{"id":3313,"date":"2025-06-23T13:30:09","date_gmt":"2025-06-23T06:30:09","guid":{"rendered":"https:\/\/hienbacsi.com\/?p=3313"},"modified":"2025-06-23T13:55:50","modified_gmt":"2025-06-23T06:55:50","slug":"tang-huyet-ap-cot-loi-lam-sang-va-nhung-tieu-chuan-moi","status":"publish","type":"post","link":"https:\/\/hienbacsi.com\/index.php\/2025\/06\/23\/tang-huyet-ap-cot-loi-lam-sang-va-nhung-tieu-chuan-moi\/","title":{"rendered":"T\u0103ng huy\u1ebft \u00e1p: c\u1ed1t l\u00f5i l\u00e2m s\u00e0ng v\u00e0 nh\u1eefng ti\u00eau chu\u1ea9n m\u1edbi"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><mark style=\"background-color:rgba(0, 0, 0, 0);color:#cf2e2e\" class=\"has-inline-color has-vivid-red-color\">Th\u1ea1c s\u0129 b\u00e1c s\u0129 Tr\u1ea7n h\u1eefu Hi\u1ec1n<\/mark><\/h2>\n\n\n\n<p><strong><mark style=\"background-color:rgba(0, 0, 0, 0);color:#cf2e2e\" class=\"has-inline-color has-vivid-red-color\"> T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU Corse C\u1ed9ng h\u00f2a Ph\u00e1p<\/mark><\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">I. T\u1ed5ng quan v\u1ec1 T\u0103ng Huy\u1ebft \u00c1p<\/h2>\n\n\n\n<p>Ko T\u0103ng huy\u1ebft \u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y b\u1ec7nh tim m\u1ea1ch, \u0111\u1ed9t qu\u1ef5, suy th\u1eadn v\u00e0 t\u1eed vong to\u00e0n c\u1ea7u. D\u00f9 y h\u1ecdc \u0111\u00e3 c\u00f3 nhi\u1ec1u ti\u1ebfn b\u1ed9, t\u1ef7 l\u1ec7 ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p v\u1eabn ch\u01b0a \u0111\u1ea1t mong mu\u1ed1n, v\u1edbi ch\u1ec9 kho\u1ea3ng <strong>50% b\u1ec7nh nh\u00e2n \u0111\u1ea1t m\u1ee5c ti\u00eau huy\u1ebft \u00e1p<\/strong> t\u1ea1i nhi\u1ec1u qu\u1ed1c gia. \u0110\u1ed1i v\u1edbi sinh vi\u00ean y khoa, hi\u1ec3u v\u00e0 qu\u1ea3n l\u00fd THA kh\u00f4ng ch\u1ec9 l\u00e0 m\u1ed9t k\u1ef9 n\u0103ng l\u00e2m s\u00e0ng m\u00e0 c\u00f2n l\u00e0 tr\u00e1ch nhi\u1ec7m x\u00e3 h\u1ed9i, v\u00ec b\u1ec7nh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i.<\/p>\n\n\n\n<p><strong>T\u1ea1i sao THA quan tr\u1ecdng?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>L\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 ch\u00ednh cho <strong>b\u1ec7nh tim m\u1ea1ch<\/strong> (nh\u1ed3i m\u00e1u c\u01a1 tim, suy tim), <strong>\u0111\u1ed9t qu\u1ef5<\/strong>, v\u00e0 <strong>suy th\u1eadn m\u1ea1n<\/strong>.<\/li>\n\n\n\n<li>G\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch (n\u00e3o, tim, th\u1eadn, m\u1eaft) n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t.<\/li>\n\n\n\n<li>T\u1ef7 l\u1ec7 m\u1eafc ng\u00e0y c\u00e0ng t\u0103ng do l\u1ed1i s\u1ed1ng hi\u1ec7n \u0111\u1ea1i (b\u00e9o ph\u00ec, \u00edt v\u1eadn \u0111\u1ed9ng, ch\u1ebf \u0111\u1ed9 \u0103n nhi\u1ec1u mu\u1ed1i).<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">II. Ch\u1ea9n \u0111o\u00e1n T\u0103ng Huy\u1ebft \u00c1p<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">1. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n (C\u1eadp nh\u1eadt 2025, d\u1ef1a tr\u00ean JNC 8 v\u00e0 ACC\/AHA)<\/h3>\n\n\n\n<p>Huy\u1ebft \u00e1p \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng mmHg, ph\u00e2n lo\u1ea1i nh\u01b0 sau:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>B\u00ecnh th\u01b0\u1eddng<\/strong>: &lt;120\/80 mmHg<\/li>\n\n\n\n<li><strong>Ti\u1ec1n THA (Elevated)<\/strong>: 120\u2013129\/&lt;80 mmHg<\/li>\n\n\n\n<li><strong>THA giai \u0111o\u1ea1n 1<\/strong>: 130\u2013139\/80\u201389 mmHg<\/li>\n\n\n\n<li><strong>THA giai \u0111o\u1ea1n 2<\/strong>: \u2265140\/\u226590 mmHg<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"928\" height=\"1024\" src=\"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-928x1024.jpg\" alt=\"\" class=\"wp-image-3315\" srcset=\"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-928x1024.jpg 928w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-272x300.jpg 272w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-768x847.jpg 768w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-1393x1536.jpg 1393w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-1170x1291.jpg 1170w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1-585x645.jpg 585w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/06\/img_9768-2-1.jpg 1398w\" sizes=\"(max-width: 928px) 100vw, 928px\" \/><\/figure>\n\n\n\n<p><strong>L\u01b0u \u00fd<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Huy\u1ebft \u00e1p t\u00e2m thu (SBP) v\u00e0 t\u00e2m huy\u1ebft tr\u01b0\u01a1ng (DBP) \u0111\u01b0\u1ee3c xem x\u00e9t \u0111\u1ed9c l\u1eadp. N\u1ebfu SBP v\u00e0 DBP thu\u1ed9c c\u00e1c giai \u0111o\u1ea1n kh\u00e1c nhau, ph\u00e2n lo\u1ea1i theo giai \u0111o\u1ea1n cao h\u01a1n.<\/li>\n\n\n\n<li>V\u00ed d\u1ee5: Huy\u1ebft \u00e1p 135\/92 mmHg \u2192 <strong>THA giai \u0111o\u1ea1n 2<\/strong>.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">2. C\u00e1ch x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n<\/h3>\n\n\n\n<p>\u0110\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u1ed9 ch\u00ednh x\u00e1c, huy\u1ebft \u00e1p c\u1ea7n \u0111\u01b0\u1ee3c \u0111o \u0111\u00fang k\u1ef9 thu\u1eadt v\u00e0 x\u00e1c nh\u1eadn qua nhi\u1ec1u l\u1ea7n \u0111o:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u0110o t\u1ea1i ph\u00f2ng kh\u00e1m<\/strong>:\n<ul class=\"wp-block-list\">\n<li>L\u1ea5y \u22652 l\u1ea7n \u0111o, c\u00e1ch nhau \u00edt nh\u1ea5t 1\u20132 ph\u00fat, trong \u22652 l\u1ea7n kh\u00e1m kh\u00e1c nhau.<\/li>\n\n\n\n<li>B\u1ec7nh nh\u00e2n c\u1ea7n ng\u1ed3i y\u00ean t\u0129nh 5 ph\u00fat, kh\u00f4ng u\u1ed1ng c\u00e0 ph\u00ea ho\u1eb7c h\u00fat thu\u1ed1c tr\u01b0\u1edbc \u0111\u00f3 30 ph\u00fat.<\/li>\n\n\n\n<li>Cuff \u0111o huy\u1ebft \u00e1p ph\u1ea3i ph\u00f9 h\u1ee3p v\u1edbi k\u00edch th\u01b0\u1edbc c\u00e1nh tay.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>\u0110o huy\u1ebft \u00e1p t\u1ea1i nh\u00e0 (HBPM)<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Khuy\u1ebfn kh\u00edch b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng m\u00e1y \u0111o huy\u1ebft \u00e1p c\u00e1 nh\u00e2n \u0111\u1ec3 theo d\u00f5i.<\/li>\n\n\n\n<li>Gi\u00fap ph\u00e1t hi\u1ec7n <strong>THA \u00e1o cho\u00e0ng tr\u1eafng<\/strong> (huy\u1ebft \u00e1p cao t\u1ea1i ph\u00f2ng kh\u00e1m nh\u01b0ng b\u00ecnh th\u01b0\u1eddng \u1edf nh\u00e0) ho\u1eb7c <strong>THA che gi\u1ea5u<\/strong> (b\u00ecnh th\u01b0\u1eddng t\u1ea1i ph\u00f2ng kh\u00e1m nh\u01b0ng cao \u1edf nh\u00e0).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Theo d\u00f5i huy\u1ebft \u00e1p 24 gi\u1edd (ABPM)<\/strong>:\n<ul class=\"wp-block-list\">\n<li>L\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh THA, \u0111\u1eb7c bi\u1ec7t khi nghi ng\u1edd THA \u00e1o cho\u00e0ng tr\u1eafng ho\u1eb7c che gi\u1ea5u.<\/li>\n\n\n\n<li>\u0110o trung b\u00ecnh huy\u1ebft \u00e1p ban ng\u00e0y<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">3. K\u1ef9 thu\u1eadt \u0111o huy\u1ebft \u00e1p \u0111\u00fang<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>B\u1ec7nh nh\u00e2n ng\u1ed3i tho\u1ea3i m\u00e1i, l\u01b0ng t\u1ef1a gh\u1ebf, ch\u00e2n ch\u1ea1m s\u00e0n.<\/li>\n\n\n\n<li>C\u00e1nh tay ngang m\u1ee9c tim, kh\u00f4ng n\u00f3i chuy\u1ec7n trong l\u00fac \u0111o.<\/li>\n\n\n\n<li>S\u1eed d\u1ee5ng m\u00e1y \u0111o \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m chu\u1ea9n, cuff ph\u00f9 h\u1ee3p (bao ph\u1ee7 80\u2013100% chu vi c\u00e1nh tay).<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"682\" height=\"1024\" src=\"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-682x1024.jpg\" alt=\"\" class=\"wp-image-3267\" srcset=\"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-682x1024.jpg 682w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-200x300.jpg 200w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-768x1153.jpg 768w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-1023x1536.jpg 1023w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-1170x1756.jpg 1170w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1-585x878.jpg 585w, https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1.jpg 1290w\" sizes=\"(max-width: 682px) 100vw, 682px\" \/><\/figure>\n\n\n\n<ul class=\"wp-block-list\">\n<li><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">III. M\u1ee5c ti\u00eau ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p (C\u1eadp nh\u1eadt 2025)<\/h2>\n\n\n\n<p>M\u1ee5c ti\u00eau huy\u1ebft \u00e1p ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1ed9 tu\u1ed5i, b\u1ec7nh l\u00fd n\u1ec1n, v\u00e0 t\u00ecnh tr\u1ea1ng t\u1ed5ng qu\u00e1t c\u1ee7a b\u1ec7nh nh\u00e2n:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>D\u00e2n s\u1ed1 chung : &lt;130\/80 mmHg<\/strong><\/li>\n\n\n\n<li><strong>Ng\u01b0\u1eddi \u226565 tu\u1ed5i<\/strong>: &lt;140\/90 mmHg<\/li>\n\n\n\n<li><strong>B\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd \u0111\u1ed3ng m\u1eafc<\/strong> (b\u1ec7nh th\u1eadn m\u1ea1n, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh m\u1ea1ch v\u00e0nh): <strong>&lt;130\/80 mmHg<\/strong><\/li>\n\n\n\n<li><strong>L\u01b0u \u00fd<\/strong>: Tr\u00e1nh h\u1ea1 huy\u1ebft \u00e1p qu\u00e1 nhanh ho\u1eb7c qu\u00e1 th\u1ea5p \u1edf ng\u01b0\u1eddi gi\u00e0 \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 thi\u1ebfu m\u00e1u n\u00e3o ho\u1eb7c ng\u00e3.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">IV. Qu\u1ea3n l\u00fd T\u0103ng Huy\u1ebft \u00c1p<\/h2>\n\n\n\n<p>Qu\u1ea3n l\u00fd THA l\u00e0 s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng v\u00e0 \u0111i\u1ec1u tr\u1ecb thu\u1ed1c, v\u1edbi m\u1ee5c ti\u00eau gi\u1ea3m huy\u1ebft \u00e1p, b\u1ea3o v\u1ec7 c\u01a1 quan \u0111\u00edch, v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">1. Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng \u2013 B\u01b0\u1edbc \u0111\u1ea7u ti\u00ean v\u00e0 n\u1ec1n t\u1ea3ng<\/h3>\n\n\n\n<p>Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng kh\u00f4ng ch\u1ec9 gi\u00fap ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p m\u00e0 c\u00f2n gi\u1ea3m nguy c\u01a1 tim m\u1ea1ch to\u00e0n di\u1ec7n:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Ch\u1ebf \u0111\u1ed9 \u0103n DASH (Dietary Approaches to Stop Hypertension)<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Gi\u00e0u tr\u00e1i c\u00e2y, rau xanh, ng\u0169 c\u1ed1c nguy\u00ean h\u1ea1t, v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m s\u1eefa \u00edt b\u00e9o.<\/li>\n\n\n\n<li>H\u1ea1n ch\u1ebf th\u1ef1c ph\u1ea9m gi\u00e0u ch\u1ea5t b\u00e9o b\u00e3o h\u00f2a, cholesterol, v\u00e0 \u0111\u01b0\u1eddng tinh luy\u1ec7n.<\/li>\n\n\n\n<li>V\u00ed d\u1ee5: T\u0103ng c\u01b0\u1eddng \u0103n chu\u1ed1i, rau bina, khoai lang (gi\u00e0u kali, gi\u00fap gi\u1ea3m huy\u1ebft \u00e1p).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Gi\u1ea3m mu\u1ed1i (natri)<\/strong>:\n<ul class=\"wp-block-list\">\n<li>M\u1ee5c ti\u00eau:<\/li>\n\n\n\n<li>H\u01b0\u1edbng d\u1eabn b\u1ec7nh nh\u00e2n \u0111\u1ecdc nh\u00e3n th\u1ef1c ph\u1ea9m, tr\u00e1nh \u0111\u1ed3 \u0103n ch\u1ebf bi\u1ebfn s\u1eb5n (m\u00ec g\u00f3i, x\u00fac x\u00edch, \u0111\u1ed3 h\u1ed9p).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>T\u1eadp th\u1ec3 d\u1ee5c<\/strong>:\n<ul class=\"wp-block-list\">\n<li>\u2265150 ph\u00fat\/tu\u1ea7n ho\u1ea1t \u0111\u1ed9ng aerobic c\u01b0\u1eddng \u0111\u1ed9 trung b\u00ecnh (\u0111i b\u1ed9 nhanh, \u0111\u1ea1p xe, b\u01a1i l\u1ed9i).<\/li>\n\n\n\n<li>K\u1ebft h\u1ee3p t\u1eadp s\u1ee9c m\u1ea1nh (n\u00e2ng t\u1ea1 nh\u1eb9) 2 l\u1ea7n\/tu\u1ea7n.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Ki\u1ec3m so\u00e1t c\u00e2n n\u1eb7ng<\/strong>:\n<ul class=\"wp-block-list\">\n<li>M\u1ee5c ti\u00eau BMI<\/li>\n\n\n\n<li>\u0110\u1eb7c bi\u1ec7t quan tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec ho\u1eb7c th\u1eeba c\u00e2n.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>H\u1ea1n ch\u1ebf r\u01b0\u1ee3u bia<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Nam: \u22642 \u0111\u01a1n v\u1ecb r\u01b0\u1ee3u\/ng\u00e0y; N\u1eef: \u22641 \u0111\u01a1n v\u1ecb\/ng\u00e0y.<\/li>\n\n\n\n<li>1 \u0111\u01a1n v\u1ecb = 355 ml bia, 150 ml r\u01b0\u1ee3u vang, ho\u1eb7c 45 ml r\u01b0\u1ee3u m\u1ea1nh.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Ng\u1eebng h\u00fat thu\u1ed1c<\/strong>:\n<ul class=\"wp-block-list\">\n<li>H\u00fat thu\u1ed1c l\u00e0m t\u0103ng huy\u1ebft \u00e1p t\u1ee9c th\u1eddi v\u00e0 g\u00e2y t\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u1ea1c m\u1ea1ch m\u00e1u.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Qu\u1ea3n l\u00fd stress<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Th\u1ef1c h\u00e0nh thi\u1ec1n, yoga, ho\u1eb7c c\u00e1c k\u1ef9 thu\u1eadt th\u01b0 gi\u00e3n \u0111\u1ec3 gi\u1ea3m cortisol v\u00e0 adrenaline.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>V\u00ed d\u1ee5 th\u1ef1c t\u1ebf<\/strong>: M\u1ed9t b\u1ec7nh nh\u00e2n 45 tu\u1ed5i, huy\u1ebft \u00e1p 135\/85 mmHg, th\u1eeba c\u00e2n (BMI 28), c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u v\u1edbi ch\u1ebf \u0111\u1ed9 \u0103n DASH, gi\u1ea3m mu\u1ed1i, v\u00e0 \u0111i b\u1ed9 30 ph\u00fat\/ng\u00e0y, 5 ng\u00e0y\/tu\u1ea7n. Theo d\u00f5i huy\u1ebft \u00e1p t\u1ea1i nh\u00e0 sau 3 th\u00e1ng tr\u01b0\u1edbc khi c\u00e2n nh\u1eafc d\u00f9ng thu\u1ed1c.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">2. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">a. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ch\u1ec9 \u0111\u1ecbnh thu\u1ed1c khi:\n<ul class=\"wp-block-list\">\n<li>THA giai \u0111o\u1ea1n 2 (\u2265140\/90 mmHg).<\/li>\n\n\n\n<li>THA giai \u0111o\u1ea1n 1 (130\u2013139\/80\u201389 mmHg) k\u00e8m nguy c\u01a1 tim m\u1ea1ch cao (\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh th\u1eadn m\u1ea1n, b\u1ec7nh m\u1ea1ch v\u00e0nh, ho\u1eb7c nguy c\u01a1 tim m\u1ea1ch 10 n\u0103m &gt;10% theo thang \u0111i\u1ec3m ASCVD).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>B\u1eaft \u0111\u1ea7u v\u1edbi li\u1ec1u th\u1ea5p, t\u0103ng d\u1ea7n \u0111\u1ec3 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5.<\/li>\n\n\n\n<li>K\u1ebft h\u1ee3p thu\u1ed1c n\u1ebfu c\u1ea7n (v\u00ed d\u1ee5: li\u1ec1u th\u1ea5p c\u1ee7a 2 thu\u1ed1c th\u01b0\u1eddng hi\u1ec7u qu\u1ea3 h\u01a1n v\u00e0 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n li\u1ec1u cao c\u1ee7a 1 thu\u1ed1c).<\/li>\n\n\n\n<li>\u0110\u00e1nh gi\u00e1 tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng xuy\u00ean.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">b. Thu\u1ed1c \u0111\u1ea7u tay<\/h4>\n\n\n\n<p>D\u1ef1a tr\u00ean h\u01b0\u1edbng d\u1eabn 2025, c\u00e1c nh\u00f3m thu\u1ed1c \u0111\u1ea7u tay bao g\u1ed3m:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Thu\u1ed1c l\u1ee3i ti\u1ec3u thiazide<\/strong> (v\u00ed d\u1ee5: chlorthalidone, hydrochlorothiazide):\n<ul class=\"wp-block-list\">\n<li>C\u01a1 ch\u1ebf: Gi\u1ea3m th\u1ec3 t\u00edch d\u1ecbch v\u00e0 gi\u00e3n m\u1ea1ch.<\/li>\n\n\n\n<li>Li\u1ec1u: Chlorthalidone 12.5\u201325 mg\/ng\u00e0y.<\/li>\n\n\n\n<li>\u01afu ti\u00ean \u1edf b\u1ec7nh nh\u00e2n da \u0111en ho\u1eb7c THA do gi\u1eef n\u01b0\u1edbc.<\/li>\n\n\n\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: H\u1ea1 kali m\u00e1u, t\u0103ng acid uric, c\u1ea7n theo d\u00f5i \u0111i\u1ec7n gi\u1ea3i.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Thu\u1ed1c ch\u1eb9n k\u00eanh canxi (CCB)<\/strong> (v\u00ed d\u1ee5: amlodipine):\n<ul class=\"wp-block-list\">\n<li>C\u01a1 ch\u1ebf: Gi\u00e3n m\u1ea1ch, gi\u1ea3m s\u1ee9c c\u1ea3n ngo\u1ea1i bi\u00ean.<\/li>\n\n\n\n<li>Li\u1ec1u: Amlodipine 5\u201310 mg\/ng\u00e0y.<\/li>\n\n\n\n<li>Hi\u1ec7u qu\u1ea3 \u1edf b\u1ec7nh nh\u00e2n da \u0111en v\u00e0 ng\u01b0\u1eddi cao tu\u1ed5i.<\/li>\n\n\n\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: Ph\u00f9 m\u1eaft c\u00e1 ch\u00e2n, \u0111\u1ecf b\u1eebng m\u1eb7t.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ACEi)<\/strong> (v\u00ed d\u1ee5: lisinopril) ho\u1eb7c <strong>thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin (ARB)<\/strong> (v\u00ed d\u1ee5: losartan):\n<ul class=\"wp-block-list\">\n<li>C\u01a1 ch\u1ebf: \u1ee8c ch\u1ebf h\u1ec7 renin-angiotensin-aldosterone, b\u1ea3o v\u1ec7 tim v\u00e0 th\u1eadn.<\/li>\n\n\n\n<li>Li\u1ec1u: Lisinopril 10\u201340 mg\/ng\u00e0y; Losartan 50\u2013100 mg\/ng\u00e0y.<\/li>\n\n\n\n<li>\u01afu ti\u00ean \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh th\u1eadn m\u1ea1n, ho\u1eb7c suy tim.<\/li>\n\n\n\n<li>T\u00e1c d\u1ee5ng ph\u1ee5: Ho khan (ACEi), t\u0103ng kali m\u00e1u, c\u1ea7n theo d\u00f5i ch\u1ee9c n\u0103ng th\u1eadn.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">c. L\u1ef1a ch\u1ecdn thu\u1ed1c theo b\u1ec7nh l\u00fd \u0111\u1ed3ng m\u1eafc<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>B\u1ec7nh nh\u00e2n da \u0111en<\/strong>: Thiazide ho\u1eb7c CCB hi\u1ec7u qu\u1ea3 h\u01a1n ACEi\/ARB.<\/li>\n\n\n\n<li><strong>B\u1ec7nh th\u1eadn m\u1ea1n ho\u1eb7c \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/strong>: ACEi\/ARB \u0111\u1ec3 b\u1ea3o v\u1ec7 th\u1eadn.<\/li>\n\n\n\n<li><strong>Sau nh\u1ed3i m\u00e1u c\u01a1 tim ho\u1eb7c suy tim<\/strong>: ACEi + ch\u1eb9n beta (v\u00ed d\u1ee5: metoprolol) \u00b1 thu\u1ed1c kh\u00e1ng mineralocorticoid (MRA, v\u00ed d\u1ee5: spironolactone).<\/li>\n\n\n\n<li><strong>Ph\u1ee5 n\u1eef mang thai<\/strong>: Methyldopa, labetalol, ho\u1eb7c nifedipine (tr\u00e1nh ACEi\/ARB do nguy c\u01a1 d\u1ecb t\u1eadt thai nhi).<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">d. T\u0103ng huy\u1ebft \u00e1p kh\u00e1ng tr\u1ecb<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u0110\u1ecbnh ngh\u0129a: Huy\u1ebft \u00e1p kh\u00f4ng \u0111\u1ea1t m\u1ee5c ti\u00eau d\u00f9 d\u00f9ng \u22653 thu\u1ed1c (bao g\u1ed3m thu\u1ed1c l\u1ee3i ti\u1ec3u) \u1edf li\u1ec1u t\u1ed1i \u01b0u.<\/li>\n\n\n\n<li><strong>Nguy\u00ean nh\u00e2n c\u1ea7n \u0111\u00e1nh gi\u00e1<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Kh\u00f4ng tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb (b\u1ec7nh nh\u00e2n b\u1ecf thu\u1ed1c ho\u1eb7c d\u00f9ng kh\u00f4ng \u0111\u1ec1u).<\/li>\n\n\n\n<li>K\u1ef9 thu\u1eadt \u0111o huy\u1ebft \u00e1p sai.<\/li>\n\n\n\n<li>THA \u00e1o cho\u00e0ng tr\u1eafng ho\u1eb7c li\u1ec1u thu\u1ed1c ch\u01b0a t\u1ed1i \u01b0u.<\/li>\n\n\n\n<li><strong>Nguy\u00ean nh\u00e2n th\u1ee9 ph\u00e1t<\/strong>:\n<ul class=\"wp-block-list\">\n<li>H\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn.<\/li>\n\n\n\n<li>C\u01b0\u1eddng aldosterone ti\u00ean ph\u00e1t.<\/li>\n\n\n\n<li>H\u1ed9i ch\u1ee9ng ng\u01b0ng th\u1edf khi ng\u1ee7.<\/li>\n\n\n\n<li>U t\u1ee7y th\u01b0\u1ee3ng th\u1eadn (pheochromocytoma).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>X\u1eed tr\u00ed<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Th\u00eam spironolactone (25\u201350 mg\/ng\u00e0y) n\u1ebfu eGFR &gt;30 mL\/ph\u00fat.<\/li>\n\n\n\n<li>S\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u quai (furosemide) n\u1ebfu eGFR<\/li>\n\n\n\n<li>Xem x\u00e9t chuy\u1ec3n b\u1ec7nh nh\u00e2n \u0111\u1ebfn chuy\u00ean khoa tim m\u1ea1ch ho\u1eb7c th\u1eadn n\u1ebfu nghi ng\u1edd nguy\u00ean nh\u00e2n th\u1ee9 ph\u00e1t.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">V. C\u00e1c \u0111i\u1ec3m m\u1ea5u ch\u1ed1t th\u1ef1c ti\u1ec5n cho sinh vi\u00ean y khoa<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>\u0110o huy\u1ebft \u00e1p \u0111\u00fang c\u00e1ch<\/strong>: Sai k\u1ef9 thu\u1eadt c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ch\u1ea9n \u0111o\u00e1n sai. H\u00e3y th\u1ef1c h\u00e0nh \u0111o huy\u1ebft \u00e1p tr\u00ean b\u1ec7nh nh\u00e2n th\u1ef1c t\u1ebf v\u00e0 ki\u1ec3m tra m\u00e1y \u0111o th\u01b0\u1eddng xuy\u00ean.<\/li>\n\n\n\n<li><strong>C\u00e1 nh\u00e2n h\u00f3a \u0111i\u1ec1u tr\u1ecb<\/strong>: Kh\u00f4ng c\u00f3 ph\u00e1c \u0111\u1ed3 \u201cm\u1ed9t k\u00edch c\u1ee1 cho t\u1ea5t c\u1ea3\u201d. H\u00e3y xem x\u00e9t tu\u1ed5i, ch\u1ee7ng t\u1ed9c, b\u1ec7nh l\u00fd n\u1ec1n, v\u00e0 ho\u00e0n c\u1ea3nh kinh t\u1ebf c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n\n\n\n<li><strong>Gi\u00e1o d\u1ee5c b\u1ec7nh nh\u00e2n<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Gi\u1ea3i th\u00edch t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c d\u00f9ng thu\u1ed1c \u0111\u1ec1u \u0111\u1eb7n v\u00e0 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng.<\/li>\n\n\n\n<li>H\u01b0\u1edbng d\u1eabn c\u00e1ch t\u1ef1 \u0111o huy\u1ebft \u00e1p t\u1ea1i nh\u00e0 v\u00e0 ghi nh\u1eadt k\u00fd huy\u1ebft \u00e1p.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Theo d\u00f5i l\u00e2u d\u00e0i<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Ki\u1ec3m tra huy\u1ebft \u00e1p, ch\u1ee9c n\u0103ng th\u1eadn, \u0111i\u1ec7n gi\u1ea3i, v\u00e0 lipid m\u00e1u \u0111\u1ecbnh k\u1ef3.<\/li>\n\n\n\n<li>\u0110\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch to\u00e0n di\u1ec7n (d\u00f9ng thang \u0111i\u1ec3m ASCVD n\u1ebfu c\u00f3).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Nh\u1eadn di\u1ec7n THA c\u1ea5p c\u1ee9u<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Huy\u1ebft \u00e1p \u2265180\/120 mmHg k\u00e8m t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch (\u0111au ng\u1ef1c, kh\u00f3 th\u1edf, l\u01a1 m\u01a1, ph\u00f9 ph\u1ed5i).<\/li>\n\n\n\n<li>X\u1eed tr\u00ed: Nh\u1eadp vi\u1ec7n, d\u00f9ng thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (nitroprusside, labetalol), v\u00e0 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><\/li>\n\n\n\n<li><\/li>\n\n\n\n<li><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><\/li>\n\n\n\n<li><\/li>\n\n\n\n<li><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\"><\/h2>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Th\u1ea1c s\u0129 b\u00e1c s\u0129 Tr\u1ea7n h\u1eefu Hi\u1ec1n T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU Corse C\u1ed9ng h\u00f2a Ph\u00e1p I. T\u1ed5ng quan v\u1ec1 T\u0103ng Huy\u1ebft \u00c1p Ko T\u0103ng huy\u1ebft \u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng&hellip;<\/p>\n","protected":false},"author":1,"featured_media":3267,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[131,1],"tags":[67,85],"jetpack_featured_media_url":"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_7213-1.jpg","_links":{"self":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3313"}],"collection":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/comments?post=3313"}],"version-history":[{"count":4,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3313\/revisions"}],"predecessor-version":[{"id":3320,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3313\/revisions\/3320"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media\/3267"}],"wp:attachment":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media?parent=3313"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/categories?post=3313"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/tags?post=3313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}