Principles for selection of antihypertensive drugs

Principles for selection of antihypertensive drugs:

1, the application of antihypertensive drugs in the treatment of essential hypertension need long-term medication. Therefore, should choose the antihypertensive effect of gentle, slow, durable, less side effects, the patient is easy to master and use the convenience of oral antihypertensive drugs (such as hydrochlorothiazide, reserpine, Compound Hypotensive Tablets) as the basis of antihypertensive drugs, according to the different stage of the disease with other antihypertensive drugs.

2, the use of antihypertensive drugs generally start from small doses, gradually increase the dose, to achieve the purpose of reducing blood pressure, can be used to maintain the volume to consolidate the efficacy, as far as possible with the least amount of maintenance to reduce side effects.

3, the use of antihypertensive drugs can cause obvious orthostatic hypotension when appropriate to the patient, from sitting up or from supine to standing up, action should be slow, especially when more attention should be paid to get up to urinate at night, so as to avoid the sudden drop in blood pressure caused by the blackout accidents.

4, slowly progressive first stage patients, no obvious symptoms, general treatment (including sedatives) that can work without use of antihypertensive drugs, if necessary, with a small amount of moderate antihypertensive drugs such as diuretics, devilpepper or reserpine can. Second patients required the use of two or more than two kinds of antihypertensive drugs, such as reserpine, hydralazine and diuretics or choose the enzyme inhibitor, postganglionic sympathetic inhibitor, ganglionic adrenergic blockers or etc.. Third patients with hypotensive effect of strong drugs such as postganglionic sympathetic ganglion blockers, inhibitors, such as clonidine hydrochloride, minoxidil treatment etc..

5, the clinical application of several antihypertensive drug therapy, the advantages are: drug synergy can improve efficacy; several drugs to play a role, can reduce the dosage of each drug; reduce the side effects of each drug, or make some side effects offset each other, so that the blood pressure drop more stable. The joint is the most commonly used diuretics and other antihypertensive drugs, diuretics can enhance the efficacy of various antihypertensive drugs, but also can reduce the side effect caused by edema; reserpine and hydralazine, beta blockers and minoxidil combination, their slow increases in heart rate and side effects cancel each other.

6, hypertension disease and treatment measures in type third similar. If blood pressure continued decline can be considered for hibernation; such as renal failure, is to choose antihypertensive drug methyldopa, hydralazine, clonidine properly, blood pressure should not be too obvious, so as to avoid reduced renal blood flow aggravate renal failure.

7, the blood pressure was significantly higher in patients has been for many years, not the blood pressure drop too fast, too much, because patients often failed to adapt to low or normal levels of blood pressure and discomfort, and lead to brain, heart and kidney blood supply caused by cerebrovascular accident, coronary artery thrombosis, renal insufficiency may. Hypertensive crisis or hypertensive encephalopathy should be used when emergency antihypertensive measures.

The choice of drugs for lowering blood pressure in diabetic patients.

Patients should be the first choice of antihypertensive drugs is an angiotensin converting enzyme inhibitor. Because the drug has the following effect on diabetic patients:

1. It also can improve the sensitivity of muscle and fat to insulin, which is especially important for the patients with the use of insulin to control blood glucose.

2, no adverse effects on glucose and lipid metabolism, and sometimes can play a role in improving the metabolism of sugar and fat

3, can inhibit the proliferation of arterial smooth muscle cells, prevent the formation of atherosclerosis, reduce or reverse left ventricular hypertrophy, improve cardiac function

4, the early diabetic nephropathy patients can significantly reduce the urine protein urine, with the function of preserving kidney.