Gabatarwa:
Ciwon hawan jini cuta ce babba wadda ke yawan haddasa ciwon zuciya. Hukumar lafiya ta duniya (WHO) ta Æ™iyasta cewa mutane biliyan É—aya da É—igo ashirin da takwas (1.28 billion) waÉ—anda ke tsakanin shekara talatin (30) zuwa saba'in da tara (79) suna fama da wannan cutar ta hawan jini. Fiye da kashi biyu cikin uku (2/3) na mutanen suna zaune ne a Æ™asashen da ke da Æ™arancin cigaba ta hanayar tattalin arziki[¹].
Mene ne hawan jini?
A lokacin da jini yake gudana a cikin jijiyoyi masu ɗaukar jini, yana gudana ne da ƙarfi tare da sanya matsin lamba akan bangon jijiyoyin. Hawan jini yana faruwa ne a lokacin da ƙarfin gudanar jini tare da sanya matsin lambar akan bangon jijiyoyin jini ya wuce adadin da ake buƙata.
Matsin lambar da jini yake sanyawa akan jijiyoyi a lokacin da zuciya ke bugawa yafi tsanani bisa ga wanda ta ke sanyawa a lokacin da take hutawa domin karÉ“ar jini. Haka zalika, matsin lambar a cikin jijiyoyi masu É—aukar jini daga zuciya zuwa sauran sassan jiki yafi tsanani bisa ga na jijiyoyi masu mayar da jini daga sauran sassan jiki zuwa zuciya[²].
Matsakaici kuma lafiyayyen adadin matsin lambar da ake buƙata a cikin jijiyoyi masu ɗaukar jini daga zuciya zuwa sauran sassan jiki shi ne ɗari da ashirin (120mmHg) a lokacin da zuciya ta ke bugawa domin harba jini zuwa sassan jiki da kuma tamanin (80mmHg) a lokacin da zuciya ke hutawa domin karɓar jini daga sauran sassan jiki.
Wannan shi ne lafiyayyen adadi na manyan mutane, ana rubuta shi kamar haka, 120/80mmHg (120 shi ne matsin lambar jini a lokacin da zuciya ke bugawa, 80 shi ne matsin lambar jini a lokacin da zuciya ke hutawa, mmHg - wani ma'auni ne da ake amfani da shi wajen auna matsin lambar)[²].
A Æ™a'idance hukumar lafiya ta duniya ta Æ™ayyade cewa ciwon hawan jini yana faruwa ne yayin da matsin lambar jini a lokacin da zuciya ke bugawa domin watsa jini zuwa sauran sassan jiki yakai kimanin É—ari da arba'in (140mmHg) ko kuma matsin lambar jini a lokacin da zuciya ke hutawa domin karÉ“ar jini daga sassan jiki yakai kimanin chas'in (90mmHg) bayan aunawa da bai kasa sau biyu ba a ranaku daban-daban[²][³].
Kashe-kashen ciwon hawan jini
Dangane da abubuwan da ke kawo ciwon hawan jini, masana sun kasa ciwon hawan jini zuwa kashi biyu (2) kamar haka:
1. Kashi na farko (primary hypertension) shi ne hawan jinin da babu wanda yasan takamammen abin da ke kawo shi. Hawan jinin yana faruwa ne kawai ba tare da wata cuta ta kawo shi ba. Likitoci zasuyi iya binciken su amma baza su gano asalin hawan jinin ba, abu ɗaya za'a iya alaƙanta shi dashi, wanda shi ne gado.
2. Hawan jini kashi na biyu ( Secondary hypertension) wannan shi ne akan iya gane takamammen abinda ya kawo hawan jinin. Wannan hawan jinin ya kan zo ne sakamakon wata cuta da tayi wa mutum illa a jiki.
Wane irin cuta ne ke kawo hawan jini?
Cututtukan da ke kawo hawan jini sun haÉ—a da:
A. Ciwon ƙoda
B. Ciwon suga
C. Sanƙarar gland dake saman ƙoda
D. Ciwon sickler
E. Toshewar numfashi da ke faruwa lokacin bacci (obstructive sleep apnea).
F. Matsalar jijiyoyin jini da ake haihuwar mutum da ita.
G. Matsalar daidaituwar wasu sinadaran jiki kamar irin su
- Pheochromocytoma - Cutar na faruwa ne saboda yawaitar sinadarin adrenaline da noradrenaline a cikin jinin mutum
- Thyrotoxicosis - Cutar na faruwa ne saboda yawaitar sinadarin thyroid a cikin jinin mutum
- Cushing's syndrome - Cutar na faruwa ne saboda yawaitar sinadarin cortisol a cikin jinin mutum
- Conn's disease - Cutar na faruwa ne saboda yawaitar sinadarin aldosterone a cikin jinin mutum
- Secondary hyperaldosteronism - Cutar na faruwa ne saboda yawaitar sinadarin aldosterone a cikin jinin mutum
- Congenital adrenal hyperplasia - Cutar na faruwa ne saboda rashin wata sindarin enzyme da ake kira 21-hydroxylase
- Hyperparathyroidism - Cutar na faruwa ne saboda yawaitar sinadarin parathyroid hormone a cikin jinin mutum
- Acromegaly - Cutar na faruwa ne saboda yawaitar sinadarin girman jiki (Growth hormone) a cikin jinin mutum
Ayi haÆ™uri mun lissafo cututtuka da dama a sama ba tare da dogon bayanin su da hausa ba. Bayanin su zai É—auki lokaci mai tsawo da rubutu mai yawa saboda ko wace cuta ce mai zaman kanta. Amma dukan cututtukan suna faruwa ne saboda Æ™aruwar wani sindari a jikin mutum[³].
Dangane da tsananin hawan jini masana sun raba hawan jini zuwa:
1. Grade I: Wannan shi ne hawan jini mai sauƙi, ya ƙunshi matsin lambar jini a lokacin bugawar zuciya tsakanin ɗari da arba'in zuwa ɗari da hamsin da tara (140 - 159mmHg). Ko kuma matsin lambar jini yayin da zuciya ke hutawa tsakanin chas'in zuwa chas'in da tara (90 - 99mmHg).
2. Grade II: Wannan shi ne hawan jini matsakaici, ya ƙunshi matsin lambar jini a lokacin bugawar zuciya tsakanin ɗari da sittin zuwa ɗari da saba'in da tara (160 - 179mmHg). Ko kuma matsin lambar jini yayin da zuciya ke hutawa tsakanin ɗari zuwa ɗari da tara (100 - 109mmHg).
3. Grade III: Wannan shi ne hawan jini mai tsanani, shi ne ya ƙunshi matsin lambar jini yayin da zuciya ke bugawa daga ɗari da tamanin zuwa abinda yayi sama (180mmHg and above). Ko kuma matsin lambar jini yayin da zuciya ke hutawa daga ɗari da goma zuwa sama.
A lura cewa ana iya samun matsin lambar jini a lokacin da zuciya ke bugawa yayi sama sosai amma matsin lambar a lokacin da zuciya ke hutawa yana nan lafiya lau, wannan shi bature ke kira 'isolated systolic hypertension'.
Haka zalika ana iya samun matsin lambar jini a lokacin da zuciya ke bugawa lafiya lau amma matsin lambar jini a lokacin da zuciya ke hutawa yayi sama, wannan shi bature yake kira 'isolated diastolic hypertension[³].
Abubuwan da ke kawo ciwon hawan jini
Likitoci masana zuciya da jijiyoyin jini sun raba abubuwan da ke kawo hawan jini zuwa gida biyu (2)[²][³].
1. Abubuwan da mutum zai iya chanja wa
A. Yawan cin gishiri
B. Yawan cin kitse
C. Rashin motsa jiki
D. Shan sigari
E. Shan giya
F. Yawan ƙiba (taiɓa)
G. Shan miyagun ƙwayoyi
H. Yawan shan wasu magunguna kamar su:
- Magungunan bada tazarar iyali
- Magungunan da ke É—auke da sinadarin steroid
- Magungunan da ake kira sympathomimetics
2. Abubuwan da mutum ba zai iya chanja wa ba
A. Zama baƙi (Ɗan Africa)
B. Zama namiji
C. Gadon hawan jini
D. Yawancin shekaru (shekara 65 zuwa sama).
Alamomin ciwon hawan jini
Ciwon hawan jini baya da wani alama da yake nunawa a lokacin da yake matashi. Shi yasa bature yakan yiwa cutar laƙabi da 'silent killer' ma'ana mai yin kisa a ɓoye.
Mafi yawancin mutanen da ke fama da hawan jini baza su san suna da shi ba har sai yayi musu wata illa, wannan shi yasa ake son mutane su dinga auna matsin lambar jinin su (blood pressure) akai-akai. Wasu alamomi da mutum yakan iya gani a wani lokaci masu nuna hawan jini sun haÉ—a da[²][³]:
1. Yawan ciwon kai tunda safe
2. Yawan haɓo (zubar jini ta hanci ba tare da dalili ba).
3. Rashin gani da kyau.
4. Yawan kasala
5. Ciwon ƙirji
6. Yawan bugawar zuciya.
7. Rashin bacci
Yadda ake kula da mai ciwon hawan jini a asibiti.
Da farko likita zai tattauna da marar lafiya domin samun bayani mai zurfi game da yanda ciwon ya fara da kuma lafiyar mutum kamin zuwan sa a asibiti.
Bayan kammala tattaunawar likita za ya duba marar lafiya akan gadon asibiti domin tantancewar bayanan da ya samu wajen tattaunawar da suka yi da kuma gano wasu muhimman alamomi da ke nuna mutum ya daÉ—e da ciwon hawan jini a jikinsa. WaÉ—annan alamomin sun haÉ—a da:
- Arterial wall thickening: Ƙarin kaurin jijiyoyin jini, ana duba shi ne a hannuwa
- Locomotor brachialis: Ganin wata jijiyar hannu tana bugawa.
- Raised JVP/Distended neck veins: Karin matsin lambar jinin dake cikin jijiyar wuya/Fitowar jijiyoyin wuya, wannan ana ganin shi ne kawai idan hawan jinin ya haifar da ciwon zuciya.
- Displaced apex beat: Tsinin kan zuciya zai ƙara daga mazaunin sa zuwa gaba, sakamakon ƙaruwar girman zuciya.
- Loud A2: Wannan shi ne ƙaruwar sautin wani ɓangare na kukan zuciya na biyu.
- Hypertensive retinopathy: Wannan yana cikin illolin da hawan jini ke yima idanuwa.
Bayan gama duba dukan sassan jikin mutum likita zai bada wasu gwaje-gwaje domin ƙara gane illolin da hawan jinin ya haifar wa marar lafiyar. Muhimmai daga cikin gwaje-gwajen sun haɗa da;
- Chest X-ray: Hoton ƙirji
- Electrocardiogram (ECG): Duba aikin lantarkin zuciya ta hanyar wani injin.
- Echocardiogram: Hoton zuciya ne na musamman.
- Ambulatory BP recording: Za'a chi gaba da auna jinin mutum duk bayan minti 20-30 da rana, duk bayan awa É—aya da dare har na tsawon kwana É—aya.
- Urinalysis: Awon fitsari.
- EuCr: Awon sinadaran da ke cikin jini.
- Da dai sauransu
Sauran gwaje-gwaje sun danganta da abinda likita ya gani ga marar lafiyar da kuma abinda ya ke tunanin ya haifar da cutar ta hawan jini[³].
Maganin hawan jini a asibiti.
Hawan jini ba cuta ce wadda za'a iya shan magani kai tsaye a warke ba, kamar irin cutar zazzaɓin cizon sauro. A ƙa'idance a asibiti ana maganin cutar hawan jini ne ta hanya biyu kamar haka:
1. Hanya ta farko ita ce chanja salon rayuwa ba tare da shan ƙwayoyin magani ba.
2. Hanya ta biyu itace bada Æ™wayoyin maganin bature[³].
1. Chanja salon gudanar da rayuwa
Chanja yanda mutum ke gudanar da rayuwa yana taimakawa wajen saukar da hawan jini, da kuma rage amfani da Æ™wayoyin magani na hawan jini. Wannan chanji ya Æ™unshi[⁴]:
- Chin abinci mai gina jiki
- Rage chin gishiri
- Daina shan giya
- Daina shan sigari
- Rage ƙiba (taiɓa)
- Rage chin kitse
- Yawan ayyukan motsa jiki, aƙalla na minti talatin kullum.
- Yawan chin Æ´aÆ´an itace da kayan lambu.
- Chin kifi
- Samun isasshen bacci.
- Amfani da man kifi yana taimakawa sosai wajen rage matsin lambar jini.
Ƙwayoyin maganin da ake amfani dasu wajen magance ciwon hawan jini
Ƙwayoyin maganin da ake amfani dasu wajen magance cutar hawan jini sun danganta da lafiyar mutum da kuma tsananin hawan jinin. WaÉ—annan magungunan sun haÉ—a da[³][⁴]:
A. Diuretics
Diuretics wasu magunguna ne da ake amfani dasu domin rage yawan ruwan da ke gudana a cikin jijiyoyin jinin mutum. Rage yawan ruwan da ke gudana yakan rage yawan ƙarfi da matsin lambar da jini ke sanyawa a bangon jijiyoyi yayin da yake gudana a cikin su. Diuretics sun haɗa da:
- Bendrofluthiazide 2.5mg dly
- Cyclopenthiazide 0.5mg dly
- Frusemide 40mg dly
- Bumetinide 1mg dly
Matsalolin da waɗannan magungunan ke kawo wa sun haɗa da yawan fitsari da kuma ƙarancin sinadarin potassium.
B. Angiotensin converting enzyme inhibitors (ACEI)
Waɗannan magungunan suna hana samar da sinadarin angiotensin II daga angiotensin I. Shi wannan sinadarin angiotensin II yana matse jijiyoyi domin rage musu yelwa. Rage yelwar jijiyoyi yakan sanya matsin lambar jini a cikin su ya ƙaru. Magungunan ACEI sun haɗa da:
- Lisinopril 10-40mg dly
- Enalapril 20mg dly
- Ramipril 5-10mg dly
Matsalolin waɗannan magungunan sun ƙunshi; tari, saukar matsin lambar sosai ƙasa da adadin da ya kamata da kuma matsalar ƙoda.
C. Angiotensin II receptor blockers (ARB)
Waɗannan magungunan suna hana sindarin angiotensin II yin aikin da ya kamata. Ba kamar irin ACEI da ke hana samar da sindarin kwata-kwata ba, su ARB sai an samar da sinadarin sai suje inda ya kamata yayi aiki a jijiyoyin jini sai su hana shi aikin da kamata, wannan shi yasa ACEI sunfi ARB yawan matsaloli. Yin haka zaisa jijiyoyin jini su ƙara yelwa a cikinsu. Misalin waɗannan magungunan ya haɗa da
- Valsartan
- Candesartan
- Talmesartan
D. Calcium channel blockers (CCB)
Waɗannan magungunan suna ƙara yelwar jijiyoyi masu ɗaukar jini ta hanyar toshe shigar sindarin calcium a cikin tantanin halittun jijiyoyin. Shigar sindarin calcium yanada matuƙar amfani wajen matse jijiyoyi da rage yelwar cikin su kana ƙaruwar hawan jini. Misalin magungunan ya haɗa da:
- Amlodipine 5-10mg dly
- Nifedifine 30-90mg dly
- Diltiazem 200-300mg dly
- Verapamil 240mg dly
E.
Alpha blockersWaɗannan magungunan suna rage saƙon da ƙwaƙwalwa ke aikowa jijiyoyin jini domin su matse su rage yelwa. Suna cimma wannan aikin ne ta hanyar toshe wasu receptors da ake kira alpha receptors. Misalin su ya haɗa da:
Suma waÉ—annan suna aiki kamar alpha blockers, amma suna cimma aikinsu ne ta hanyar toshe beta receptors. Misalan su:
- Metoprolol
- Atenolol
- Bisoprolol
G. Alpha-beta blockersWaɗannan suma suna toshe saƙon ƙwaƙwalwa zuwa jijiyoyin jini kamar alpha blockers amma su, suna toshe da receptors na alpha da na beta baki ɗaya. Ana amfani dasu ne wajin maganin hawan jini na gaggawa. Misalin su
H. Aldosterone antagonist Waɗannan magungunan suna toshe aikin sindarin aldosterone. Sinadarin aldosterone wani sinadari ne mai taimakawa wajen riƙe ruwa da gishiri a cikin jini. Toshe aikin wannan sinadari yakan sa matsin lambar jini ya rage sakamakon rasa ruwa da gishiri. Misalin waɗannan magungunan sun haɗa da:
- Spironolactone
- Eplerenone
- Milrinone
I. VasodilatorsWaɗannan magungunan suna rage hawan jini ta hanyar ƙarawa jijiyoyin jini faɗi daga ciki. Suna cimma wannan aiki ne ta hanyar hana wa naman da ke jikin jijiyoyin ya takura ko ya matse. Misalin su:
- Hydralazine
- Minoxidil
- Nitric oxide
Yadda ake bada maganin hawan jini.
Ana bada ƙwayoyin magungunan hawan jini idan chanja salon yadda ake gudanar da rayuwa ya kasa rage adadin matsin lambar jini zuwa adadin da ake buƙata. Ana bada magungunan ne akan wasu matakai kamar haka:
Mataki na farko shi ne ayi amfani da magani É—aya cikin calcium channel blockers wadanda muka yi bayani a baya. Ko kuma ayi amfani da diuretics É—aya[³].
Mataki na biyu shi ne, idan har mataki na farko ya kasa cimma abinda ake so, to sai ayi mataki na farko sannan a ƙara da ACE ko ARB.
Mataki na uku shi ne amfani da magunguna guda uku, ɗaya daga cikin ACEI ko ARB tare da ɗaya daga cikin CCB da kuma ɗaya daga cikin Diuretics. Ana yinsa ne yayin da mataki na biyu ya kasa cimma biyan buƙata.
Mataki na ƙarshe ka ƙara da wani diuretics, alpha blockers ko beta blockers.
Bayanin rufewa
Hawan jini cuta ce babba dake damuwar al'umma. Acikin wannan rubutu munga abubuwan da ke kawo ciwon hawan jini, kashe-kashen sa, alamomin sa da kuma yanda ake maganin sa. A lura cewa, damuwa da yawan baƙin ciki basu kawo ciwon hawan jini saɓanin yadda mafi yawan mutane ke ɗauka.
Amma damuwa da baƙin ciki suna sanya hawan jinin da dama akwai shi ya ta'azzara ko kuma ya tashi. Wannan yana faruwa ne sakamakon fitar da sinadarin adrenaline da noradrenaline dake faruwa a lokacin damuwa da baƙin ciki.
Idan kuna da tambaya sai kuyi a cikin akwatin sharhi dake ƙasa, Insha Allah zamu karba ba tare da jinkiri ba. Haka kuma zaku iya shiga group dinmu na WhatsApp domin kasancewa damu damu a koda yaushe da kuma samun ingantattun bayanan mu a cikin sauki. Ku danna wannan domin shiga:
Lafiyata Group 3. GargaÉ—i
Wannan rubutu anyi shi ne kawai saboda ilmantar wa, saboda haka rubutun bazai taɓa maye gurbin ganin likita ko zuwa asibiti ba. Bugu da ƙari, marubucin ya barranta kansa ga duk wani kuskure da ya faru ga wanda ya ɗauki magani a hannun sa. Haka zalika ba'a yadda wani wanda ba likita ba yayi amfani da wannan rubutu yana bada magani ba. Ba'a kuma yarda wani ya saci wani sashe na wannan rubutu ya wallafa wani wuri ba tare da izinin ainihin marubuci ba.
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