti\u1ec3u \u0111\u1ea1m.<\/td>\n<\/tr>\n<tr>\n<td width=\"172\">M\u1ea1n<\/td>\n<td width=\"588\">Creatinin huy\u1ebft thanh &gt; 1.5 mg%, \u0111\u1ea1m ni\u1ec7u &gt; 1+ tr\u00ean que nh\u00fang.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" width=\"154\">V\u00f5ng m\u1ea1c<\/td>\n<td width=\"172\">C\u1ea5p<\/td>\n<td width=\"588\">Ph\u00f9 gai th\u1ecb, xu\u1ea5t huy\u1ebft.<\/td>\n<\/tr>\n<tr>\n<td width=\"172\">M\u1ea1n<\/td>\n<td width=\"588\">Xu\u1ea5t huy\u1ebft, xu\u1ea5t ti\u1ebft, co \u0111\u1ed9ng m\u1ea1ch.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h2>2. \u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p theo JNC 7<\/h2>\n<p>T\u00d3M T\u1eaeT<strong><br \/>\n<\/strong>Khi b\u1eaft tay v\u00e0o \u0111i\u1ec1u tr\u1ecb THA th\u00ec tr\u01b0\u1edbc ti\u00ean ph\u1ea3i ch\u1ea9n \u0111o\u00e1n cho \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 nguy\u00ean nh\u00e2n \u2013 y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch \u2013 t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch tr\u00ean l\u00e2m s\u00e0ng.<strong><em><br \/>\n<\/em><\/strong>\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p tr\u01b0\u1edbc ti\u00ean l\u00e0 ph\u00e2n th\u00e0nh 2 nh\u00f3m: nh\u00f3m c\u00f3 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c \u2013 nh\u00f3m kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c. Trong nh\u00f3m kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c th\u00ec ph\u1ea3i ph\u00e2n nh\u00f3m th\u00e0nh: c\u00f3 nh\u00f3m nguy c\u01a1 tim m\u1ea1ch cao hay kh\u00f4ng. N\u1ebfu kh\u00f4ng ph\u1ea3i l\u00e0 nh\u00f3m nguy c\u01a1 cao tim m\u1ea1ch th\u00ec ph\u1ea3i ph\u00e2n nh\u00f3m theo JNC VII. Ph\u00e2n nh\u00f3m nh\u01b0 v\u1eady \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb thu\u1ed1c hay kh\u00f4ng v\u00e0 n\u1ebfu c\u00f3 th\u00ec ch\u1ecdn thu\u1ed1c h\u1ea1 \u00e1p lo\u1ea1i n\u00e0o.<\/p>\n<p>Song song v\u1edbi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p lu\u00f4n lu\u00f4n ph\u1ea3i nh\u00ecn xem c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 ph\u1ed1i h\u1ee3p v\u1edbi t\u0103ng huy\u1ebft \u00e1p nh\u01b0 th\u1ebf n\u00e0o v\u00e0 \u0111i\u1ec1u ch\u1ec9nh cho b\u1ec7nh nh\u00e2n. C\u1ee5 th\u1ec3 l\u00e0 ph\u1ea3i \u0111\u1eb7t ra c\u00e2u h\u1ecfi: li\u1ec7u c\u00f3 c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u1edbi statin hay fibrate hay kh\u00f4ng? B\u1ec7nh nh\u00e2n c\u00f3 c\u1ea7n ph\u1ea3i d\u00f9ng kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u hay kh\u00f4ng? \u0110\u01b0\u1eddng huy\u1ebft c\u1ee7a b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t hay ch\u01b0a?<\/p>\n<p>M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p theo JNC 7:<strong><em><br \/>\n<\/em><\/strong>1. \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n.<br \/>\n2. N\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n hay \u0111\u00f3 l\u00e0 THA nguy\u00ean ph\u00e1t \u00e0 \u0111i\u1ec1u tr\u1ecb lo\u1ea1i b\u1ecf y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch v\u00e0 THA + ki\u1ec3m so\u00e1t m\u1ee9c huy\u1ebft \u00e1p \u0111\u1ec3 ph\u00f2ng tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng.<br \/>\n3. M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb l\u00e0 duy tr\u00ec:<br \/>\n\u00b6 HA &lt; 140\/90 mmHg.<br \/>\n\u00b6 HA &lt; 130\/80 mmHg \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u0110T\u0110 v\u00e0 b\u1ec7nh th\u1eadn m\u1ea1n.<\/p>\n<p>&nbsp;<\/p>\n<p>C\u00e1c m\u1ee5c ti\u00eau tr\u00ean c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng \u0111i\u1ec1u tr\u1ecb thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng hay ph\u1ea3i d\u00f9ng thu\u1ed1c.<br \/>\n&#8211; \u0110\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb c\u1ea7n ph\u1ea3i x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n t\u0103ng huy\u1ebft \u00e1p n\u1ebfu c\u00f3 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n, \u0111\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch, t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch c\u0169ng nh\u01b0 c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng kh\u00e1c v\u00ec c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c ch\u1ecdn l\u1ef1a thu\u1ed1c \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n.<\/p>\n<p><strong><em>N\u1ebfu kh\u00f4ng c\u00f3 nguy c\u01a1 tim m\u1ea1ch cao th\u00ec ph\u00e2n \u0111\u1ed9 theo JNC VII t\u1eeb \u0111\u00f3 c\u00f3 c\u00e1ch l\u1ef1a<br \/>\nch\u1ecdn ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u.<\/em><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"319\"><strong>M\u1ee9c huy\u1ebft \u00e1p<\/strong><\/td>\n<td width=\"317\"><strong>D\u00f9ng thu\u1ed1c h\u1ea1 \u00e1p khi kh\u00f4ng<br \/>\nc\u00f3 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c v\u00e0 ko c\u00f3<br \/>\ny\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch cao<\/strong><\/td>\n<td width=\"320\"><strong>Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng (thay \u0111\u1ed5i<br \/>\nl\u1ed1i s\u1ed1ng l\u00e0 l\u00e0m c\u00e1i g\u00ec?)<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"319\">Huy\u1ebft \u00e1p b\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"317\">Kh\u00f4ng c\u1ea7n d\u00f9ng thu\u1ed1c<\/td>\n<td width=\"320\">Khuy\u1ebfn kh\u00edch<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">Ti\u1ec1n t\u0103ng huy\u1ebft \u00e1p<\/td>\n<td width=\"317\">Kh\u00f4ng c\u1ea7n d\u00f9ng thu\u1ed1c<\/td>\n<td width=\"320\">B\u1eaft bu\u1ed9c<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">THA giai \u0111o\u1ea1n 1<\/td>\n<td width=\"317\">D\u00f9ng 1 thu\u1ed1c ban \u0111\u1ea7u<\/td>\n<td width=\"320\">B\u1eaft bu\u1ed9c<\/td>\n<\/tr>\n<tr>\n<td width=\"319\">THA giai \u0111o\u1ea1n 2<\/td>\n<td width=\"317\">Ph\u1ed1i h\u1ee3p 2 thu\u1ed1c<\/td>\n<td width=\"320\">B\u1eaft bu\u1ed9c<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Xem th\u00eam: <a href=\"https:\/\/docs.google.com\/document\/d\/1SPj-VBUeRUm4FQVachVwsfOAo3njObKV5JI_8vS4JWM\/edit?usp=sharing\">T\u0103ng huy\u1ebft \u00e1p: Nguy\u00ean nh\u00e2n v\u00e0 c\u00e1ch ch\u1ea9n \u0111o\u00e1n \u0111\u00fang \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u0103ng huy\u1ebft \u00e1p theo JNC 7 , t\u0103ng huy\u1ebft \u00e1p l\u00e0 khi huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng (SBP) &gt; 140 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m thu (DBP) &gt; 90 mmHg l\u00e0m b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao v\u00e0 c\u00f3 th\u1ec3 k\u00e8m t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch: v\u00f5ng m\u1ea1c \u2013 n\u00e3o \u2013 tim \u2013 th\u1eadn \u2013 c\u00e1c [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>T\u0103ng huy\u1ebft \u00e1p: T\u1ea1i sao ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo JNC 7 l\u00e0 quan tr\u1ecdng \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ea1n? 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