Views:98 Author:Site Editor Publish Time: 2019-12-19 Origin:Site
Antihypertensive drugs are a class of drugs that control blood pressure and are used to treat hypertension. Antihypertensive drugs exert their antihypertensive effect mainly by affecting the sympathetic nervous system, renin-angiotensin-aldosterone system, and endothelin system, which play an important role in the physiological regulation of blood pressure.
Five kinds of commonly used antihypertensive drugs can be used as the initial treatment drugs. It is recommended to select targeted drugs according to the type of special population and comorbidities for individualized treatment. The initial single drug or combination therapy should be selected according to blood pressure level and cardiovascular risk.
The general patients use the conventional dose. The elderly should usually use the smaller effective treatment dose in the initial treatment. Gradual increase to sufficient dose may be considered as required. Prioritize the use of long-acting antihypertensive drugs to effectively control blood pressure for 24 hours and more effectively prevent cardiovascular and cerebrovascular complications.
High-risk patients with blood pressure values higher than 160 / 100mmHg, or patients with hypertension who have failed single-agent therapy should be treated with combined antihypertensive therapy (I, C), including free combination or monolithic compound preparations. For patients with blood pressure values higher than 140 / 90mmHg, low-dose combination therapy can also be initiated (I, C).
Common antihypertensive drugs include five types of calcium channel blockers (CCB), angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor antagonist ARB, diuretics and β-receptor blockers, as well as fixed proportion compound preparations composed of the above drugs.
This guideline recommends that the five major classes of antihypertensive drugs can be used as initial and maintenance medication choices. Drugs should be used reasonably, and a certain class of antihypertensive drugs should be preferentially selected based on patient risk factors, subclinical target organ damage, and combined clinical disease. These clinical conditions can be called strong indications. In addition, alpha blockers or other types of antihypertensive drugs can sometimes be used in some people with hypertension.
The combined application of antihypertensive drugs has become the basic method of antihypertensive treatment. In order to reach the target blood pressure level, most people with hypertension need to use two or more antihypertensive drugs.
Indications for combined use: High-risk groups with blood pressure higher than 160 / 100mmHg often require the use of two antihypertensive drugs for initial treatment. If the blood pressure higher than 140/90 mmHg, the initial low-dose combination antihypertensive medication can also be considered. If the target blood pressure is still not achieved, the amount can be increased on the basis of the original drug, or it may need three or more than four kinds of antihypertensive drugs.
The CHIEF study shows that the initial combined treatment has a good antihypertensive effect on the middle-aged and old hypertensive patients at high risk of cardiovascular disease in China, and obviously improves the rate of blood pressure control.
All in all, patients with hypertension should take medication under the guidance of a doctor for a long time when choosing antihypertensive drugs. At the same time, using a blood pressure monitor to record changes in patient's blood pressure can well control the risk of disease caused by hypertension.