{"id":35894,"date":"2023-06-30T14:02:18","date_gmt":"2023-06-30T07:02:18","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35894"},"modified":"2023-06-30T14:02:18","modified_gmt":"2023-06-30T07:02:18","slug":"phoi-hop-thuoc-tang-huyet-ap-khuyen-cao-tu-cac-hiep-hoi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/30\/phoi-hop-thuoc-tang-huyet-ap-khuyen-cao-tu-cac-hiep-hoi\/","title":{"rendered":"Ph\u1ed1i h\u1ee3p thu\u1ed1c t\u0103ng huy\u1ebft \u00e1p: khuy\u1ebfn c\u00e1o t\u1eeb c\u00e1c hi\u1ec7p h\u1ed9i"},"content":{"rendered":"<p><strong>T\u0103ng huy\u1ebft \u00e1p (THA) v\u1eabn l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Hi\u1ec7n nay c\u00e1c khuy\u1ebfn c\u00e1o \u0111\u01b0a ra quan ni\u1ec7m ph\u1ed1i h\u1ee3p thu\u1ed1c THA nh\u1eb1m \u0111\u1ea1t m\u1ee5c ti\u00eau huy\u1ebft \u00e1p \u0111\u00edch v\u00e0 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c.\u00a0 &#8220;Tr\u00ean to\u00e0n c\u1ea7u, b\u1ec7nh tim m\u1ea1ch chi\u1ebfm kho\u1ea3ng 17 tri\u1ec7u ca t\u1eed vong m\u1ed7i n\u0103m, chi\u1ebfm g\u1ea7n m\u1ed9t ph\u1ea7n ba t\u1ed5ng s\u1ed1. Trong s\u1ed1 n\u00e0y, c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a ch\u1ee9ng cao huy\u1ebft \u00e1p chi\u1ebfm 9,4 tri\u1ec7u ng\u01b0\u1eddi tr\u00ean th\u1ebf gi\u1edbi m\u1ed7i n\u0103m. T\u0103ng huy\u1ebft \u00e1p l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra \u00edt nh\u1ea5t 45% t\u1eed vong do b\u1ec7nh tim v\u00e0 51% t\u1eed vong do \u0111\u1ed9t qu\u1ef5.. &#8220;(T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi \u2013 WHO 2013). Trong 15 n\u0103m tr\u1edf l\u1ea1i \u0111\u00e2y, kh\u00f4ng c\u00f3 nhi\u1ec1u ti\u1ebfn b\u1ed9 v\u1ec1 ph\u00e1t minh thu\u1ed1c m\u1edbi \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35895 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5187c002-328e-44a0-827d-c0b5ec2f9575-300x300.jpg\" alt=\"phoi-hop-thuoc-tang-huyet-ap\n\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5187c002-328e-44a0-827d-c0b5ec2f9575-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5187c002-328e-44a0-827d-c0b5ec2f9575-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5187c002-328e-44a0-827d-c0b5ec2f9575-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5187c002-328e-44a0-827d-c0b5ec2f9575.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1. T\u0103ng huy\u1ebft \u00e1p c\u00f3 g\u00ec m\u1edbi trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y:<\/h2>\n<p>\uf075 \u0110\u1ecbnh ngh\u0129a t\u0103ng huy\u1ebft \u00e1p l\u00e0 140\/90 mmHg, ri\u00eang AHA\/ACC 2017 \u0111\u1ecbnh ngh\u0129a l\u1ea1i t\u0103ng huy\u1ebft \u00e1p l\u00e0 130\/80 mmHg.<\/p>\n<p>\uf075 H\u1ea7u h\u1ebft c\u00e1c guideline \u0111\u1ec1u ch\u1ea5p nh\u1eadn HA m\u1ee5c ti\u00eau d\u01b0\u1edbi 140\/90 mmHg cho d\u00e2n s\u1ed1 chung. C\u00f3 m\u1ed9t s\u1ed1 kh\u00e1c bi\u1ec7t gi\u1eefa c\u00e1c guideline v\u1ec1 HA m\u1ee5c ti\u00eau tr\u00ean b\u1ec7nh nh\u00e2n b\u1ec7nh th\u1eadn m\u1ea1n ho\u1eb7c \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n<p>\uf075 C\u00e1c guideline th\u1ed1ng nh\u1ea5t 4 nh\u00f3m: l\u1ee3i ti\u1ec3u thiazide, UCMC\/UCTT v\u00e0 ch\u1eb9n canxi l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay cho d\u00e2n s\u1ed1 chung.<\/p>\n<p>\uf075 C\u00e1c t\u1ed5 ch\u1ee9c \u1edf M\u1ef9 b\u00e1c b\u1ecf vai tr\u00f2 ch\u1eb9n beta c\u00f2n Ch\u00e2u \u00c2u, CHEP v\u00e0 Vi\u1ec7t Nam \u1ee7ng h\u1ed9 ch\u1eb9n beta.<\/p>\n<p>\uf075 Hi\u1ec7n t\u1ea1i c\u00f3 nhi\u1ec1u \u0111i\u1ec3m c\u00e1c guideline c\u00f2n nhi\u1ec1u \u0111i\u1ec3m ch\u01b0a th\u1ed1ng nh\u1ea5t. \u0110\u00f4i khi l\u00e0m b\u1ed1i r\u1ed1i c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng<\/p>\n<p>Th\u00e0nh t\u1ef1u l\u1edbn nh\u1ea5t: quan \u0111i\u1ec3m v\u1ec1 ph\u1ed1i h\u1ee3p thu\u1ed1c v\u00e0 ph\u1ed1i h\u1ee3p thu\u1ed1c trong m\u1ed9t vi\u00ean duy nh\u1ea5t. V\u00ec v\u1eady vi\u1ec7c hi\u1ec3u r\u00f5 nguy\u00ean t\u1eafc v\u00e0 ph\u01b0\u01a1ng ph\u00e1p ph\u1ed1i h\u1ee3p thu\u1ed1c trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng.<\/p>\n<p>*Note:<\/p>\n<p>ACC\/AHA : <em><strong>American Heart Association<\/strong><\/em> &#8211; Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3<\/p>\n<p>UCMC: \u1ee9c ch\u1ebf men chuy\u1ec3n<\/p>\n<p>UCTT: \u1ee8c ch\u1ebf th\u1ee5 th\u1ec3<\/p>\n<p>CHEP: Canadian Hypertension Education Program Recommendations<\/p>\n<p>M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p c\u00f3 g\u00ec kh\u00e1c nhau gi\u1eefa c\u00e1c khuy\u1ebfn c\u00e1o?<\/p>\n<p>X\u00e1c \u0111\u1ecbnh m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb huy\u1ebft \u00e1p cho b\u1ec7nh nh\u00e2n l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c do:<\/p>\n<ul>\n<li>\u0110\u00e1nh gi\u00e1 th\u1ea5p c\u00e1c nguy c\u01a1 c\u1ee7a b\u1ec7nh nh\u00e2n .<\/li>\n<li>\u01af\u1edbc l\u01b0\u1ee3ng d\u01b0\u1edbi m\u1ee9c THA th\u1eadt s\u1ef1 c\u1ee7a b\u1ec7nh nh\u00e2n<\/li>\n<li>Ch\u01b0a c\u00f3 s\u1ef1 th\u1ed1ng nh\u1ea5t ch\u1eb7t ch\u1ebd v\u1ec1 kh\u00e1i ni\u1ec7m \u201chuy\u1ebft \u00e1p\u201d v\u00e0 \u201c\u0111\u00edch\u201c \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>Ch\u01b0a t\u01b0 v\u1ea5n k\u1ef9 v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh l\u1ed1i s\u1ed1ng b\u1ec7nh nh\u00e2n<\/li>\n<li>Ch\u01b0a theo d\u00f5i s\u00e1t c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p..<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<table width=\"935\">\n<tbody>\n<tr>\n<td width=\"170\"><strong>\u0110\u00edch BP<\/strong><\/td>\n<td width=\"144\"><strong>JNC-7<\/strong><\/td>\n<td width=\"144\"><strong>JNC-8<\/strong><\/td>\n<td width=\"130\"><strong>ASH\/<\/strong><\/p>\n<p><strong>ISH<\/strong><\/td>\n<td width=\"131\"><strong>ESC\/<\/strong><\/p>\n<p><strong>ESH<\/strong><\/td>\n<td width=\"216\"><strong>CHEP<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"170\">Tu\u1ed5i &lt; 60<\/td>\n<td width=\"144\">&lt;140\/90<\/td>\n<td width=\"144\"><strong>&lt;140\/90<\/strong><\/td>\n<td width=\"130\">&lt;140\/90<\/td>\n<td width=\"131\">&lt;140\/90<\/td>\n<td width=\"216\">&lt;140\/90<\/td>\n<\/tr>\n<tr>\n<td width=\"170\">Tu\u1ed5i 60-79<\/td>\n<td width=\"144\">&lt;140\/90<\/td>\n<td width=\"144\"><strong>&lt;150\/90<\/strong><\/td>\n<td width=\"130\">&lt;140\/90<\/td>\n<td width=\"131\">&lt;140\/90<\/td>\n<td width=\"216\">&lt;140\/90<\/td>\n<\/tr>\n<tr>\n<td width=\"170\">Tu\u1ed5i\u00a0 80+<\/td>\n<td width=\"144\">&lt;140\/90<\/td>\n<td width=\"144\"><strong>&lt;150\/90<\/strong><\/td>\n<td width=\"130\">&lt;150\/90<\/td>\n<td width=\"131\">&lt;150\/90<\/td>\n<td width=\"216\">&lt;150\/90<\/td>\n<\/tr>\n<tr>\n<td width=\"170\">\u0110T\u0110<\/td>\n<td width=\"144\">&lt;130\/80<\/td>\n<td width=\"144\"><strong>&lt;140\/90<\/strong><\/td>\n<td width=\"130\">&lt;140\/90<\/td>\n<td width=\"131\">&lt;140\/85<\/td>\n<td width=\"216\">&lt;130\/80<\/td>\n<\/tr>\n<tr>\n<td width=\"170\">B.Th\u1eadn m\u1ea1n<\/td>\n<td width=\"144\">&lt;130\/80<\/td>\n<td width=\"144\"><strong>&lt;140\/90<\/strong><\/td>\n<td width=\"130\">&lt;140\/90<\/td>\n<td width=\"131\">&lt;130\/90<\/td>\n<td width=\"216\">&lt;140\/90<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>2. C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb\u00a0 v\u00e0 nguy\u00ean t\u1eafc ph\u1ed1i h\u1ee3p thu\u1ed1c t\u0103ng huy\u1ebft \u00e1p<\/h2>\n<p><strong>2.1 C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p hi\u1ec7n c\u00f3<\/strong><\/p>\n<ul>\n<li>Ch\u1eb9n k\u00eanh canxi (CCB)<\/li>\n<li>\u1ee8c ch\u1ebf men chuy\u1ec3n (ACEI)<\/li>\n<li>\u1ee8c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin (ARB)<\/li>\n<li>L\u1ee3i ti\u1ec3u<\/li>\n<li>Gi\u00e3n m\u1ea1ch ngo\u1ea1i vi<\/li>\n<li>Ch\u1eb9n alpha-1<\/li>\n<li>Ch\u1eb9n beta<\/li>\n<li>K\u00edch th\u00edch alpha-2<\/li>\n<li>\u1ee8c ch\u1ebf h\u1ea1ch giao c\u1ea3m<\/li>\n<li>\u1ee8c ch\u1ebf \u0111\u1ea7u t\u1eadn TK giao c\u1ea3m<\/li>\n<\/ul>\n<p>Ph\u1ed1i h\u1ee3p c\u00e1c thu\u1ed1c t\u0103ng huy\u1ebft \u00e1p nh\u01b0 sau:<\/p>\n<p>B\u01b0\u1edbc 1 k\u1ebft h\u1ee3p 2:\u00a0 A + C or D<\/p>\n<p>B\u01b0\u1edbc 2 k\u1ebft h\u1ee3p 3: A+ C + D<\/p>\n<p>B\u01b0\u1edbc 3: k\u1ebft h\u1ee3p 3 Th\u00eam Spironolactone (25-50mg \/ng\u00e0y) Ho\u1eb7c l\u1ee3i ti\u1ec3u kh\u00e1c<\/p>\n<p>Trong \u0111\u00f3:<\/p>\n<p>A: ACEi ho\u1eb7c ARB<\/p>\n<p>B: \u1ee9c ch\u1ebf beta<\/p>\n<p>C: CCB<\/p>\n<p>D: l\u1ee3i ti\u1ec3u<\/p>\n<p><strong>2.2 Nguy\u00ean t\u1eafc:<\/strong><\/p>\n<ul>\n<li>Kh\u00f4ng k\u1ebft h\u1ee3p ACEi v\u1edbi ARB<\/li>\n<li>Kh\u00f4ng d\u00f9ng ACEi ho\u1eb7c ARB \u1edf ph\u1ee5 n\u1eef c\u00f3 thai hay\u00a0 nghi ng\u1edd c\u00f3 thai<\/li>\n<li>S\u1eed d\u1ee5ng \u1ee9c ch\u1ebf Beta khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c,<\/li>\n<\/ul>\n<p>Ph\u1ed1i h\u1ee3p ch\u1eb9n k\u00eanh calci v\u00e0 \u1ee9c ch\u1ebf men chuy\u1ec3n<\/p>\n<p><strong><u>Ch\u1eb9n Calci<\/u><\/strong><\/p>\n<ul>\n<li>Gi\u00e3n ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch<\/li>\n<li>G\u00e2y ph\u00f9 ch\u00e2n<\/li>\n<li>Hi\u1ec7u qu\u1ea3 tr\u00ean BN c\u00f3 renin th\u1ea5p<\/li>\n<li>Gi\u1ea3m thi\u1ebfu m\u00e1u c\u01a1 tim<\/li>\n<li>Ho\u1ea1t h\u00f3a RAS<\/li>\n<li>Kh\u00f4ng c\u00f3 l\u1ee3i \u00edch tr\u00ean BN suy tim, suy th\u1eadn<\/li>\n<\/ul>\n<p><strong><u>\u01afCMC<\/u><\/strong><\/p>\n<ul>\n<li>\u01afc ch\u1ebf h\u1ec7 renin-angiotensin<\/li>\n<li>Ch\u1ed1ng suy tim, hi\u1ec7u qu\u1ea3 tr\u00ean BN suy th\u1eadn<\/li>\n<li>Gi\u00e3n t\u0129nh m\u1ea1ch<\/li>\n<li>Gi\u1ea3m ph\u00f9 ch\u00e2n<\/li>\n<li>Hi\u1ec7u qu\u1ea3 tr\u00ean BN c\u00f3 renin cao<\/li>\n<li>Kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng thi\u1ebfu m\u00e1u c\u01a1 tim<\/li>\n<\/ul>\n<ul>\n<li>Hai thu\u1ed1c n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng hi\u1ec7p \u0111\u1ed3ng<\/li>\n<\/ul>\n<p>Ph\u1ed1i h\u1ee3p c\u00e1c thu\u1ed1c nh\u01b0 th\u1ebf n\u00e0o gi\u1eefa c\u00e1c hi\u1ec7p h\u1ed9i<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"207\">Guideline<\/td>\n<td width=\"207\">\u0110i\u1ec1u tr\u1ecb kh\u1edfi \u0111\u1ea7u<\/td>\n<td width=\"207\">\u0110i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p 2 thu\u1ed1c<\/p>\n<p>&nbsp;<\/td>\n<td width=\"207\">\u0110i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p 3 thu\u1ed1c<\/p>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"207\">JNC 8<\/td>\n<td width=\"207\">&#8211; L\u1ee3i ti\u1ec3u thiazide, Ch\u1eb9n k\u00eanh Canxi,<\/p>\n<p>UCMC ho\u1eb7c UCTT<\/p>\n<p>&#8211; D\u00f9ng \u0111\u01a1n tr\u1ecb<\/p>\n<p>li\u1ec7u ho\u1eb7c k\u1ebft<\/p>\n<p>h\u1ee3p<\/td>\n<td width=\"207\">Th\u00eam 1 thu\u1ed1c t\u1eeb<\/p>\n<p>nh\u00f3m kh\u00e1c: L\u1ee3i<\/p>\n<p>ti\u1ec3u thiazide,<\/p>\n<p>Ch\u1eb9n k\u00eanh<\/p>\n<p>Canxi, UCMC<\/p>\n<p>ho\u1eb7c CTTA<\/td>\n<td width=\"207\">Ch\u1eb9n k\u00eanh canxi<\/p>\n<p>+ Thiazide +<\/p>\n<p>UCMC ho\u1eb7c<\/p>\n<p>CTTA<\/td>\n<\/tr>\n<tr>\n<td width=\"207\">ASH\/ISH<\/td>\n<td width=\"207\">\u0110\u1ed9 1: UCMC<\/p>\n<p>ho\u1eb7c UCTT<\/p>\n<p>&nbsp;<\/p>\n<p>&#8211; \u0110\u1ed9 2: 2 thu\u1ed1c<\/td>\n<td width=\"207\">UCMC ho\u1eb7c<\/p>\n<p>UCTT + Ch\u1eb9n<\/p>\n<p>k\u00eanh canxi ho\u1eb7c<\/p>\n<p>Thiazide<\/td>\n<td width=\"207\">Ch\u1eb9n k\u00eanh canxi<\/p>\n<p>+ Thiazide +<\/p>\n<p>UCMC ho\u1eb7c<\/p>\n<p>CTTA<\/td>\n<\/tr>\n<tr>\n<td width=\"207\">AHA\/ACC\/CDC<\/td>\n<td width=\"207\">&#8211; \u0110\u1ed9 1: Thiazide<\/p>\n<p>cho ph\u1ea7n l\u1edbn<\/p>\n<p>b\u1ec7nh nh\u00e2n ho\u1eb7c<\/p>\n<p>UCMC\/UCTT,<\/p>\n<p>Ch\u1eb9n k\u00eanh Canxi<\/p>\n<p>&nbsp;<\/p>\n<p>&#8211; \u0110\u1ed9 2: Thiazide +<\/p>\n<p>UCMC\/UCTT<\/p>\n<p>ho\u1eb7c Ch\u1eb9n k\u00eanh<\/p>\n<p>canxi ho\u1eb7c<\/p>\n<p>UCMC + Ch\u1eb9n<\/p>\n<p>k\u00eanh Canxi<\/td>\n<td width=\"207\">Th\u00eam 1 thu\u1ed1c<\/p>\n<p>t\u1eeb nh\u00f3m kh\u00e1c,<\/p>\n<p>ho\u1eb7c l\u1ee3i ti\u1ec3u<\/p>\n<p>thiazide, ch\u1eb9n<\/p>\n<p>k\u00eanh Canxi,<\/p>\n<p>UCMC\/UCTT<\/td>\n<td width=\"207\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td width=\"207\">ESH\/ESC<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/td>\n<td width=\"207\">&#8211; \u0110\u1ed9 1: L\u1ee3i ti\u1ec3u,<\/p>\n<p>UCMC, UCTT,<\/p>\n<p>ch\u1eb9n k\u00eanh<\/p>\n<p>canxi ho\u1eb7c<\/p>\n<p>ch\u1eb9n beta<\/p>\n<p>&nbsp;<\/p>\n<p>&#8211; \u0110\u1ed9 2: 2 thu\u1ed1c<\/p>\n<p>&nbsp;<\/td>\n<td width=\"207\">K\u1ebft h\u1ee3p \u01b0u<\/p>\n<p>ti\u00ean:<\/p>\n<p>Thiazide +<\/p>\n<p>UCMC\/UCTT,<\/p>\n<p>Thiazide +<\/p>\n<p>Ch\u1eb9n k\u00eanh<\/p>\n<p>Canxi, Ch\u1eb9n<\/p>\n<p>k\u00eanh Canxi +<\/p>\n<p>UCMC\/UCTT<\/p>\n<p>(kh\u00f4ng k\u1ebft h\u1ee3p<\/p>\n<p>ch\u1eb9n beta)<\/p>\n<p>&nbsp;<\/td>\n<td width=\"207\">Th\u00eam 1 thu\u1ed1c<\/p>\n<p>t\u1eeb nh\u00f3m kh\u00e1c,<\/p>\n<p>ho\u1eb7c l\u1ee3i ti\u1ec3u<\/p>\n<p>thiazide, ch\u1eb9n<\/p>\n<p>k\u00eanh canxi,<\/p>\n<p>UCMC ho\u1eb7c<\/p>\n<p>UCTT<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>D\u00f9 l\u00e0 khuy\u1ebfn c\u00e1o n\u00e0o th\u00ec c\u0169ng t\u1eadp trung tr\u1ea3 l\u1eddi c\u00e1c c\u00e2u h\u1ecfi sau:<\/p>\n<p>-T\u1ea1i sao ph\u1ea3i \u0111i\u1ec1u tr\u1ecb THA (gi\u00fap gi\u1ea3m &gt; 50% suy tim, 35-40% \u0111\u1ed9t qu\u1ef5, 20-25% nh\u1ed3i m\u00e1u c\u01a1 tim) .<\/p>\n<p>-M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb: \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n; N\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n ho\u1eb7c l\u00e0 THA v\u00f4 c\u0103n th\u00ec \u0111i\u1ec1u tr\u1ecb lo\u1ea1i b\u1ecf y\u1ebfu t\u1ed1 nguy c\u01a1, ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p \u0111\u1ec3 ph\u00f2ng bi\u1ebfn ch\u1ee9ng =&gt; M\u1ee5c ti\u00eau \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng \u0111i\u1ec1u tr\u1ecb thu\u1ed1c \/ kh\u00f4ng d\u00f9ng thu\u1ed1c.<\/p>\n<p>&#8211; \u0110\u00edch HA \u0111i\u1ec1u tr\u1ecb l\u00e0 bao nhi\u00eau.(xem ph\u1ea7n 1)<\/p>\n<p>&#8211; Chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u1ebf n\u00e0o? Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng th\u1ebf n\u00e0o? Khi n\u00e0o cho thu\u1ed1c? Cho thu\u1ed1c g\u00ec , nh\u01b0 th\u1ebf n\u00e0o? Ph\u1ed1i h\u1ee3p thu\u1ed1c ra sao?<\/p>\n<p>C\u00e1c ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c: tu\u1ef3 theo ch\u1ec9 \u0111\u1ecbnh m\u00e0 ch\u1ecdn nh\u00f3m thu\u1ed1c.<\/p>\n<p>\uf075 Nh\u00f3m THA \u0111\u01a1n thu\u1ea7n: c\u00e1c guideline \u0111\u1ec1u th\u1ed1ng nh\u1ea5t 4 nh\u00f3m: ch\u1eb9n Ca, \u1ee9c ch\u1ebf men chuy\u1ec3n, \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 v\u00e0 l\u1ee3i ti\u1ec3u l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u. L\u1ee3i \u00edch do ch\u00fang mang l\u1ea1i l\u00e0 do vi\u1ec7c h\u1ea1 \u0111\u01b0\u1ee3c HA ch\u1ee9 kh\u00f4ng ph\u1ea3i do s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa c\u00e1c nh\u00f3m thu\u1ed1c.<\/p>\n<p>\uf075 Ri\u00eang vai tr\u00f2 l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay c\u1ee7a ch\u1eb9n beta: c\u00f2n nhi\u1ec1u b\u00e0n c\u00e3i do n\u00f3 hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 \u0111\u1ed9t qu\u1ef5 k\u00e9m h\u01a1n v\u00e0 l\u00e0m t\u0103ng \u0110T\u0110 m\u1edbi m\u1eafc.<\/p>\n<p>THA kh\u00e1ng tr\u1ecb<\/p>\n<p>&nbsp;<\/p>\n<p>\uf075 \u0110\u1ecb\u1ec1u tr\u1ecb: b\u1ed9 3 chu\u1ea9n: Ch\u1eb9n Ca + UCMC\/UCTT + Clorthalidone.<\/p>\n<p>\uf075 Th\u00eam: \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 aldosterone ho\u1eb7c ch\u1eb9n beta gi\u00e3n m\u1ea1ch (carvedilol, nebivolol,&#8230;).<\/p>\n<p>\uf075 Tri\u1ec7t ph\u00e1 h\u1ea1ch th\u1ea7n kinh giao c\u1ea3m (c\u00f2n \u0111ang nghi\u00ean c\u1ee9u).<\/p>\n<p>\uf075 C\u1ea5y m\u00e1y k\u00edch th\u00edch th\u1ee5 c\u1ea3m th\u1ec3 xoang c\u1ea3nh.<\/p>\n<p>K\u1ebft lu\u1eadn:<\/p>\n<p>C\u00e1c h\u01b0\u1edbng d\u1eabn th\u1ef1c h\u00e0nh (guidelines) hi\u1ec7n nay khuy\u1ebfn c\u00e1o k\u1ebft h\u1ee3p thu\u1ed1c \u1ee9c ch\u1ebf h\u1ec7 renin-angiotensin\/ch\u1eb9n calci\/l\u1ee3i ti\u1ec3u nh\u1eb1m ki\u1ec3m so\u00e1t t\u1ed1t HA v\u00e0 b\u1ea3o v\u1ec7 tim m\u1ea1ch.<\/p>\n<p>L\u1ef1a ch\u1ecdn ph\u1ed1i h\u1ee3p thu\u1ed1c n\u00ean d\u1ef1a tr\u00ean n\u1ec1n t\u1ea3ng nh\u1eefng thu\u1ed1c ri\u00eang r\u1ebd v\u1ed1n c\u00f3 nhi\u1ec1u b\u1eb1ng ch\u1ee9ng v\u1ec1 l\u1ee3i \u00edch l\u00e2m s\u00e0ng nh\u01b0 PERINDOPRIL- AMLODIPIN &#8211; INDAPAMIDE\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0+ Perindopril + Amlodipin\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 : COVERAM\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + Perindopril + Indapamide\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 : COVERSYL PLUS\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + Amlodipin\u00a0\u00a0 + Indapamide\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 : NATRIXAM\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + Perindopril + Amlodipine + Indapamide : TRIPLIXAM.<\/p>\n<p>Ph\u1ed1i h\u1ee3p thu\u1ed1c gi\u00fap:<\/p>\n<p>+Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p ch\u1eb7t ch\u1ebd<\/p>\n<p>+ T\u0103ng tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb<\/p>\n<p>+Gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5<\/p>\n<p>+Gi\u1ea3m chi ph\u00ed.<\/p>\n<p>Xu h\u01b0\u1edbng hi\u1ec7n nay l\u00e0 k\u1ebft h\u1ee3p thu\u1ed1c trong m\u1ed9t vi\u00ean duy nh\u1ea5t (single-pill combination) \u0111\u01b0\u1ee3c nhi\u1ec1u guidlines khuy\u1ebfn c\u00e1o.<\/p>\n<p>Xem th\u00eam: <a href=\"https:\/\/vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/thay-doi-loi-song-co-lam-giam-huyet-ap-cua-ban\/\">Ki\u1ec3m so\u00e1t l\u1ed1i s\u1ed1ng \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u0103ng huy\u1ebft \u00e1p (THA) v\u1eabn l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Hi\u1ec7n nay c\u00e1c khuy\u1ebfn c\u00e1o \u0111\u01b0a ra quan ni\u1ec7m ph\u1ed1i h\u1ee3p thu\u1ed1c THA nh\u1eb1m \u0111\u1ea1t m\u1ee5c ti\u00eau huy\u1ebft \u00e1p \u0111\u00edch v\u00e0 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c.\u00a0 &#8220;Tr\u00ean to\u00e0n c\u1ea7u, b\u1ec7nh tim m\u1ea1ch chi\u1ebfm kho\u1ea3ng 17 tri\u1ec7u ca [&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>Ph\u1ed1i h\u1ee3p thu\u1ed1c t\u0103ng huy\u1ebft \u00e1p: khuy\u1ebfn c\u00e1o t\u1eeb c\u00e1c hi\u1ec7p h\u1ed9i<\/title>\n<meta name=\"description\" content=\"T\u0103ng huy\u1ebft \u00e1p v\u1eabn l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. 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