{"id":35902,"date":"2023-06-30T14:40:21","date_gmt":"2023-06-30T07:40:21","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35902"},"modified":"2023-06-30T14:42:42","modified_gmt":"2023-06-30T07:42:42","slug":"hieu-ro-ve-co-che-thuoc-tri-tang-huyet-ap-tac-dong-va-ung-dung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/30\/hieu-ro-ve-co-che-thuoc-tri-tang-huyet-ap-tac-dong-va-ung-dung\/","title":{"rendered":"Hi\u1ec3u r\u00f5 v\u1ec1 c\u01a1 ch\u1ebf thu\u1ed1c  tr\u1ecb t\u0103ng huy\u1ebft \u00e1p: T\u00e1c \u0111\u1ed9ng v\u00e0 \u1ee9ng d\u1ee5ng"},"content":{"rendered":"<p><strong>Huy\u1ebft \u00e1p (HA) l\u00e0 \u00e1p l\u1ef1c m\u00e1u l\u01b0u th\u00f4ng t\u00e1c \u0111\u1ed9ng l\u00ean th\u00e0nh m\u1ea1ch. \u00a0C\u00e1c th\u00e0nh ph\u1ea7n t\u1ea1o n\u00ean HA: S\u1ee9c b\u00f3p c\u1ee7a tim, Th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n (ti\u1ec1n g\u00e1nh), S\u1ee9c c\u1ea3n th\u00e0nh m\u1ea1ch (h\u1eadu g\u00e1nh). T\u0103ng huy\u1ebft \u00e1p (THA) l\u00e0 khi huy\u1ebft \u00e1p t\u0103ng t\u1edbi m\u1ee9c c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng c\u00e1c c\u01a1 quan \u0111\u00edch nh\u01b0 v\u00f5ng m\u1ea1c, n\u00e3o, tim, th\u1eadn, m\u1ea1ch m\u00e1u l\u1edbn&#8230; C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p c\u00f3 c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng kh\u00e1c nhau d\u1ef1a tr\u00ean s\u1ef1 ph\u1ed1i h\u1ee3p thu\u1ed1c \u0111\u1ec3 \u0111\u1ea1t m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35904 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/70214199-274e-411d-b681-0f859da9b40d-300x300.jpg\" alt=\"co-che-thuoc-tri-tang-huyet-ap\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/70214199-274e-411d-b681-0f859da9b40d-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/70214199-274e-411d-b681-0f859da9b40d-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/70214199-274e-411d-b681-0f859da9b40d-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/70214199-274e-411d-b681-0f859da9b40d.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1. S\u01a1 l\u01b0\u1ee3c v\u1ec1 t\u0103ng huy\u1ebft \u00e1p<\/h2>\n<p>T\u0103ng huy\u1ebft \u00e1p nguy\u00ean ph\u00e1t<\/p>\n<ul>\n<li>Ch\u01b0a r\u00f5 nguy\u00ean nh\u00e2n<\/li>\n<li>Chi\u1ebfm 90% d\u00e2n s\u1ed1 t\u0103ng huy\u1ebft \u00e1p<\/li>\n<\/ul>\n<p>T\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t<\/p>\n<ul>\n<li>Do t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan nh\u01b0 th\u1eadn, n\u1ed9i ti\u1ebft, tim m\u1ea1ch, n\u00e3o \u2026<\/li>\n<li>Chi\u1ebfm 10% d\u00e2n s\u1ed1 t\u0103ng huy\u1ebft \u00e1p<\/li>\n<\/ul>\n<p>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1:<\/p>\n<ul>\n<li>Ti\u1ec1n s\u1eed gia \u0111\u00ecnh b\u1ec7nh tim m\u1ea1ch (\u0111\u00e0n \u00f4ng &lt; 55 tu\u1ed5i, \u0111\u00e0n b\u00e0 &lt; 65 tu\u1ed5i)<\/li>\n<li>H\u00fat thu\u1ed1c<\/li>\n<li>R\u1ed1i lo\u1ea1n lipid<\/li>\n<li>Ti\u1ec3u \u0111\u01b0\u1eddng<\/li>\n<li>Tu\u1ed5i t\u00e1c<\/li>\n<li>Gi\u1edbi t\u00ednh: \u0111\u00e0n \u00f4ng, ph\u1ee5 n\u1eef sau m\u00e3n kinh<\/li>\n<\/ul>\n<p>Bi\u1ebfn ch\u1ee9ng:<\/p>\n<ul>\n<li>B\u1ec7nh tim (ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i, \u0110TN c\u00f3 tr\u01b0\u1edbc, NMCT, suy tim)<\/li>\n<li>\u0110\u1ed9t qu\u1ef5<\/li>\n<li>B\u1ec7nh th\u1eadn<\/li>\n<li>B\u1ec7nh m\u1ea1ch m\u00e1u ngo\u1ea1i bi\u00ean<\/li>\n<li>B\u1ec7nh v\u00f5ng m\u1ea1c<\/li>\n<\/ul>\n<h2>2. Ph\u00e2n lo\u1ea1i v\u00e0 c\u01a1 ch\u1ebf thu\u1ed1c tr\u1ecb t\u0103ng huy\u1ebft \u00e1p:<\/h2>\n<p>\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p: m\u1ee5c ti\u00eau l\u00e0 gi\u1ea3m t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan cu\u1ed1i, gi\u1ea3m bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch -&gt; h\u1ea1 th\u1ea5p t\u1ec9 l\u1ec7 m\u1eafc b\u1ec7nh v\u00e0 t\u1ec9 l\u1ec7 t\u1eed vong<\/p>\n<p>HA m\u1ee5c ti\u00eau:<\/p>\n<ul>\n<li>T\u0103ng HA kh\u00f4ng tri\u1ec7u ch\u1ee9ng &lt; 140\/90 mmHg<\/li>\n<li>Ti\u1ec3u \u0111\u01b0\u1eddng, b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh, b\u1ec7nh m\u1ea1ch v\u00e0nh &lt;130\/80 mmHg<\/li>\n<li>R\u1ed1i lo\u1ea1n th\u1ea5t tr\u00e1i &lt; 120\/80 mmHg<\/li>\n<\/ul>\n<p>\u0110i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c: Gi\u1ea3m c\u00e2n, thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 \u0103n, ti\u1ebft ch\u1ebf u\u1ed1ng r\u01b0\u1ee3u, t\u0103ng v\u1eadn \u0111\u1ed9ng th\u1ec3 l\u1ef1c, \u0103n h\u1ea1n ch\u1ebf mu\u1ed1i, b\u1ecf h\u00fat thu\u1ed1c.<\/p>\n<p>Ph\u00e2n lo\u1ea1i v\u00e0 c\u01a1 ch\u1ebf thu\u1ed1c tr\u1ecb t\u0103ng huy\u1ebft \u00e1p:<\/p>\n<ul>\n<li>Thu\u1ed1c l\u1ee3i ti\u1ec3u: th\u1ea3i natri v\u00e0 n\u01b0\u1edbc n\u00ean l\u00e0m gi\u1ea3m th\u1ec3 t\u00edch m\u00e1u<\/li>\n<li>Thu\u1ed1c li\u1ec7t giao c\u1ea3m: l\u00e0m gi\u1ea3m s\u1ee9c c\u1ea3n ngo\u1ea1i bi\u00ean, gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng tim do \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng tim v\u00e0 g\u00e2y \u1ee9 tr\u1ec7 m\u00e1u trong t\u0129nh m\u1ea1ch<\/li>\n<li>Thu\u1ed1c gi\u00e3n m\u1ea1ch: l\u00e0m gi\u1ea3m s\u1ee9c c\u1ea3n ngo\u1ea1i bi\u00ean, g\u00e2y \u1ee9 tr\u1ec7 m\u00e1u trong t\u0129nh m\u1ea1ch, ch\u1ec9 c\u00f3 nitroprussid gi\u00e3n c\u1ea3 ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch c\u00f2n l\u1ea1i ch\u1ec9 gi\u00e3n ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch.<\/li>\n<li>Thu\u1ed1c t\u00e1c \u0111\u1ed9ng tr\u00ean h\u1ec7 RAA: \u1ee9c ch\u1ebf s\u1ea3n sinh angiotensin hay \u0111\u1ed1i kh\u00e1ng angiotensin t\u1ea1i receptor.\n<ul>\n<li>Thu\u1ed1c l\u1ee3i ti\u1ec3u<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>2.1.1 THU\u1ed0C L\u1ee2I TI\u1ec2U THIAZID: hydrochlorothiazid, chlorthalidon, indapamid<\/p>\n<p>C\u01a1 ch\u1ebf: \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu Na+ v\u00e0 Cl- \u1edf \u1ed1ng l\u01b0\u1ee3n xa<\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n<ul>\n<li>T\u0103ng huy\u1ebft \u00e1p<\/li>\n<li>Ph\u00f9 do suy tim sung huy\u1ebft gan, th\u1eadn<\/li>\n<li>Tr\u1ecb \u0111\u00e1i th\u00e1o nh\u1ea1t<\/li>\n<\/ul>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5: gi\u1ea3m Na huy\u1ebft, gi\u1ea3m kali huy\u1ebft (lo\u1ea1n nh\u1ecbp \ud83e\udc6a li\u1ec1u nh\u1ecf, ph\u1ed1i h\u1ee3p LT ti\u1ebft ki\u1ec7m K+\u2026), t\u0103ng acid uric huy\u1ebft, t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft (\u0111i\u1ec1u\u00a0 ch\u1ec9nh ch\u1ebf \u0111\u1ed9 \u0103n, insulin ho\u1eb7c thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft), t\u0103ng cholesterol huy\u1ebft (\u0103n ki\u00eang m\u1ee1 b\u00e3o h\u00f2a v\u00e0 cholesterol), t\u0103ng calci huy\u1ebft.<\/p>\n<p>2.1.2 L\u1ee2I TI\u1ec2U QUAI: furosemid, bumetamid, torsemid<\/p>\n<ul>\n<li>C\u01a1 ch\u1ebf: \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu Na+ K+ Cl- \u1edf ph\u1ea7n d\u00e0y nh\u00e1nh l\u00ean quai Henle.<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: l\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u m\u1ea1nh v\u00e0 ng\u1eafn h\u1ea1n. Tr\u1ecb t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng c\u00f3 \u1ee9 n\u01b0\u1edbc v\u00e0 natri nhi\u1ec1u (thiazid v\u00e0 spironolacton kh\u00f4ng hi\u1ec7u qu\u1ea3).<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: gi\u1ed1ng thiazid tr\u1eeb gi\u1ea3m calci huy\u1ebft.<\/li>\n<\/ul>\n<p>2.1.3 THU\u1ed0C L\u1ee2I TI\u1ec2U TH\u1ea8M TH\u1ea4U: manitol, ure, glycerin<\/p>\n<p>C\u01a1 ch\u1ebf: gi\u1ea3m t\u00e1i h\u1ea5p thu th\u1ee5 \u0111\u1ed9ng n\u01b0\u1edbc v\u00e0 Na+ \u1edf \u1ed1ng l\u01b0\u1ee3n g\u1ea7n v\u00e0 quai Henle.<\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n<ul>\n<li>Ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u01b0\u1edbc \u0111\u1ea7u suy th\u1eadn c\u1ea5p<\/li>\n<li>Gi\u1ea3m \u00e1p su\u1ea5t v\u00e0 th\u1ec3 t\u00edch d\u1ecbch n\u00e3o t\u1ee7y tr\u01b0\u1edbc v\u00e0 sau ph\u1eabu thu\u1eadt<\/li>\n<li>Tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea5t c\u00e2n b\u1eb1ng do th\u1ea9m ph\u00e2n.<\/li>\n<\/ul>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5: b\u00e0nh tr\u01b0\u1edbng t\u1ea1m th\u1eddi d\u1ecbch ngo\u1ea1i b\u00e0o, nh\u1ee9c \u0111\u1ea7u, bu\u1ed3n n\u00f4n, \u00f3i m\u1eeda.<\/p>\n<p>2.1.4 THU\u1ed0C L\u1ee2I TI\u1ec2U \u1ee8C CH\u1ebe CARBONIC ANHYDRASE: acetazolamid, diclophenamid, methazolamid.<\/p>\n<ul>\n<li>Ch\u1ec9 \u0111\u1ecbnh: Tr\u1ecb t\u0103ng nh\u00e3n \u00e1p (gi\u1ea3m t\u1ea1o th\u1ee7y d\u1ecbch)<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: l\u00e0m n\u1eb7ng th\u00eam nhi\u1ec5m acid chuy\u1ec3n h\u00f3a hay acid h\u00f4 h\u1ea5p.<\/li>\n<\/ul>\n<p>2.1.5 L\u1ee2I TI\u1ec2U TI\u1ebeT KI\u1ec6M KALI: spironolacton, triamteren, amilorid<\/p>\n<ul>\n<li>C\u01a1 ch\u1ebf: Spironolacton c\u1ea1nh tranh aldosteron t\u1ea1i receptor \u1edf \u1ed1ng l\u01b0\u1ee3n xa v\u00e0 \u1ed1ng thu \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu Na+ v\u00e0 b\u00e0i ti\u1ebft K+.<\/li>\n<\/ul>\n<p>Triamteren, amilorid \u1ee9c ch\u1ebf k\u00eanh Na+ \u1edf \u1ed1ng thu v\u00e0 \u1ed1ng u\u1ed1n xa n\u00ean gi\u1ea3m t\u00e1i h\u1ea5p thu Na+<\/p>\n<ul>\n<li>Ch\u1ec9 \u0111\u1ecbnh: ph\u1ed1i h\u1ee3p thu\u1ed1c LT m\u1ea5t K+ \u0111\u1ec3 \u0111i\u1ec1u h\u00f2a n\u1ed3ng \u0111\u1ed9 K+ huy\u1ebft.<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: t\u0103ng K+ huy\u1ebft tr\u00e1nh d\u00f9ng chung thu\u1ed1c t\u0103ng K+ huy\u1ebft ACEI, \u03b2-blocker, NSAIDs.<\/li>\n<\/ul>\n<p>2.2 THU\u1ed0C \u03b2-BLOCKER<\/p>\n<ul>\n<li>Bao g\u1ed3m: Propranolol, atenolol, nadolol, esmolol, carvedilol, metoprolol, acebutolol, bisoprolol, labetalol.<\/li>\n<\/ul>\n<p>C\u01a1 ch\u1ebf:<\/p>\n<ul>\n<li>Gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng tim do gi\u1ea3m d\u1eabn truy\u1ec1n v\u00e0 gi\u1ea3m co b\u00f3p c\u01a1 tim<\/li>\n<li>Gi\u1ea3m ti\u1ebft renin (h\u1ec7 giao c\u1ea3m)<\/li>\n<li>Gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c giao c\u1ea3m trung \u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n<ul>\n<li>Sau NMCT c\u1ea5p v\u00e0 STSH \u0111\u00e3 \u1ed5n \u0111\u1ecbnh<\/li>\n<li>Ki\u1ec3m so\u00e1t nh\u1ecbp tim, \u0110TN<\/li>\n<\/ul>\n<p>Ch\u00fa \u00fd: \u03b2-blocker d\u00f9ng sau l\u1ee3i ti\u1ec3u thiazid, CCB, ACEI\/ARB<\/p>\n<p>2.3 THU\u1ed0C ACEI<\/p>\n<p>Bao g\u1ed3m: Captopril, analapril, lisinopril<\/p>\n<ul>\n<li>\u1ee8c ch\u1ebf tr\u1ef1c ti\u1ebfp renin<\/li>\n<li>C\u01a1 ch\u1ebf: Gi\u1ea3m ch\u1ea5t co m\u1ea1ch angiotensin v\u00e0 gi\u1ea3m ti\u1ebft aldosteron (gi\u1eef mu\u1ed1i v\u00e0 n\u01b0\u1edbc)<\/li>\n<li>T\u00e1c d\u1ee5ng tr\u1ef1c ti\u1ebfp l\u00ean c\u01a1 tim ng\u0103n ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i<\/li>\n<li>Ch\u1eadm ti\u1ebfn tri\u1ec3n b\u1ec7nh th\u1eadn do ti\u1ec3u \u0111\u01b0\u1eddng v\u00e0 b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh nh\u01b0 x\u01a1 h\u00f3a c\u1ea7u th\u1eadn.<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: THA k\u00e9m ti\u1ec3u \u0111\u01b0\u1eddng, suy tim \u1ee9 m\u00e1u m\u1ea1n<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: h\u1ea1 HA n\u1eb7ng khi d\u00f9ng li\u1ec1u \u0111\u1ea7u, ho khan<\/li>\n<\/ul>\n<p>2.4 THU\u1ed0C ARB<\/p>\n<ul>\n<li>Bao g\u1ed3m: Losartan, valsartan, irbesartan, telmosartan, candesartan<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: t\u01b0\u01a1ng t\u1ef1 ACEI, d\u00f9ng thay th\u1ebf ACEi khi b\u1ecb ho khan<\/li>\n<\/ul>\n<p>C\u00f3 2 lo\u1ea1i receptor angiotensin II:<\/p>\n<ul>\n<li>AT1: co m\u1ea1ch, k\u00edch th\u00edch giao c\u1ea3m, ph\u00ec \u0111\u1ea1i t\u1ebf b\u00e0o<\/li>\n<li>AT2: gi\u00e3n m\u1ea1ch, ch\u1ed1ng t\u0103ng sinh, s\u1eeda ch\u1eefa m\u00f4, ch\u1ed1ng ph\u00ec \u0111\u1ea1i tim<\/li>\n<\/ul>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5: gi\u1ea3m HA l\u00fac \u0111\u1ea7u, suy th\u1eadn, t\u0103ng K+ huy\u1ebft, ph\u00f9 m\u1ea1ch v\u00e0 ho khan \u00edt h\u01a1n ACEI<\/p>\n<p>2.5 THU\u1ed0C \u1ee8C CH\u1ebe K\u00caNH CALCI<\/p>\n<ul>\n<li>Nh\u00f3m dihydropyridin: Nifedipin, amlodipin \u2026.<\/li>\n<li>Nh\u00f3m non-dihydropyridin: verapamil, diltiazem<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: t\u0103ng huy\u1ebft \u00e1p, \u0111au th\u1eaft ng\u1ef1c, suy tim r\u1ed1i lo\u1ea1n t\u00e2m tr\u01b0\u01a1ng<\/li>\n<\/ul>\n<p>CCB th\u00edch h\u1ee3p\u00a0 cho b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 tu\u00e2n th\u1ee7 \u0103n ki\u00eang mu\u1ed1i.<\/p>\n<p>CCB th\u00edch h\u1ee3p ng\u01b0\u1eddi tr\u1ecb b\u1eb1ng NSAIDs<\/p>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5: nh\u1ee9c \u0111\u1ea7u, \u0111\u1ecf b\u1eebng m\u1eb7t, ch\u00f3ng m\u1eb7t, t\u00e1o b\u00f3n (verapamil &#8211; ng\u01b0\u1eddi gi\u00e0).<\/p>\n<p>2.6 THU\u1ed0C \u03b11-BLOCKER<\/p>\n<ul>\n<li>Prazosin, terazosin, dosazosin<\/li>\n<li>C\u01a1 ch\u1ebf: \u1ee9c ch\u1ebf \u03b11-adrenergic l\u00e0m gi\u00e3n m\u1ea1ch, gi\u1ea3m s\u1ee9c c\u1ea3n ngo\u1ea1i bi\u00ean<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: THA k\u00e8m ph\u00ec \u0111\u1ea1i tuy\u1ebfn ti\u1ec1n li\u1ec7t, ti\u1ec3u kh\u00f3, t\u0103ng lipid huy\u1ebft<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: h\u1ea1 huy\u1ebft \u00e1p th\u1ebf \u0111\u1ee9ng li\u1ec1u \u0111\u1ea7u (u\u1ed1ng l\u00fac \u0111i ng\u1ee7), ch\u00f3ng m\u1eb7t, nh\u1ee9c \u0111\u1ea7u, tim nhanh, t\u00e1o b\u00f3n.<\/li>\n<\/ul>\n<p>2.7 THU\u1ed0C \u03b1,\u03b2-BLOCER: Labetalol<\/p>\n<ul>\n<li>Ch\u1ec9 \u0111\u1ecbnh: t\u0103ng huy\u1ebft \u00e1p do u t\u1ee7y th\u01b0\u1ee3ng th\u1eadn, t\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: h\u1ea1 HA th\u1ebf \u0111\u1ee9ng, suy tim sung huy\u1ebft, bu\u1ed3n ng\u1ee7, ch\u00f3ng m\u1eb7t, m\u1ec7t m\u1ecfi<\/li>\n<li>Carvedilol<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: THA, THA k\u00e8m suy tim<\/li>\n<\/ul>\n<p>2.8 THU\u1ed0C \u1ee8C CH\u1ebe GIAO C\u1ea2M TW<\/p>\n<ul>\n<li>Bao g\u1ed3m: Methyldopa, clonidin, guanadrel<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: Methyldopa tr\u1ecb THA k\u00e8m suy th\u1eadn, mang thai, thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9\n<ul>\n<li>clonidin k\u00e8m cai thu\u1ed1c l\u00e1, r\u01b0\u1ee3u, t\u0103ng HA kh\u00e1ng tr\u1ecb. \u00cdt d\u00f9ng v\u00ec thi\u1ebfu d\u1eef ki\u1ec7n l\u00e0m gi\u1ea3m nguy c\u01a1 tim m\u1ea1ch<\/li>\n<\/ul>\n<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: an th\u1ea7n, kh\u00f4 mi\u1ec7ng, t\u00e1o b\u00f3n, b\u00ed ti\u1ec3u .<\/li>\n<\/ul>\n<h2>3. \u0110i\u1ec1u tr\u1ecb nh\u01b0 th\u1ebf n\u00e0o<\/h2>\n<p>C\u00f3 5 trong thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ecdn kh\u1edfi \u0111\u1ea7u theo ESC 2018 (ACE-I\/ARBs, BB, CCB, l\u1ee3i ti\u1ec3u thiazide); C\u00f2n theo JNC-8 th\u00ec thu\u1ed1c kh\u1edfi tr\u1ecb kh\u00f4ng ch\u1ecdn BB.<\/p>\n<p>&#8211; Theo JNC-7: 5 nh\u00f3m, v\u00e0 thiazide l\u00e0 \u0111\u1ea7u tay n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh. Ch\u1ec9 \u0111\u1ecbnh theo c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo.<\/p>\n<p>&#8211; Theo: JNC -8 : L\u1ef1a ch\u1ecdn \u0111\u1ea7u tay trong 4 nh\u00f3m: l\u1ee3i ti\u1ec3u, CCB, ACE-I, ARB. Ch\u1ec9 \u0111\u1ecbnh d\u1ef1a tr\u00ean r\u00e0 so\u00e1t CKD, ti\u1ec1u \u0111\u01b0\u1eddng, ch\u1ee7ng t\u1ed9c.<\/p>\n<p>Xem th\u00eam: (ch\u00e8n link sau khi xu\u1ea5t b\u1ea3n): <a href=\"https:\/\/docs.google.com\/document\/d\/1g_3H-FbJAalDYXCIVFAYSYaExaqKx7V9MEq3OFiKICk\/edit?usp=sharing\">\u0110i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng v\u00e0 ch\u1ebf \u0111\u1ed9 d\u00f9ng c\u1ee7a d\u01b0\u1ee3c ph\u1ea9m h\u1ea1 huy\u1ebft \u00e1p: Nguy\u00ean t\u1eafc v\u00e0 ph\u01b0\u01a1ng ph\u00e1p<\/a><\/p>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o: b<\/strong>\u00e0i gi\u1ea3ng D\u01b0\u1ee3c l\u00fd h\u1ecdc &#8211; \u0110HYD TPHCM<\/p>\n<p><strong>Tags: #Tim m\u1ea1ch h\u1ecdc,#D\u01b0\u1ee3c l\u00fd h\u1ecdc,#T\u0103ng huy\u1ebft \u00e1p,#C\u01a1 ch\u1ebf thu\u1ed1c tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Huy\u1ebft \u00e1p (HA) l\u00e0 \u00e1p l\u1ef1c m\u00e1u l\u01b0u th\u00f4ng t\u00e1c \u0111\u1ed9ng l\u00ean th\u00e0nh m\u1ea1ch. \u00a0C\u00e1c th\u00e0nh ph\u1ea7n t\u1ea1o n\u00ean HA: S\u1ee9c b\u00f3p c\u1ee7a tim, Th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n (ti\u1ec1n g\u00e1nh), S\u1ee9c c\u1ea3n th\u00e0nh m\u1ea1ch (h\u1eadu g\u00e1nh). T\u0103ng huy\u1ebft \u00e1p (THA) l\u00e0 khi huy\u1ebft \u00e1p t\u0103ng t\u1edbi m\u1ee9c c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng c\u00e1c c\u01a1 [&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>Hi\u1ec3u r\u00f5 v\u1ec1 c\u01a1 ch\u1ebf thu\u1ed1c tr\u1ecb t\u0103ng huy\u1ebft \u00e1p: T\u00e1c \u0111\u1ed9ng v\u00e0 \u1ee9ng d\u1ee5ng - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p c\u00f3 c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng kh\u00e1c nhau d\u1ef1a tr\u00ean s\u1ef1 ph\u1ed1i h\u1ee3p thu\u1ed1c \u0111\u1ec3 \u0111\u1ea1t m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hi\u1ec3u r\u00f5 v\u1ec1 c\u01a1 ch\u1ebf thu\u1ed1c tr\u1ecb t\u0103ng huy\u1ebft \u00e1p: T\u00e1c \u0111\u1ed9ng v\u00e0 \u1ee9ng d\u1ee5ng - 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