There are many kinds of antihypertensive drugs, and the mechanism of action is different. For different individuals, it can not only effectively control blood pressure, but also can reduce the complications and mortality of patients with hypertension. Therefore, it is very important to select drugs. What is the principle of high blood pressure medication?
One, the principle of individual: medication varies according to the individual, according to the blood pressure level, the degree of increase and acute, slow, not without complications and the body of the drug reaction to the drug, light and part of the medium to high blood pressure patients with diuretic drugs is effective, side effects are relatively small. The emergency of antihypertensive treatment often choose ganglionic injection on hypertensive crisis.
Two, ladder type treatment method: according to the high degree of blood pressure to the high degree of the treatment is a wide range of countries in the world. In general patients, the first to one kind of antihypertensive drugs, such as the gradual increase in the use of one or two different mechanisms of antihypertensive drugs.
First level applies to light hypertension. General use of Dihydrochlorothiazide 25mg or propranolol 10mg, 3 times a day. Such as the treatment of 8 weeks of blood pressure does not fall, then according to the two grade treatment.
The second level is invalid, the diuretic based on the use of adrenergic inhibitors, such as reserpine, Ca Guido Ba etc.. 4-8 weeks after the treatment was not effective at three levels of treatment.
The third level is mainly in severe hypertension, morality should be strictly limit daily sodium sodium, <5 grams, plus vasodilator hydralazine, prazosin, nifedipine or minoxidil. 2-4 weeks after the blood pressure is not ideal, then according to the four grade treatment.
Grade fourth is mainly high blood pressure or high blood pressure, the need for admission treatment, generally within 72 hours of the low pressure control in 14kpa (110mmHg) the following, can be treated with diuretics, sympathetic nerve agents and blood vessels. Or diuretics, receptor blockers and angiotensin converting enzyme inhibitors in combination with the three.
Three, antihypertensive drug selection varies from person to person, to achieve the goal of lowering blood pressure
The research confirmed that if the blood pressure is controlled in the range of 120 / 80mmHg in patients with hypertension, heart and cerebrovascular events in the lowest risk, so that patients with uncomplicated hypertension target blood pressure should be less than or equal to 120 / 80mmHg.
If hypertension combined with diabetes or coronary heart disease, its target blood pressure should be set to 130 / 80mmHg the following, hypertension combined with renal damage in patients with lower blood pressure, should be reduced to 125 / 75mmHg the following, while the elderly systolic hypertension and the occurrence of stroke in patients with blood pressure less than 140mmHg can be, do not drop too low, in order to prevent important organ ischemia and hypoxia.
Expert advice: the different conditions of hypertension patients with different blood pressure to meet the requirements. Can not be too fast, should step down; the target blood pressure values are not exactly the same, which requires doctors according to the actual situation of patients in a comprehensive analysis, in the choice of antihypertensive drugs vary, so that patients with more reasonable and effective, and strive to achieve blood pressure. A lot of antihypertensive drugs, antihypertensive drugs currently used in clinical have specific choice of a hundred species or what kinds of antihypertensive drugs should be based on the duration of the disease, the severity of disease, cardiovascular status, complications and other diseases to decide.
Four, effective control of blood pressure for 24 hours, stable control
In general, all antihypertensive drugs marked "release" or "release" is a long-term preparation, such as the commonly used nifedipine and felodipine sustained-release tablets, nicardipine hydrochloride sustained-release capsules. In addition, indapamide, diuretics, angiotensin converting enzyme inhibitor (ACEI) in enalapril and lisinopril, ramipril, cilazapril, amlodipine, a calcium antagonist of nitrendipine, and angiotensin II receptor antagonist (ARB) chloride in losartan and valsartan, belong to the daily 1 take can make long-acting antihypertensive drugs 24 hours blood pressure decline.
Expert advice: at the same time a day of medication can also reduce the patient to forget to take, leakage service, improve medication compliance, to lay a good foundation for long-term stable control of blood pressure. Therefore, should try to choose to be able to effectively control the 24 hour blood pressure drugs. If you can control the 24 hours a day to control the blood pressure, can effectively reduce blood pressure fluctuations, to prevent the night and morning blood pressure has important significance, can avoid sustained blood pressure increased to target organ damage, suitable for long-term use of patients.
Five, the optimal antihypertensive drugs, blood pressure and improve blood vessel function as follows:
At present, there are 5 major types of antihypertensive drugs, namely, diuretics, beta blockers, calcium antagonists, angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists. Among them, the antihypertensive drugs acting on blood vessels are mainly calcium antagonists, followed by angiotensin converting enzyme inhibitors and angiotensin receptor antagonists. These types of antihypertensive drugs can be directly acting on the vascular smooth muscle by different mechanisms, so that they can relax, thereby reducing the peripheral resistance, lower blood pressure.
Expert advice: the first treatment should be single drug dosing, step (severe hypertension exception), the combined treatment was better than high-dose monotherapy; dosage according to the prescribed dose by foot; cannot suddenly stop or suddenly stopped a drug; master and insist on the use of several drugs.
Six: the combination of antihypertensive drug use and lifestyle conditioning
As is known to all, the influence factors of hypertension are many, many of them are related to the bad life style.