{"id":963,"date":"2024-01-15T08:56:41","date_gmt":"2024-01-15T06:56:41","guid":{"rendered":"https:\/\/docsites.cgmlife.com\/puvl\/?page_id=963"},"modified":"2024-01-22T11:20:54","modified_gmt":"2024-01-22T09:20:54","slug":"clanky","status":"publish","type":"page","link":"https:\/\/docsites.cgmlife.com\/puvl\/clanky\/","title":{"rendered":"\u010cl\u00e1nky"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Ambulantn\u00ed monitorov\u00e1n\u00ed krevn\u00edho tlaku<\/h2>\n\n\n\n<p>Nov\u011b v ordinaci nab\u00edz\u00edme tzv. ambulantn\u00ed monitorov\u00e1n\u00ed krevn\u00edho tlaku (Ambulatory Blood Pressure Monitoring \u2013 ABPM&nbsp;), nespr\u00e1vn\u011b tzv. TK Holter &#8211; nen\u00ed kontinu\u00e1ln\u00ed m\u011b\u0159en\u00ed tlaku<\/p>\n\n\n\n<p><strong>Krevn\u00ed tlak p\u0159edstavuje jeden z nejd\u016fle\u017eit\u011bj\u0161\u00edch rizikov\u00fdch faktor\u016f z hlediska kardiovaskul\u00e1rn\u00ed, ale i celkov\u00e9 mortality. Jeho spr\u00e1vn\u00e9 m\u011b\u0159en\u00ed je nezbytn\u00e9 pro adekv\u00e1tn\u00ed management hypertenze.<\/strong><\/p>\n\n\n\n<p><strong>Po\u017eadavek na p\u0159esnost se zde prohlubuje spolu s t\u00edm, jak se up\u0159es\u0148uj\u00ed terapeutick\u00e9 c\u00edle v l\u00e9\u010db\u011b hypertenze.<\/strong> <strong>Izolovan\u00e9 m\u011b\u0159en\u00ed krevn\u00edho tlaku ve zdravotnick\u00e9m za\u0159\u00edzen\u00ed je v\u0161ak zat\u00ed\u017eeno ur\u010ditou chybovost\u00ed.&nbsp;<\/strong><\/p>\n\n\n\n<p>Pr\u016fm\u011brn\u00e9 hodnoty monitorace krevn\u00edho tlaku jsou obvykle ni\u017e\u0161\u00ed ne\u017e hodnoty nam\u011b\u0159en\u00e9 v ordinaci.<\/p>\n\n\n\n<p><strong>Pr\u016fm\u011br ABPM za 24 hodin by nem\u011bl p\u0159esahovat<\/strong>\u00a0<strong>130\/80 mm Hg<\/strong>, v noci by to m\u011blo b\u00fdt m\u00e9n\u011b ne\u017e\u00a0<strong>120\/70 mm Hg<\/strong> a\u00a0denn\u00ed pr\u016fm\u011br by nem\u011bl p\u0159ekro\u010dit\u00a0<strong>135\/85 mm Hg.<\/strong><\/p>\n\n\n\n<p>INDIKACE:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>podez\u0159en\u00ed na fenom\u00e9n b\u00edl\u00e9ho pl\u00e1\u0161t\u011b, tzv &#8222;white coat syndrom&#8220;<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>vysok\u00e1 variabilita krevn\u00edho tlaku<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>epizodick\u00e1 hypertenze<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>nevysv\u011btliteln\u00e9 hypotenze<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>rezistence k terapii hypertenze<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>kontrola terapie<\/strong><\/li>\n<\/ul>\n\n\n\n<p>AMPM&nbsp;postup:<\/p>\n\n\n\n<p>Pacient p\u0159i takov\u00e9m vy\u0161et\u0159en\u00ed nos\u00ed zpravidla po dobu 24 hodin p\u0159\u00edstroj, jen\u017e automaticky ve stanoven\u00e9 frekvenci m\u011b\u0159\u00ed a zaznamen\u00e1v\u00e1 hodnoty krevn\u00edho tlaku.<\/p>\n\n\n\n<p><strong>V na\u0161em p\u0159\u00edpad\u011b p\u0159es den ka\u017ed\u00fdch 30 minut a v noci ka\u017ed\u00fdch 45 minut<\/strong><\/p>\n\n\n\n<p>M\u011b\u0159en\u00ed by m\u011blo prob\u011bhnout v den, kter\u00fd je pro \u017eivotn\u00ed styl pacienta typick\u00fd, je ale vhodn\u00e9 se vyhnout del\u0161\u00edmu cestov\u00e1n\u00ed &#8211; pro spr\u00e1vnou interpretaci vy\u0161et\u0159en\u00ed je nezbytn\u00e9, aby si pacient vedl \u201eden\u00ed\u010dek\u201d, do kter\u00e9ho zaznamen\u00e1 v\u0161echny okolnosti d\u016fle\u017eit\u00e9 z hlediska ovlivn\u011bn\u00ed krevn\u00edho tlaku, medikaci a tak\u00e9 p\u0159\u00edpadn\u00e9 obt\u00ed\u017ee (pocit bu\u0161en\u00ed srdce, z\u00e1vrat\u011b, bolest hlavy, pocit slabosti apod.). Zvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00e9 je p\u0159esn\u00e9 vyzna\u010den\u00ed doby sp\u00e1nku. P\u0159i m\u011b\u0159en\u00ed (p\u0159i nafukov\u00e1n\u00ed man\u017eety) by m\u011bla b\u00fdt ruka voln\u011b spu\u0161t\u011bna a uvoln\u011bna &#8211; s man\u017eetou a z\u00e1znamn\u00edkem&nbsp;<strong>nen\u00ed mo\u017en\u00e9 se sprchovat ani koupat<\/strong>, pacient se nesm\u00ed pokou\u0161et p\u0159\u00edstroj otev\u00edrat \u010di m\u011bnit baterie. P\u0159\u00edstroj je nutn\u00e9 vr\u00e1tit v\u010das dle domluvy druh\u00fd den.<\/p>\n\n\n\n<p>M\u011b\u0159en\u00ed ABPM hrad\u00ed ZP maxim\u00e1ln\u011b 2x ro\u010dn\u011b.<\/p>\n\n\n\n<p><em>Terapie hypertenze je dal\u0161\u00ed t\u00e9ma, za m\u011b krom\u011b nezbytn\u00e9 farmakoterapie jsou nutn\u00e1 re\u017eimov\u00e1 opat\u0159en\u00ed, adekv\u00e1tn\u00ed hmotnost, tzv. protiz\u00e1n\u011btliv\u00e1, low carb strava obsahuj\u00edc\u00ed kvalitn\u00ed tuky a b\u00edlkoviny. Dobr\u00e9 zku\u0161enosti m\u00e1m s \u0159epou, ln\u011bn\u00fdm olejem a dal\u0161\u00edmi. D\u00e1le nutn\u00e1 redukce stresu, pr\u00e1ce s mysl\u00ed, mindfulness, meditace, dal\u0161\u00ed relaxa\u010dn\u00ed metody.<\/em><\/p>\n\n\n\n<p><em>Mo\u017en\u00e1 konzultace v ordinaci za poplatek.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ambulantn\u00ed monitorov\u00e1n\u00ed krevn\u00edho tlaku Nov\u011b v ordinaci nab\u00edz\u00edme tzv. ambulantn\u00ed monitorov\u00e1n\u00ed krevn\u00edho tlaku (Ambulatory Blood Pressure Monitoring \u2013 ABPM&nbsp;), nespr\u00e1vn\u011b tzv. TK Holter &#8211; nen\u00ed kontinu\u00e1ln\u00ed m\u011b\u0159en\u00ed tlaku Krevn\u00ed tlak p\u0159edstavuje jeden z nejd\u016fle\u017eit\u011bj\u0161\u00edch rizikov\u00fdch faktor\u016f z hlediska kardiovaskul\u00e1rn\u00ed, ale i celkov\u00e9 mortality. Jeho spr\u00e1vn\u00e9 m\u011b\u0159en\u00ed je nezbytn\u00e9 pro adekv\u00e1tn\u00ed management hypertenze. Po\u017eadavek na p\u0159esnost [&hellip;]<\/p>\n","protected":false},"author":394,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-963","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/pages\/963","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/users\/394"}],"replies":[{"embeddable":true,"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/comments?post=963"}],"version-history":[{"count":15,"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/pages\/963\/revisions"}],"predecessor-version":[{"id":1023,"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/pages\/963\/revisions\/1023"}],"wp:attachment":[{"href":"https:\/\/docsites.cgmlife.com\/puvl\/wp-json\/wp\/v2\/media?parent=963"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}