Antihypertensive drugs, commonly used in clinical antihypertensive drugs can be divided into seven categories of dozens of kinds, including old drugs and new drugs, there are also unilateral and recurrent preparations, there are domestic collection drugs and imported drugs, although they can be used to treat hypertension, but due to the different mechanisms of action, so in the use of hypertension patients of different ages, different types of hypertension and different complications, there will be different choices and emphases.
I don't know if you have found that the antihypertensive drugs commonly used in elderly hypertensive patients often contain diuretics, while young hypertensive patients use sartan-type antihypertensive drugs more. Today, I will explain to you why this phenomenon occurs.
Elderly patients with hypertension are characterized differently from younger people with elevated blood pressure
We all know that blood pressure has systolic blood pressure and diastolic blood pressure, we often call systolic blood pressure as upward pressure, diastolic pressure as downward pressure. Elderly people due to hardening of the blood vessels, thickening of the blood vessel wall, arterial elasticity is weak, which makes the heart need more force to pump blood to make the blood through the whole body, so the elderly hypertension is often the main increase in the upper pressure, and the lower pressure is normal or slightly low.
Young people, on the contrary, have good blood vessel elasticity and no atherosclerosis, but are more likely to cause increased blood pressure in the veins due to various factors, so young hypertensive patients often show elevated lower pressure and normal upper pressure. Although they are all hypertension, this characteristic also determines the difference in the blood pressure medications chosen.
Why do the elderly use diuretics more?
Sodium ions in the body have a regulatory effect on the relaxation and contraction of blood vessels, sodium ion concentration increases, vasoconstriction blood pressure will rise, elderly hypertension is often due to increased sodium ion concentration, and blood vessel sensitivity to sodium ions is enhanced, while sodium caused by sodium ions caused by water sodium retention also often leads to increased blood volume. Therefore, if antihypertensive drugs are used alone, the effect is often reduced, so the elderly usually need to use diuretic antihypertensive drugs in combination. However, it should be noted that commonly used first-line diuretics have more antihypertensive effects and are usually not suitable for use alone.
Why do young people use sartans?
The cause of young hypertension is often due to failure of renin-angiotensin-aldosterone system (RAAS) regulation, either due to increased renin-angiotensin activity or increased sensitivity to angiotensin II receptors. There are two main types of drugs that act on the system, namely the pry and the satans.
The puly class mainly reduces the hypotensive effect by inhibiting the transformation of angiotensin I into angiotensin II, reducing peripheral vascular resistance, while sartan class directly antagonizes angiotensin II receptors to reduce blood pressure. Although both can be used optionally, pry drugs have a very prominent side effect, that is, long-term use is more likely to cause dry cough, and sartan side effects in this regard are much less common than puly class, so in fact, young hypertension is more likely to choose sartan antihypertensive drugs.
In addition, young patients with high blood pressure may also have another factor, that is, increased sympathetic excitability. At this time, it is also possible to choose β receptor blockers that have a certain inhibitory effect on sympathetic excitability, that is, the often said lorres such as metoprolol, propranolol and so on.
It is worth reminding that young people's hypertension is often related to unhealthy lifestyles, such as obesity caused by long-term lack of exercise, which is the cause of high blood pressure in many young people, which requires young people to actively improve their lifestyle, strengthen exercise, control weight, and the elderly also pay attention to developing good living habits while standardizing the use of antihypertensive drugs.
bibliography:
[1] Guidelines for the Rational Use of Drugs for Hypertension (2nd Edition)
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