The older of increased pulse pressure in hypertensive patients, conventional antihypertensive therapy by reducing the total peripheral vascular resistance, although also can the degree of narrowing pulse pressure, but limited role. Now think, hypertension, dyslipidemia, hyperglycemia, smoking, hyperhomocysteinemia, oxygen free radical production increase, can affect the arterial endothelial function.
Cause of elevated systolic blood pressure, diastolic pressure, pulse pressure. Therefore, improving arterial elastic function is a new therapeutic approach, the application of hypotensive drugs will play an important role. This class of drugs has the following categories:
1, nitrate medication : direct diastolic arterial vascular smooth muscle, improve large artery elasticity, play a role in fast.
In 2, he ordered drugs: he ordered drugs not only can regulate blood lipids, but also to improve arterial elastic function, can decrease the production of oxygen free radicals. He ordered drugs improve arterial elasticity and narrow pulse pressure effect is relatively slow, the need for long-term therapy can be effective.
3, folic acid: hyperhomocysteinemia, significant impairment of endothelial function, and atherosclerosis and isolated systolic hypertension in the elderly is closely related to the occurrence of. Long term supplementation of folic acid and vitamin B6 may reduce plasma homocysteine, thereby improving arterial elastic function, but also the lack of evidence of dose and duration of treatment.
In 4, Shima Somasu sensitizers: the presence of insulin resistance, antihypertensive treatment should also be taking insulin sensitizer, in order to improve the elasticity of blood vessels, but takes 3~6 months to effect.
The long-term benefits of antihypertensive therapy
Treatment of hypertension in patients with the biggest problem, non-standard medication, including medication intermittently, or a decrease in blood pressure after discontinuation of medication, these practices are harmful. Hypertensive patients after 6~12 months of treatment if invalid, or that the presence of other risk factors, needs to implement effective long-term treatment of hypotensive drugs. First of all, after antihypertensive treatment after the restoration of normal blood pressure, which is the result of antihypertensive therapy, but the average 6~8 months after drug withdrawal, the vast majority of the blood pressure of the patients will be restored to its previous level. If the withdrawal, in this period of time because of not knowing when the rise in blood pressure, and blood pressure related to target organs in loss protection state. Secondly, the blood pressure returned to normal, is not due to hypertension caused by cardiovascular and cerebrovascular lesions usually returned to normal, these lesions after at least two years of treatment can be improved. Third, there are a lot of patient concerns about side effects of drugs and drug withdrawal. In fact, hypertension, drug side effects are most likely to occur at the start of treatment for 2~4 weeks, long after the treatment, but fewer side effects. If used to stop drugs, patients will continue to endure the initiation of treatment period unnecessary side effects. Fourth, some patients continue to worry about normal blood pressure after treatment, can make blood pressure is more and more low, so they will lower blood pressure in the summer to stop medication, in fact, antihypertensive drugs is the main function of dilated vessels around, decreased peripheral resistance. Resistance to normal, blood pressure will not be reduced.
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