Post 9 : Thisen-Sâng/BP Sâng (Hypertension)

Thisen sâng chu engnge? 

Thisen sâng hi Mizo ṭawnga hrilhfiah han tum chhin ila:  Lungin thisen a ‘pump’ chhuah hian taksa bung hrang hrangah thisen zâm kal tlangin thisen a pe a. Chung thisen zâm chhunga “pressure”  chu a nih tûr aia a lo sân hian thisen-sâng  an ti ṭhin a ni.  Thisen sân leh sân loh (blood pressure=BP)  tehna hi “BP Apparatus” (Sphignomanometer) an ti a. BP chhinchhiahnaa a sâng lam hi “Systolic pressure” an ti a, a hniam lam hi “Diastolic pressure” an ti  thung.  Khawvêl ram hrang hrangah thisen-sâng  sawifiah dân a dang hret hret thei a,  British Hypertension Society hovin an hrilhfiah dân chu hetiang hi a ni:

A pangngaia ngaih chin	Systolic (mmHg)	Diastolic(mmHg)
*duhthusâm	<120	<80
*Ṭha pangngai	<130	<85
*Ṭha thawkhat	130-139	85-89
Thisen-sâng
*Grade 1 (mild)	140-149	90-99
*Grade 2 (moderate)	160-179	100-109
*Grade 3 (severe)	> 180	> 110
Systolic chauh sâng (Isolated systolic hypertension)
*Grade 1	140-149	<90
*Grade 2	> 160	<90

Thisen-sâng chu engtia lo awm nge?  

BP sâng zinga 90% emaw lai hi a chhan hriat mai  loh an ni a, hetiang BP sâng hi  ‘Essential Hypertension’  an ti.  A chhan puh tûr awm ho hi “Secondary Hypertension” an ti thung.

Essential Hypertension hi a chhan chiah hriat loh ni mahse hêng a hnuaia mite hi a kaihhnawih tih chu hriat a ni:

·         Genetic (pianpui):  BP sâng hi chhungkuaah leh thlah chhâwng hovah a awm duh bîk an ti.

·         Pian tirha rihna hniam (low birth weight): Heng ho hian puitlin hnuah BP sâng an nei duh bîk nia chhût a ni.

·         Thau lutuk: An zingah BP sâng nei an tam bîk.

·         Zu in tam : zu in tam ho zingah BP sâng an tam. Amaherawhchu, tlêm tlêma in ṭhin ho chu mi pangngai aiin an BP a hniam thei thung.

·         Chi al ei tam: BP sâng leh chi al ei tam hi an inlaichîn bawk.

·         Zun thlum (diabetes) kaihhnawih: BP sâng leh zun thlum hi a inkawp duh viau bawk.

Secondary Hypertension  awmtirtu pawimawh zualte chu:

·         Kal (kidneys) ṭha lo:  BP sâng chhan hriat zinga 80% chuang hi kal lam ṭhat loh vâng a ni.

·         Kawchhûng lam ‘gland’ (Endocrine glands) dik lohna:

o   Conn’s syndrome

o   Cushing’s syndrome

o   Adrenal hyperplasia

o   Pheochromocytoma, adt.

·         Damdawi ṭhenkhat – na chhâwkna chi khat NSAIDs an tih ho te, chhang khâtna (oral pills) te, steroids leh adt.

·         Naupai laiin BP a sâng  thei bawk.

·         Pianpui lung/thisen zâm  ṭha lo – Coarctation of aorta.

Thisen sâng chu engtinnge a lo lanchhuah ṭhin?  Thisen a sâng hle a nih loh chuan taksaah insawisêlna êm êm a awm lo fo ṭhin. Chuvangin, kum 40 vêl kai tawh tân chuan a khât tâwka BP check fo a ṭha.  Mi ṭhenkhat chu an BP sâng mahse anmahni hriat dânah engmah harsatna an neih loh chuan inenkawl vak pawh ṭûl lovin an hria a, hei hi thil âtthlak leh hlauhawm tak a ni.  Vawilehkhatah Stroke emaw lungphu châwl (heart attack) emaw an nei thut thei a ni.  

Thisen sâng a nasat viau erawh chuan lu nâ, lu hai, mit vai ruai angtein a langchhuak thei.

Thisen sâng pawikhawih theih lâr zualte (Complications):

·         Stroke: Thisen sâng nei zingah Stroke hi a lêt rukin a tam.

·         Lungphu châwl: Thisen sâng ho zingah hian mi pangngai aiin a lêt thumin lungphu châwla thi an tam.

·         Kal nâ: Kal lam ṭha lo hian BP sâng a siam thei ang bawkin BP sâng hrim hrim hian kal ṭha lo a siam thei bawk.

·         Kut leh ke hmâwr lam thisen kal ṭha lo a thlen thei bawk.

‘Malignant Hypertension’ :  Thisen sâng nasa tak, ‘Diastolic BP’ pawh 120 leh a aia sâng sawina a ni.  Mit a khawih chhe tel a, lu nâ, lu hai leh mit khaw hmuh fiah lo tein a lang chhuak fo ṭhin. Rang taka enkawl nghâl loh chuan za zêla 90 vêl laiin kum 1 chhûngin an thihpui ṭhin.

Test tih ngaite:  Thisen sâng awmtîrtu chhui chhuah nan Test chi hrang hrang doctor-in an râwn ṭhin. A tlangpuiin hengte hi i test a ngai ang:

·         Thisen:   urea, electrolytes, creatinine, glucose, cholesterol.

·         Zun:  sugar, protein, RBCs, adt.

·         ECG/ECHO – lung lam enna

·         Ultrasound – a bîk takin kal (kidneys) en nân

·         Fundoscopy – mit chhûng lam enna

A enkawl dan:  Thisen sâng a nasa hle a nih loh chuan a tîrah damdawi ei nghâl mai tûr a ni lo.  BP chu eng ang chiaha sâng nge tih enfiah hmasak zet a ṭûl a, ni khat chhûngin a danglam em tih te an enfiah bawk ṭhin. Ram changkângah chuan nilênga (24 hours) BP endikna hmanrua te an nei.

BP tisângtu taksaah natna dang a awm leh awm loh enfiah pahin, damdawi tel lova inenkawl  hmasak phawt a ṭha a, a hnuaia mi ang hian tih a ṭangkai:

·         Rihna tihhniam

·         Thau lam ei tlêm

·         Chi al ei tlêm

·         Zu in tlêm

·         Mei zûk bânsan

·         Exercise – ni tin minit 30 chhûng tal kêa kal tûr

·         Thei leh thlai hring ei tam

Damdawi hmanga enkawlna:  BP sân dâna zirin damdawi pêk tûr doctor-in a ruahman ang. A tlangpuiin:

Ø  BP 160/100 vêl a nih reng chuan damdawi ei ṭan tur a ni.

Ø  BP  a sâng lam (systolic) 140 aṭanga 159 inkâr leh a hniam lam (diastolic) 90 aṭanga  99 inkâr ho hi chu zun thlum emaw natna dang an neih chuan damdawi ei ṭan tho tur a ni. Natna dang an neih lêm loh chuan la enthlâk rih deuh a pawi lo.

Ø  Damdawia enkawlnain a tum chu:  BP 140/85 aia hniama dah a ni a, zun thlum vei erawh chu BP 130/80 aia hniama dah a ṭha.

Ø  Thisen sâng nei tam ber chuan damdawi chi hnih emaw a aia tam emaw an mamawh thei bawk.

In lama inenkawl dân:  Thisen sâng enkawlnaah hian a veitu inpêkna leh tumruhna a pawimawh hle. Thisen sâng tam ber hi natna dang angin  ‘dam hlen’ chi a ni ve lo va, damdawi leh thil danga dam chhûng inenkawl ngai a ni tih hi hriat hmasak phawt a ṭûl. Inenkawl nguna BP a pangngaia dah reng theih erawh chuan mi dam ṭha pangngai ang tho kan ni thei tih hre bawk ila.

Doctor-in damdawi a chawh rêng rêng kha dik taka ei tur a ni a, damdawi ei veleh thisen kha a hniam nghâl sawt sawt dawn lo va, damdawi hnathawh lan nan hun engemaw chen a duh ṭhin tih hriat a pawimawh bawk. Chuvangin, ni hnih khat hnuah kan BP a hniam nghâl mai lo a nih pawhin damdawi kha ei zawm zêl tho tur a ni.

BP hi mahni pawhin inen harsa lo tak a ni a, a hmanrua mahniin neih theih phei chuan a ṭha leh zual.  Damdawi rêng rêng hian side-effect an nei vek a, chuvangin, damdawi ei hnuah emaw ei laiin emaw insawisêlna neih chuan  doctor râwn thuai tur a ni. 

Inenkawlna chungchângah engemaw hriat thiam loh neih chuan doctor zawh fiah hreh loh tur a ni a, damloin a inenkawlna chungchâng engkim a hriat thiam ve chuan amahah ṭan nasa takin a la ve thei a, a damna turin phûr takin a thawk ve thei dâwn a ni.  A tawp berah chuan BP sâng enkawlnaah hian chhungkuaa ṭan tlân a pawimawh êm êm tih i hria ang u.