I-ACE inhibitors vs beta blockers: Imiphi imishanguzo yegazi ekufanele?

Imininingwane Yezidakamizwa

Abantu abadala baseMelika abangamashumi ayisikhombisa nanhlanu bane-high blood pressure (umfutho wegazi ophakeme), kodwa kuphela 54% amazinga abo angaphansi kokulawulwa. Ngenhlanhla yesimo esivame kakhulu njengomfutho wegazi ophakeme, kunemithi ehlukahlukene engasiza. Phakathi kwabo kukhona i-ACE inhibitors kanye ne-beta blockers, odokotela abaningi abazoyinikeza ngaphambi kwanoma yiluphi olunye uhlobo lomuthi.

Uma ungenazimpawu, njengabantu abaningi abanomfutho wegazi ophakeme, udokotela mhlawumbe uzozama i-ACE inhibitor kuqala. Uma umfutho wegazi ophakeme uhambisana nobuhlungu besifuba noma ukukhathazeka, i-beta blocker ingaba yindlela engcono. Odokotela bangaze banikeze zombili izinhlobo zemithi ngasikhathi sinye ezimweni ezithile.

Yimuphi umuthi omuhle kakhulu womfutho wegazi kuwe? Sebenzisa lo mhlahlandlela ukuqhathanisa i-ACE inhibitors kuqhathaniswa ne-beta blockers ukulungiselela ukuvakasha kukadokotela wakho olandelayo.

Ufuna intengo engcono kakhulu ku-Acebutolol HCL?

Bhalisela izexwayiso zentengo ye-Acebutolol HCL bese uthola ukuthi intengo ishintsha nini!

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Ngabe ama-ACE inhibitors nama-beta blocker asebenza kanjani?

I-ACE inhibitors (i-angiotensin-converting-enzyme inhibitors) ivula imithambo yegazi futhi yehlise ivolumu yegazi, eyehlisa umfutho wegazi futhi inyuse ukugeleza kwegazi liye enhliziyweni. Ukuze wenze kanjalo, Ama-ACE inhibitors vimba i-enzyme eguqula i-angiotensin ekuguquleni i-angiotensin I ibe yi-angiotensin II — i-hormone evimba imithambo yegazi. Ngokuvimba i-hormone, umfutho wegazi womuntu wehliswa.

Ama-ACE inhibitors ajwayele ukunikezwa odokotela ukuthi belaphe umfutho wegazi ophakeme kanye nokwehluleka kwenhliziyo. Zingasiza futhi ekunciphiseni ubungozi bokufa kwabantu ngemuva kokuhlaselwa yinhliziyo (i-myocardial infarction).

Abavimbela i-Beta (beta-adrenergic blocking agents) vimba imiphumela yama-hormone okucindezeleka ayingxenye yohlelo lwemizwa oluzwelayo. Lawa mahomoni abandakanya i-norepinephrine ne-epinephrine (ebizwa nangokuthi i-adrenaline ). Ukuvimba la mahomoni kuvumela imithambo yegazi ukuba ikhululeke futhi ivuleke. Ngokulandelayo, ama-beta blockers anganciphisa ukushaya kwenhliziyo, anciphise umfutho wegazi, futhi athuthukise ukugeleza kwegazi.

Ama-beta blockers angalapha umfutho wegazi ophakeme kanye nezinye izimo ze-hmnealth ezinjenge-congestive heart failure, isigqi senhliziyo esingajwayelekile, ukukhathazeka nobuhlungu besifuba.

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Ama-ACE inhibitors kuqhathaniswa ne-beta blocker
	Ama-ACE inhibitors	Abavimbela i-Beta
Kulashwa izimo zezempilo	Umfutho wegazi ophakeme Ukwehluleka kwenhliziyo Isifo semithambo yegazi Isifo sezinso esingalapheki	Umfutho wegazi ophakeme Ukwehluleka kwenhliziyo yokubopha Isigqi senhliziyo esingajwayelekile Ubuhlungu besifuba Ukukhathazeka I-Glaucoma Migraines I-Tachycardia
Imithi ejwayelekile ebekiwe	I-Lisinopril Enalapril maleate IBenazepril HCl	I-Acebutolol HCl I-Atenolol I-Bisoprolol fumarate
Imiphumela emibi ejwayelekile	Isiyezi Ukukhwehlela okomile Ukudideka	Ukuqunjelwa Inkinga yokulala Ezinye zingadala ukuzuza kwesisindo
Izexwayiso	Kuyingozi kwabesifazane abakhulelwe futhi kungadala ukukhubazeka kokuzalwa Kukhuphula amazinga e-potassium futhi kungadala i-hyperkalemia	Kuyingozi kwabesifazane abakhulelwe futhi kungadala ukukhubazeka kokuzalwa Ezinye zingathinta amazinga e-cholesterol ne-triglyceride
Ukusebenzisana	Izidakamizwa ezingezona ukuvuvukala (ama-NSAID) Izithako ze-potassium noma okufakwa esikhundleni sikasawoti okuqukethe i-potassium	Izidakamizwa ezingezona ukuvuvukala (ama-NSAID)

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Ungathatha ama-ACE inhibitors anama-beta blocker?

Udokotela angahle anikeze i-ACE inhibitor kanye ne-beta blocker ngasikhathi sinye ukukhulisa amazinga egazi lomfutho weziguli ezinobungozi obukhulu noma abantu abanezimo ezithile zezokwelapha ezifana nesifo senhliziyo noma ukwehluleka kwenhliziyo okungamahlalakhona.

Iziguli ezilinganiselwa ku-75% ezine-high blood pressure zizodinga ukwelashwa okuhlanganisiwe (imithi engaphezu kweyodwa) ukufinyelela izinhloso zazo zokucindezelwa kwegazi, ngokusho Ijenali yeAmerican Society of Hypertension . Lokhu kwelashwa okuhlanganayo kungafaka ukuthatha ama-ACE inhibitors kanye ne-beta blocker ngasikhathi sinye noma ukuthatha eyodwa nolunye uhlobo lwemithi yomfutho wegazi njengama-angiotensin receptor blockers (ARBs).

Ama-ACE inhibitors nama-beta blocker asebenza ngokuhlukile futhi akhomba izingxenye ezahlukahlukene zomzimba. Ngale ndlela, bangaphelelisana.

Izexwayiso

Kokubili i-ACE inhibitors kanye ne-beta blocker kungaba yingozi kwabesifazane abakhulelwe. Zingadala isiyezi kusuka kumfutho wegazi ophansi futhi kungadala ukukhubazeka kokuzalwa. Uma ukhulelwe noma ungakhulelwa, ukukhuluma nodokotela kuyindlela engcono yokuthola ukuthi ngabe ama-beta blockers noma ama-ACE inhibitors akulungele yini noma cha.

Ama-ACE inhibitors akhulisa amazinga e-potassium egazi, ngakho-ke ukuqapha ukungena kwe-potassium ngesikhathi sokwelashwa kuyadingeka. Ngenxa yalokho, ukuthatha izithako ze-potassium noma ukusebenzisa okunye okufaka usawoti okuqukethe i-potassium kungadala amazinga we-potassium egazi ngokweqile (hyperkalemia). I-Hyperkalemia ingaholela kwezinye, ezingaba nezinkinga zempilo ezisongela impilo. Izimpawu ze-hyperkalemia zifaka ukudideka, ukushaya kwenhliziyo okungajwayelekile, nokugedlezela noma ukuba ndikindiki ezandleni noma ebusweni.

Ngakolunye uhlangothi, amanye ama-beta blocker angakhuphula ama-triglycerides futhi anciphise amazinga we-cholesterol enhle. Lokhu kuvame ukuba kwesikhashana kepha kungathinta iziguli ezine-metabolic syndrome.

Ukusebenzisana kwezidakamizwa

Ama-ACE inhibitors kanye ne-beta blockers kungenzeka angasebenzi kahle uma ethathwe ngezidakamizwa ezingezona ukuvuvukala (ama-NSAID) njenge-ibuprofen, i-Advil ne-Aleve. Khuluma nodokotela wakho ngaphambi kokuthatha noma yimaphi ama-NSAID ngenkathi uthatha ama-ACE inhibitors, ama-beta blocker, noma womabili.

Ukushintsha kusuka kuma-beta blocker kuya kuma-ACE inhibitors

Kwesinye isikhathi, udokotela angashintsha imishanguzo yakho ye-beta blocker iye ku-ACE inhibitor noma okuphambene nalokho.

Ezimweni lapho iziguli zinezinga eliphansi lokushaya kwenhliziyo noma isigqi senhliziyo, noma ngabe umthamo we-beta blockers udinga ukwehliswa, noma omunye umuthi womfutho wegazi onjenge-ACEi ungasetshenziswa, kusho Atif Zafar , MD, umqondisi wezokwelapha we-University of New Mexico Stroke Program. Kwesinye isimo, lapho iziguli zinesifo somgogodla wezinso (njenge-stenosis yemithambo yezinso), i-ACEi ayinconyelwe ukulawula umfutho wegazi. Eminye imishanguzo ye-BP ilungele kangcono lezo ziguli.

Abanye izifundo ziphakamisa ukuthi ukushintsha kusuka kuma-beta blocker uye kuma-ACE inhibitors kungasiza ekwehliseni izimpawu zokozela futhi kuthuthukise ukuqonda. Kodwa-ke, lokhu akusho ukuthi ama-beta blocker angcono kune-ACE inhibitors.

Umuthi ngamunye unenhloso yawo futhi ungahle ube ngcono ekwelapheni isimo esithile kunesinye. [Ama-ACE inhibitors] ayizindlela zokwelapha zomugqa wokuqala kuyilapho ama-beta blockers ehlukaniswa njengokwelashwa komugqa wesibili wokuphatha i-BP, kusho uDkt. Zafar. Kodwa-ke, ezigulini ezine-coronary artery disease (CAD), noma isifo senhliziyo esisimeme njenge-comorbid ye-hypertension, i-beta blockers ne-ACEI kunconyelwa ukukhetha komugqa wokuqala.

Okubaluleke kakhulu, ukukhuluma nodokotela noma uchwepheshe wezokwelapha kuyindlela engcono yokuthola ukuthi ukushintsha noma ukungashintshi kusuka kuma-beta blocker kuya kuma-ACE inhibitors kuyindlela efanelekile kuwe ngokuya ngempendulo yakho ekwelashweni nanoma yimiphi imiphumela emibi oyitholayo.

Okuqhamuka uma udla imishanguzo

Njenganoma imuphi umuthi, kuhlale kunamandla emiphumela emibi. Ukuthatha ama-beta blocker, ama-ACE inhibitors, noma womabili kungaholela kweminye imiphumela emibi elandelayo:

Imiphumela emibi ye-ACE inhibitor vs. beta
Imiphumela emibi ye-ACE	Imiphumela emibi ye-Beta blocker
Isiyezi Ukukhwehlela okomile Ukudideka Ukuphathwa ikhanda Ukukhathala Ukuqhuma kwesikhumba Amazinga aphakeme we-potassium egazi Ukunambitheka kwensimbi noma okunosawoti emlonyeni Ubuthakathaka	Izandla nezinyawo ezibandayo Ukuqunjelwa Ukucindezeleka Isiyezi Umlomo owomile, isikhumba namehlo Ukungasebenzi kahle kwe-Erectile Ubumhlophe Ukukhathala Ubuhlungu bekhanda Isicanucanu Ukuphelelwa umoya Ukushaya kwenhliziyo okuhamba kancane Inkinga yokulala Ukuzuza kwesisindo

Lolu hlu lwemiphumela engemihle alunabele ngokuphelele. Uchwepheshe wezokwelapha angakunika uhlu oluphelele lwemiphumela emibi ehlotshaniswa ne-ACE inhibitors vs.

Yize kungavamile, ama-ACE inhibitors nama-beta blocker angahlotshaniswa nemiphumela emibi kakhulu. Ukuthatha ama-ACE inhibitors kungadala angioedema , isimo esingajwayelekile esidala ukuvuvukala kobuso ezinye izitho zomzimba. Ama-ACE inhibitors nawo angadala ukwehluleka kwezinso noma ukwehla kwamaseli amhlophe egazi.

Ama-beta blockers adale ukuhlaselwa yisifo somoya. Kubantu abanesifo sikashukela, ama-beta blockers angagcina umzimba ungakhombisi izimpawu zoshukela wegazi ophansi (njengokuzamazama nokushaywa). Amazinga omfutho wegazi nokushaya kwenhliziyo kumele kubhekwe ngenkathi kuthathwa ama-beta blocker.

Yimiphi imithi engcono kakhulu yomfutho wegazi ophezulu?

Yize ungekho umuthi owodwa owodwa ongcono kakhulu ekwelapheni umfutho wegazi ophezulu, ama-ACE inhibitors nama-beta blockers aphakathi kwezinhlobo ezidume kakhulu zemithi yomfutho wegazi ophezulu. Imithi enqunyiwe izoncika kumlando wezokwelapha womuntu ngamunye, izimpawu zakhe, kanye nempendulo yakhe ekwelashweni. Uchwepheshe wezokunakekelwa kwempilo angasiza ekunqumeni i- imithi engcono kakhulu yomfutho wegazi ophezulu ngokwesisekelo ngamacala. Nalu uhlu lweminye yemithi esetshenziswa kakhulu ekwelapheni umfutho wegazi ophakeme:

Imithi ye-ACE inhibitor vs. beta blocker
Ama-ACE inhibitors	Abavimbela i-Beta
ILotensin (benazepril HCl) IVasotec (enalapril maleate) Prinivil (lisinopril) Zestril (lisinopril) I-Capoten ( bongiwe ) I-Monopril ( fosinopril sodium ) I-Accupril ( i-quinapril HCl ) I-Altace ( sbucwa ) I-Univasc ( moexipril HCl ) I-Mavik ( ebandla ) I-Aceon ( perindopril erbumine )	Ingxenye ( i-acebutolol HCl ) I-Tenormin ( atenolol ) Zebeta ( i-bisoprolol fumarate ) I-Bystolic (i-nebivolol) Lopressor ( i-metoprolol tartrate ) ITrolrol XL ( i-metoprolol succinate ) UCoreg ( isithombe ) Corgard ( khanyisile ) Inderal LA ( i-propranolol )

Imithi yengcindezi yegazi ikhethwa ngokuya ngokuthi yehlisa kangakanani umfutho wegazi futhi yehlise ubungozi bokuhlaselwa yisifo senhliziyo, ukushaywa unhlangothi, nokwehluleka kwenhliziyo, ngokushoIjenali yeAmerican Society of Hypertension. Uma i-ACE inhibitor noma i-beta blocker ingeke ikusebenzele, udokotela wakho angancoma olunye uhlobo lomuthi we-antihypertensive, njenge-calcium channel blockers, diuretics, alpha blockers, njll.

Ngokwengeziwe, izinguquko endleleni yokuphila kungasiza ukuphatha umfutho wegazi kanye nemithi. Kepha ngaphezu kwakho konke, uchwepheshe wezokwelapha angakusiza ukunquma uhlelo oluhle kakhulu lwezokwelapha lwakho ngokuya ngezimpawu zakho nomlando wezokwelapha.