가장 잔인하고 끔직한 질병, 혈관 질환

가장 무서운 질환인 암은 말기암 환자라도 온전한 이성을 갖고 자신의 인생을 정리할 수 있는 여유가 있지만 뇌졸증이나 심장병 등 혈관 질환은 갑자기 예고없이 찾아 옵니다. 중증의 심혈관 질환이 생기게 되면 최하가 반신불수 아니면 사지마비, 아니면 식물인간이나 뇌사가 됩니다.
만약 사지마비가 되는 경우 손가락 하나도 까닥 못하고 대소변도 못가리고 몇달 몇년간 통나무 처럼 자리에 누워있게 만듭니다.

제일 끔찍한 것은 환자의 의식은 살아 있어 자신에게 말하는 모든 내용을 알고 있다는 것입니다. 또한 환자의 보호자가 돌아 가면서 모든 음식과 대소변 수발을 들면서 살이 썩는 욕창이 들지 않도록 2시간 마다 계속 움직이고 주물러 줘야 한다는 사실입니다.
“침묵의 살인자” 고혈압
사진 : 픽사베이, 고혈압으로 망가지는 주요 신체 장기 부위들
고혈압이란 수축기 혈압이 140mmHg 이상이거나 이완기 혈압이 90mmHg 이상일 때를 말합니다. 고혈압은 관상동맥질환과 뇌졸중, 신부전 등 전신에 걸쳐 다양한 혈관질환과 합병증을 일으키며 환자의 생명과 건강을 직접적으로 위협합니다. 그러나 일반적으로 고혈압은 특별한 증상이 없어 혈압을 측정해 보기 전까지는 진단이 되지 않고, 진단이 되더라도 별다른 증상이 없읍니다.

따라서 고혈압 환자는 혈압이 심각한 수준까지 올라갈 때조차도 증상이 없으며 혈압이 높은 상태가 장기적으로 지속되어 신체 각 부위에 다양한 합병증이 발생하고 심장발작이나 뇌졸중처럼 치명적으로 나타날 때 비로소 알아 차리게 됩니다. 이런 이유로 고혈압을 “침묵의 살인자”라고 부르기도 합니다.
연극배우 김흥기씨는 평소 고혈압을 앓다가 연극 도중 갑자기 뇌졸증으로 쓰러진 후 5년 정도 병상에서 눈으로만 의사소통이 가능할 정도로 오래 앓다가 운명을 달리하였습니다. 반만에 여윤계씨는신장암으로 고생하였지만 임종 일주일 전까지 TV에서 활약하였습니다.
젊은 나이에 심장마비나 뇌졸중이?
우리 주위에 20대나 30대 창창한 나이에 과로로 갑자기 쓰러졌다는 소식을 듣습니다. 이것은 자기도 모르게 고협압을 가지고 있었다는 것을 말해 줍니다. 10대의 경우에도 전국적으로 고혈압 환자가 대략 8만명이나 됩니다.

보건복지부에서 발표한 국민건강영양조사 제6기 2차년도(2014) 결과보고에 의하면 만 30세 이상에서의 고혈압 유병률은 전체 30.4%, 남자 34.2%, 여자 26.9%로 남자가 여자보다 7.3% 높았습니다. 30대, 40대, 50대는 남자의 고혈압 유병률이 여자보다 높으나, 60대와 70세 이상에서는 여자의 유병률이 더 높았습니다.
또한 본인이 고혈압 환자라는 것을 알고 있는 인지율은 65.9%, 고혈압 환자임을 알고 치료 받고 있는 비율인 치료율이 61.3%, 실제로 치료 받아 잘 조절되고 있는 환자는 43.8%(유병자 기준)에 불과합니다. 바로 이런 이유로 자신도 모르고 “침묵의 살인자” 고혈압을 가지고 있는 사람들이 반 이상이나 됩니다.
고혈압 관리가 쉽지 않은 이유

평소 가슴이 답답하거나 두통이 있는 등 혈압이 높다는 의심이 들면 혈압을 수시로 재어 보아야 합니다. 특히 고혈압은 별다른 증상을 동반하지 않으므로 혈압을 측정하는 것 외에는 고혈압의 발생 여부를 확인할 방법이 없습니다.
혈압의 발생에 영향을 주는 위험 요인 중 환자에게 교정이 필요한 생활습관을 찾아내서 교육하고 바른 생활습관을 가지도록 중재하는 것을 생활요법이라 하며 이는 고혈압의 치료 및 관리에 가장 중요합니다. 혈압을 낮추는데 그 효과가 밝혀진 생활요법으로 절주, 금연, 체중감량, 규칙적 운동, 저염식과 적절한 식이습관이 있습니다. 그러나 이러한 것은 모두 생활습관을 고쳐야 하기 때문에 대부분의 경우 지속적으로 실천하기는 쉽지 않으며 마음먹고 하더라도 작심삼일이 되기 쉽습니다.
나트륨이 고혈압에 치명적인 이유
사람의 정상 수축기 혈압인 120mmHg의 위력은 수은 기둥을 120mm라 밀어올리는 압력인데 동맥의 혈관이 파열될 경우 피가 천장까지 솟구칠 정도로 엄청난 힘으로 혈관벽에 강력한 힘을 가합니다. 만약 고혈압 상태가 지속될 경우 경화되고 좁아진 동맥에 미치는 강력한 압력은 혈관벽에 상처를 내어 그 틈으로 혈액 속의 콜레스테롤이 쌓여 죽상동맥경화합니다. 이런 경우 어느 순간 혈관 전체가 막히거나 터져 치명적인 위기 상황으로 발전하게 됩니다.

이렇게 혈압이 정상 범위보다 높아 진 고혈압 환자의 경우 혈액의 나트륨 농도, 즉 염도가 오르면 삼투압 현상으로 혈액량은 대폭 늘어나는 반면 혈관세포를 자극하고 혈관은 좁아져 심장·뇌혈관질환의 기폭제가 됩니다. 결과적으로 혈관이 가장 많은 콩팥부터 파괴되어 나트륨이 몸밖으로 배출되는 것이 지연되는 악순환이 되어 뇌·심근경색 위험이 크게 증가합니다.
고혈압 환자라면 나트륨 관리는 필수
사진=신지호 헬스조선 기자, 그래픽=유두호 기자 출처 : http://health.chosun.com/site/data/html_dir/2017/08/30/2017083000197.html
나트륨을 섭취했을 때 신장을 통해 잘 배출되지 않고 나트륨에 대한 지나친 반응으로 혈압이 상승하는 현상을 나트륨 민감성 혹은 소금 민감성이라고 합니다. 동양인의 경우 약 85%가 나트륨 민감성을 일으키는 유전자를 가지고 있다고 하므로 고혈압 환자는 나트륨 섭취량을 특히 제한해야 합니다.
사진 출처:조선닷컴
나트륨 하루 2,000그램 정도만 섭취할 때 혈압약 복용 효과
소금 섭취량을 세계 보건기구 권장량인 하루 2,000mg 정도를 섭취할 때 혈압약을 복용할 때와 비슷한 혈압 강하효과가 나는 것이 임상적으로 검증이 되었습니다.

한양대병원 내과 전대원 교수팀은 비만인 80명을 저나트륨 식사 그룹과 저칼로리 식사 그룹으로 나누고 저나트륨식사 그룹에 하루 2g의 나트륨을, 저칼로리식사 그룹엔 40대 한국인의 평균 섭취량인 4.6g의 나트륨을 넣은 식사를 2달간 제공하였습니다.
그 결과, 저 칼로리 식사 그룹의 효과는 예상보다 작았고 저 나트륨 식사 그룹에 있어 수축기 최대 혈압은 저나트륨식사 전 129.5㎜Hg에서 뒤 121.7㎜Hg로, 공복 혈당은 82.8㎎/㎗에서 68.8㎎/㎗로, 중성지방은 154.0㎎/㎗에서 84.1㎎/㎗로 감소하였다고 합니다. 또 혈관 건강에 이로운 HDL 콜레스테롤은 저나트륨식 전 53.3㎎/㎗에서 뒤 35.9㎎/㎗로 증가했습니다. 이는 저나트륨식이 고혈압ㆍ고지혈증ㆍ당뇨병 예방이나 치료를 도울 수 있음을 뜻합니다.
고혈압 환자의 나트륨 관리, 카드로 쉽고 즐겁게!
고혈압 환자들은 혈압을 낮추기 위해 식이조절이나 운동, 혹은 저염식 등의 평소 생활 습관을 개선해야 하지만 지속적으로 유지하기가 쉽지 않습니다. 따라서 생활 속에서 가장 쉽게 할 수 있는 방법으로 하루 나트륨 섭취량을 2,000mg정도만 제한하더라도 혈압약을 먹는 효과와 비슷하므로 저염식을 생활 속에서 쉽게할 수 있는 방법이 중요합니다.

저염식을 하기 위해 혀로는 나트륨 농도를 알 수 없기에 염도계가 필요하지만 크고 휴대하기 어렵습니다. 이 경우 카드형 스마트 나트륨 측정기를 사용한다면 편리하고 재미있게 나트륨을 관리할 수 있습니다.
세계 최초 카드형 스마트 나트륨 측정기인 “솔투조이”는 신용카드처럼 생겨 지갑속에 보관하여 어디서나 쉽고 편리하게 사용할 수 있습니다. 특히 자주 먹는 음식의 용액 한두방울만 카드의 센서에 떨어 뜨린 후 스마트폰을 접촉하면 자동적으로 나트륨 농도를 체크할 수 있습니다.

또한 요즘에는 가공식품이나 간편 즉석 식품을 통해 과량의 나트륨을 자신도 모르게 섭취합니다. 예를 들면 라면 한 그릇을 모두 먹는 다음 하루 나트륨 섭취량을 한번에 섭취하게 되는 셈입니다. 라면 외에도 패스트 푸드, 과자나 빵, 쏘시지 등 이런 가공식품을 자주 먹을 경우 자신이 나트륨 폭탄에 얼마나 노출되어 있는 지를 알 수 있는 방법으로 자신의 소변을 한 두 방울 떨어뜨려 측정하면 됩니다.

카드형 스마트 나트륨 측정기를 이용하면 아주 간단하게 자신의 소변 속 나트륨 농도가 저염인지, 중간인지, 고염인지 바로 알 수 있어 자신도 모르는 나트륨 중독을 예방하는 데 큰 도움을 줍니다.
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