Older people use of antihypertensive drugs and medication attention principle

The ideal blood pressure lowering drugs, shall meet the following conditions: ( 1) the antihypertensive effect of good, mild side effects, the decrease of blood pressure trough / peak ratio greater than 50%; ( 2) can prevent or reverse of life of the patients with damage to vital organs; ( 3) on blood lipids, blood glucose, uric acid metabolism without adverse effects, can improve insulin resistance, does not cause low blood potassium; ( 4) the drug effect for a long time ( long half-life ), every day just to a medication.

As a result of elderly patients with hypertension accompanied with coronary heart disease, diabetes, hyperlipidemia, so the use of blood pressure lowering drugs should differ from man to man, and in the choice of drugs to pay more attention to.

1, appropriate to hypotensive effect of mild, persistent, good effect and side effects of the drug as a basis for medication light. On blood pressure lowering requirements should not be too fast, too fast, the first general with a small dose, and then as the blood pressure, gradually increasing doses, or a combination of two or more antihypertensive agents with, so that the pressure drop to a lower security level ( <140/80 ), diabetic patients should be appropriately below this value.

In 2, the elderly hypertension treatment, many advocates combined medication. According to statistics, single drugs on blood pressure control rate of 45~55%, and combined with two kinds of medicine application for 75~80%. Combined medication can reduce the dose of medicinal use, and may be coordinated effectively interfere with multiple boosting mechanism, prolong action time and offset or reduce some undesirable side effects, better protect the heart, brain, kidney and other organs.

3, should adhere to the long-term use of antihypertensive drugs. Even after taking antihypertensive effect is satisfactory and stable blood pressure, also can adjust the dose, cannot easily or sudden withdrawal. Otherwise, prone to drug withdrawal syndrome, blood pressure can rebound quickly even higher, also can cause anxiety, arrhythmia, angina pectoris.

In 4, the elderly due to the regulation of blood pressure decrease blood pressure baroreceptor sensitivity, tend to have relatively substantially fluctuant, also easily complicated by cardiovascular and cerebrovascular events, the antihypertensive efficacy evaluation, not by one or a blood pressure level and calm, and should be systematically measured several times observed, even blood pressure fluctuations should also be kept in a relatively safe range.

In 5, aged antihypertensive drugs should be individualized, with condition of patients with combined medication. The current tendency to calcium antagonists ( CCB ) and angiotensin converting enzyme inhibitor ( ACEI ) or angiotensin II receptor antagonists ( ARB ) as the preferred, such as after taking antihypertensive effect is not ideal, may be appropriate to increase the small doses of diuretics.

6, the rapid heart rate, sympathetic excitation excitable patients with hypertension, coronary heart disease, angina or in combination, heart beat, can be in the preferred medical basis, plus clothing times he receptor blockers ( such as metoprolol etc.). But this kind of Medicine on hyperlipemia, hyperglycemia should be used, and the slow heartbeat, asthma, cardiac atrioventricular block were hanged.

In 7, small doses of thiazide diuretics: double hydrogen grams of urine plug and any kind of antihypertensive drugs, has good synergistic effect for reducing blood pressure. But the medicine with larger doses of long-term application on diabetes, hyperlipidemia and renal dysfunction is appropriate, also can lead to low blood potassium.

8, blood pressure lowering drugs should be as far as possible not to take in the night. Of course the morning hypertension according to the circumstances of other different.