{"id":2031,"date":"2021-04-16T10:09:28","date_gmt":"2021-04-16T07:09:28","guid":{"rendered":"https:\/\/izmirkalpdoktoru.com\/?p=2031"},"modified":"2021-04-16T10:09:28","modified_gmt":"2021-04-16T07:09:28","slug":"oruc-tutmak-kalp-damar-hastaliklarini-tetikleyebilir-mi","status":"publish","type":"post","link":"https:\/\/izmirkalpdoktoru.com\/oruc-tutmak-kalp-damar-hastaliklarini-tetikleyebilir-mi\/","title":{"rendered":"Oru\u00e7 tutmak, kalp damar hastal\u0131klar\u0131n\u0131 tetikleyebilir mi?"},"content":{"rendered":"

Oru\u00e7 tutmak, kalp damar hastal\u0131klar\u0131n\u0131 tetikleyebilir mi? <\/strong>
\nBu konuda da yeteri \u00e7al\u0131\u015fma olmamakla birlikte, Katar\u2019da 10 y\u0131ll\u0131k izlemde Ramazan ay\u0131 ve izleyen ay s\u00fcresince kalp hastal\u0131klar\u0131na ba\u011fl\u0131 hastaneye yat\u0131\u015f oran\u0131nda di\u011fer aylara g\u00f6re art\u0131\u015f olmad\u0131\u011f\u0131 saptanm\u0131\u015ft\u0131r. Ankara\u2019da yap\u0131lan bir \u00e7al\u0131\u015fmada ise benzer \u015fekilde sa\u011fl\u0131kl\u0131 insanlarda<\/strong> orucun kalp damar hastal\u0131klar\u0131n\u0131 art\u0131r\u0131c\u0131 bir etkisi olmad\u0131\u011f\u0131n\u0131 g\u00f6sterilmi\u015ftir.<\/p>\n

Ancak, s\u0131cak ve uzun yaz g\u00fcnlerinde oru\u00e7 tutmak pek \u00e7ok kalp hastas\u0131nda sorun yaratabilir. A\u015f\u0131r\u0131 s\u0131v\u0131 ve tuz kayb\u0131, kan bas\u0131nc\u0131nda a\u015f\u0131r\u0131 d\u00fc\u015fmelere, bayg\u0131nl\u0131k geli\u015fmesine yol a\u00e7abilir hatta kalbin beslenmesinin bozulmas\u0131 sonucunda kalp krizi ve kalp yetersizli\u011fine neden olabilir. Bu durum ya\u015fl\u0131 hastalarda daha da belirgin olabilir.<\/p>\n

Kalp damar hastalar\u0131n\u0131n oru\u00e7 tutmas\u0131 sak\u0131ncal\u0131 m\u0131d\u0131r? <\/strong>
\nGenel olarak, kurallar\u0131na uygun oru\u00e7 tutan kalp hastalar\u0131nda, oru\u00e7 tutmayan kalp hastalar\u0131na k\u0131yasla Ramazan ay\u0131 s\u00fcresince hastal\u0131\u011f\u0131n farkl\u0131 seyretmedi\u011fi, anlaml\u0131 k\u00f6t\u00fcle\u015fme olmad\u0131\u011f\u0131 bilinmektedir. Hatta kurallar\u0131na uygun tutulan oru\u00e7, hastalarda yararl\u0131 sonu\u00e7lar do\u011furmaktad\u0131r. \u00d6rne\u011fin hipertansiyon hastalar\u0131nda, ila\u00e7lar\u0131na devam etmek ko\u015fulu ile oru\u00e7 tutmak kan bas\u0131nc\u0131nda d\u00fc\u015fmeye ve zay\u0131flamaya yol a\u00e7maktad\u0131r. Burada \u00f6nemli olan kalp damar sa\u011fl\u0131\u011f\u0131n\u0131 g\u00f6z \u00f6n\u00fcnde bulundurarak oru\u00e7 tutmakt\u0131r, yani kullan\u0131lan ila\u00e7lar\u0131n aksat\u0131lmadan devam edilmesi ve iftar- sahur d\u00f6neminde do\u011fru beslenilmesidir. Ancak kalp hastalar\u0131, oru\u00e7 tutma karar\u0131n\u0131 mutlaka kendilerini izleyen hekime dan\u0131\u015farak almal\u0131 ve onun \u00f6nerisi do\u011frultusunda davranmal\u0131d\u0131r. \u00c7\u00fcnk\u00fc pek \u00e7ok hastada oru\u00e7 tutarken ila\u00e7 tedavisinin tekrardan d\u00fczenlenmesi, doz ayarlamas\u0131 gerekecektir.<\/p>\n

Hangi Kalp damar hastalar\u0131 kesinlikle oru\u00e7 tutmamal\u0131d\u0131r?<\/strong>
\n\u00d6zellikle g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, nefes darl\u0131\u011f\u0131 gibi kalp damar hastal\u0131klar\u0131na ba\u011fl\u0131 yak\u0131nmalar\u0131 devam eden olgular\u0131n oru\u00e7 tutmas\u0131 sak\u0131ncal\u0131 olabilir. \u0130leri kalp yetersizli\u011fi olan hastalar kesinlikle oru\u00e7 tutmamal\u0131d\u0131r. Y\u00fcksek doz idrar s\u00f6kt\u00fcr\u00fcc\u00fc alan hastalar\u0131n \u00f6zellikle yaz d\u00f6neminde oru\u00e7 tutmalar\u0131 sak\u0131ncal\u0131d\u0131r.<\/p>\n

Son 6 ay i\u00e7erisinde kalp krizi ge\u00e7iren hastalar, kalp hastal\u0131\u011f\u0131 nedeniyle g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 olan hastalar, son 6 ay i\u00e7erisinde kalp damarlar\u0131na balon yap\u0131lan, stent tak\u0131lan veya bypass ameliyat\u0131 olmu\u015f hastalar da oru\u00e7 tutmaktan ka\u00e7\u0131nmal\u0131d\u0131r.
\nKontrol alt\u0131na al\u0131namayan veya hayat\u0131 tehdit edici aritmi riski olan hastalarda da oru\u00e7 riskli olabilir. Diren\u00e7li hipertansiyonu olan yani ila\u00e7 tedavisine ra\u011fmen kan bas\u0131nc\u0131 y\u00fcksek olan hastalar da tansiyonlar\u0131 normale inmeden oru\u00e7 tutmamal\u0131d\u0131r. Tek ba\u015f\u0131na hipertansiyonu olan ve ila\u00e7la kan bas\u0131nc\u0131 normal d\u00fczeylerde seyreden hastalar ise ila\u00e7lar\u0131n\u0131 her g\u00fcn d\u00fczenli almak ko\u015fulu ile oru\u00e7 tutabilirler. Bu say\u0131lan durumlar\u0131n d\u0131\u015f\u0131ndaki t\u00fcm kalp damar hastalar\u0131 oru\u00e7 tutup tutamayacaklar\u0131n\u0131 mutlaka hekimlerine dan\u0131\u015fmal\u0131d\u0131r.<\/p>\n

Oru\u00e7 Tutarken Kalp Hastalar\u0131n\u0131n \u0130la\u00e7 Tedavileri Nas\u0131l D\u00fczenlenmelidir?<\/strong>
\nOru\u00e7 tutarken ila\u00e7lar\u0131n d\u00fczenli al\u0131nmamas\u0131 veya ila\u00e7 tedavisinin b\u0131rak\u0131lmas\u0131 hastal\u0131\u011f\u0131n k\u00f6t\u00fcle\u015fmesine neden olaca\u011f\u0131 i\u00e7in ramazan ay\u0131 \u00f6ncesinde hastalar\u0131n ila\u00e7 tedavilerinde gerekli d\u00fczenlemeler yap\u0131lmal\u0131d\u0131r. Oru\u00e7 tutarken kalp ila\u00e7lar\u0131n\u0131n nas\u0131l kullan\u0131lmas\u0131 gerekti\u011fine dair klinik \u00e7al\u0131\u015fmalar ve dolay\u0131s\u0131yla k\u0131lavuz \u00f6nerileri hen\u00fcz yoktur. Ancak, ila\u00e7lar\u0131n etki s\u00fcreleri g\u00f6z \u00f6n\u00fcne al\u0131narak d\u00fczenlemeler yap\u0131labilir. G\u00fcnde tek doz ila\u00e7 kullanan hastalar\u0131n (hipertansiyon ve aritmi hastalar\u0131 gibi) tedavisi, ila\u00e7 dozunun sahur veya iftara kayd\u0131r\u0131lmas\u0131 ile d\u00fczenlenebilir. Burada \u00f6nemli olan ilac\u0131n her g\u00fcn ayn\u0131 saatte al\u0131nmas\u0131d\u0131r. Aksi taktirde tansiyonda y\u00fckselmeler olacakt\u0131r.<\/p>\n

Aspirin d\u0131\u015f\u0131nda kan suland\u0131r\u0131c\u0131 ila\u00e7 kullananlar (atriyal fibrilasyon, protez kapak, veya stentli vb hastalar) mutlaka kardiyologlar\u0131na Ramazan \u00f6ncesinde oru\u00e7 i\u00e7in dan\u0131\u015fmal\u0131d\u0131r. Bu hastalarda s\u0131kl\u0131kla ila\u00e7 dozlar\u0131nda d\u00fczenleme hatta de\u011fi\u015fiklik yapmak gerekecektir. Baz\u0131 kan suland\u0131r\u0131c\u0131 ila\u00e7lar ki g\u00fcnde 2 kez al\u0131nanlar\u0131n iftar ve sahurda al\u0131nmas\u0131 kan sulanmas\u0131 i\u00e7in yeterli olmayabilir. Nitekim yakla\u015f\u0131k 17 saat s\u00fcren iftar ve sahur aras\u0131 d\u00f6nemde 12 saat etki s\u00fcresi olan bir ila\u00e7, son 5 saatte etkisini yitirecektir ve bu da hastan\u0131n p\u0131ht\u0131 atmas\u0131na veya inme ge\u00e7irmesine neden olabilir. Bu \u00e7ok \u00f6nemli bir durumdur; hele ki hasta ya\u015fl\u0131 ise, \u00e7ok s\u0131cak ortamda oru\u00e7 tutulacaksa hastan\u0131n zarar g\u00f6rme olas\u0131l\u0131\u011f\u0131 artaca\u011f\u0131ndan oru\u00e7 tutmas\u0131 sak\u0131ncal\u0131 olacakt\u0131r.<\/p>\n

Kan\u0131 suland\u0131rmak i\u00e7in kumadin kullanan hastalarda da oru\u00e7la INR d\u00fczeyleri artmaktad\u0131r ve yine hekim taraf\u0131ndan doz ayarlamas\u0131 ve s\u0131k INR \u00f6l\u00e7\u00fcmleri yap\u0131lmas\u0131 gerekecektir. Aksi taktirde bu hastalarda oru\u00e7 tutma sonucu kanamalar geli\u015febilir.<\/p>\n

Oru\u00e7 tutabilen bir kalp hastas\u0131 beslenmede nelere dikkat etmelidir?<\/strong>
\nRamazan ay\u0131n\u0131n yaz d\u00f6nemine rastlamas\u0131 dolay\u0131s\u0131yla hem s\u0131cakl\u0131k hem de oru\u00e7 tutulan s\u00fcrenin uzun olmas\u0131 kalp hastalar\u0131nda beslenme \u00f6nerilerinin \u00f6nemini art\u0131rmaktad\u0131r.<\/p>\n

S\u0131cak hava nedeniyle s\u0131v\u0131 kayb\u0131n\u0131n fazla olaca\u011f\u0131 g\u00f6z \u00f6n\u00fcnde bulundurularak iftar ile sahur aras\u0131nda yeterli s\u0131v\u0131 al\u0131m\u0131 sa\u011flanmal\u0131d\u0131r. S\u0131ca\u011f\u0131n etkisi ile terle a\u015f\u0131r\u0131 su ve tuz kaybeden ki\u015fi, yeterli s\u0131v\u0131y\u0131 d\u0131\u015fardan almazsa tansiyon d\u00fc\u015fer, hayati organlara kan ak\u0131\u015f\u0131 aksayabilir. Bu nedenle oru\u00e7 tutarken s\u0131cak ortamlardan uzak durulmal\u0131, s\u0131cakta a\u011f\u0131r i\u015f yapmaktan ka\u00e7\u0131n\u0131lmal\u0131d\u0131r.<\/p>\n

Ramazan\u2019da oru\u00e7 tutan hastalar\u0131m\u0131zda s\u0131k\u00e7a g\u00f6rd\u00fc\u011f\u00fcm\u00fcz bir hata da a\u011f\u0131r ve \u00e7ok yemek yemeleri. Kimi hasta uzun s\u00fcren a\u00e7l\u0131\u011f\u0131n etkisi ile iftarda a\u011f\u0131r ve a\u015f\u0131r\u0131 yerken kimisi ise oru\u00e7 s\u0131ras\u0131nda a\u00e7l\u0131\u011fa dayanabilmek i\u00e7in sahurda \u00e7ok yemek yemektedir. Halbuki, a\u011f\u0131r bir yemek sonras\u0131 kalp daha h\u0131zl\u0131 atmaya ba\u015flar, tansiyon y\u00fckselir. A\u011f\u0131r yemek nedeniyle kana sal\u0131nan baz\u0131 hormonlar kan\u0131n p\u0131ht\u0131la\u015fmas\u0131n\u0131 kolayla\u015ft\u0131r\u0131r. A\u011f\u0131r bir yemek sonras\u0131 kan\u0131n sindirim organlar\u0131nda g\u00f6llenmesi de yine hayati organlara giden kan ak\u0131m\u0131n\u0131 azaltabilir. B\u00fct\u00fcn bunlar\u0131n sonucunda kalp krizi olu\u015fmas\u0131 kolayla\u015fabilir. Bu nedenle iftar ve sahurda yediklerimiz ve miktar\u0131 kalp damar sa\u011fl\u0131\u011f\u0131 i\u00e7in \u00e7ok \u00f6nemlidir.<\/p>\n

Ramazanda acil servise ba\u015fvurular, iftar sonras\u0131 ilk birka\u00e7 saatte artmaktad\u0131r. Bunun iftarda t\u00fcketilen g\u0131dalara ba\u011fl\u0131 oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmektedir. Kalp damar hastalar\u0131 Ramazan boyunca iki \u00f6\u011f\u00fcn yerine \u00fc\u00e7 \u00f6\u011f\u00fcn yemek yemelidirler. Bu \u00fc\u00e7 \u00f6\u011f\u00fcn iftar, iftardan 2-3 saat sonra ve sahur \u015feklinde olmal\u0131d\u0131r.<\/p>\n

Orucun asl\u0131nda \u201c<\/strong>nefsi terbiye\u201d oldu\u011fu unutulmamal\u0131, iftardan itibaren de \u00f6l\u00e7\u00fcl\u00fc beslenilmelidir. Bu sadece kalp damar hastalar\u0131 i\u00e7in de\u011fil, sa\u011fl\u0131kl\u0131 insanlar i\u00e7in de ge\u00e7erlidir. Orucu a\u00e7t\u0131ktan sonra i\u015flenmi\u015f karbonhidratlardan, \u015fekerli g\u0131dalardan, ya\u011fdan zengin yemeklerden uzak durulmal\u0131, t\u0131ka basa yemenin ciddi sorunlara yol a\u00e7abilece\u011fi unutulmamal\u0131d\u0131r. Maalesef ki \u00e7o\u011fu hastam\u0131z, iftar-sahur d\u00f6neminde ald\u0131\u011f\u0131 kalori g\u00fcn boyu ihtiyac\u0131ndan daha fazla oldu\u011fundan Ramazan sonras\u0131 kilo almakta, tansiyonlar\u0131 y\u00fckselmekte ve kan ya\u011flar\u0131 f\u0131rlamaktad\u0131r.<\/p>\n

\u0130ftar ve sahurda ne yemeli?<\/strong>
\nBu \u00f6\u011f\u00fcnlerde sindirimi uzun s\u00fcren g\u0131dalarda se\u00e7ilmesi gerekmektedir. Lifli, proteinden zengin a\u011f\u0131rl\u0131kl\u0131 sebze ve meyveden olu\u015fan \u00f6\u011f\u00fcnler uzun s\u00fcreli (yakla\u015f\u0131k 8 saat) sindirime u\u011frarken tokluk hissinin de uzun s\u00fcreli olmas\u0131n\u0131 sa\u011flayacak, aksine i\u015flenmi\u015f karbonhidrat i\u00e7eren \u015fekerli, unlu g\u0131dalar ise k\u0131sa s\u00fcrede sindirime u\u011frayaca\u011f\u0131ndan (yakla\u015f\u0131k 3 saat) k\u0131sa s\u00fcrede a\u00e7l\u0131k hissedilmesine neden olacakt\u0131r. \u0130\u015flenmi\u015f karbonhidrat (\u015fekerli g\u0131dalar, b\u00f6rek, \u00e7\u00f6rek, baklava, makarna, kurabiye, re\u00e7el vb) yerine sebze yemekleri, fasulye, bezelye, nohut, mercimek gibi g\u0131dalar\u0131 tercih etmeli. Asitli me\u015frubatlardan uzak durulmal\u0131. Sahura kalkmadan oru\u00e7 tutmamal\u0131d\u0131r.<\/p>\n

Sonu\u00e7 olarak, Ramazan ay\u0131nda kalp damar hastalar\u0131, kalp sa\u011fl\u0131klar\u0131na dikkat etmeli. Oru\u00e7 tutma karar\u0131n\u0131 hekimlerine dan\u0131\u015fmadan vermemeli. Oru\u00e7 tutabilecekse de ila\u00e7lar\u0131n\u0131n d\u00fczeni hekimi taraf\u0131ndan belirlendikten sonra ila\u00e7lar\u0131n\u0131 aksatmadan, orucun nefsi terbiye oldu\u011funu unutmadan, iftar ve sahurda do\u011fru ve \u00f6l\u00e7\u00fcl\u00fc beslenerek, yeterli s\u0131v\u0131 alarak sa\u011fl\u0131\u011f\u0131na dikkat etmesi gerekmektedir.<\/p>\n

Sa\u011fl\u0131kl\u0131 Ramazanlar dile\u011fiyle<\/p>\n

Haz\u0131rlayanlar: Prof Dr Meral Kay\u0131k\u00e7\u0131o\u011flu1<\/sup>, Prof Dr Sinan Aydo\u011fdu2<\/sup>
\n1.Ege \u00dcniversitesi T\u0131p Fak\u00fcltesi. Kardiyoloji Anabilim Dal\u0131; \u0130zmir
\n2.T\u00fcrkiye Y\u00fcksek \u0130htisas Hastanesi Kardiyoloji Klini\u011fi, Ankara<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Oru\u00e7 tutmak, kalp damar hastal\u0131klar\u0131n\u0131 tetikleyebilir mi? Bu konuda da yeteri \u00e7al\u0131\u015fma olmamakla birlikte, Katar\u2019da 10 y\u0131ll\u0131k izlemde Ramazan ay\u0131 ve izleyen ay s\u00fcresince kalp hastal\u0131klar\u0131na ba\u011fl\u0131 hastaneye yat\u0131\u015f oran\u0131nda di\u011fer aylara g\u00f6re art\u0131\u015f olmad\u0131\u011f\u0131 saptanm\u0131\u015ft\u0131r. Ankara\u2019da yap\u0131lan bir \u00e7al\u0131\u015fmada ise benzer \u015fekilde sa\u011fl\u0131kl\u0131 insanlarda orucun kalp damar hastal\u0131klar\u0131n\u0131 art\u0131r\u0131c\u0131 bir etkisi olmad\u0131\u011f\u0131n\u0131 g\u00f6sterilmi\u015ftir. Ancak, […]<\/p>\n","protected":false},"author":1,"featured_media":2007,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[351,343,241,141],"class_list":["post-2031","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","tag-oruc","tag-kalp","tag-damar","tag-saglik"],"_links":{"self":[{"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/posts\/2031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/comments?post=2031"}],"version-history":[{"count":1,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/posts\/2031\/revisions"}],"predecessor-version":[{"id":2032,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/posts\/2031\/revisions\/2032"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/media\/2007"}],"wp:attachment":[{"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/media?parent=2031"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/categories?post=2031"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/izmirkalpdoktoru.com\/wp-json\/wp\/v2\/tags?post=2031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}