Under the grass-roots inspection, a 70-year-old hypertensive patient came.
It is said that the blood pressure is high, the control of taking medicine is unstable, sometimes normal, most of them are high, and the high pressure is often 150-160mmHg.
Doctor: What antihypertensive drugs did you take?
Suffering: What I ate earlier, because my legs were swollen and changed. Now take two pills.
With that, he pulled out a pill box and a small bottle. At first glance, the pill box is "valsartan hydrochlorothiazide", the bottle is "compound captopril tablets", and the ingredient is "captopril hydrochlorothiazide".
A satan, a puly, both have hydrochlorothiazide, which belongs to repeated medication, and "sartan" and "puly" generally do not advocate combined use.
Doctor: These two drugs belong to the same category, generally do not eat together, and there are diuretics in them, and the dose is large when used together.
Accrual: I didn't eat together. I eat this today and that tomorrow. Take 1 tablet daily.
Doctor: This captopril hydrochlorothiazide is a short-acting drug that should be taken 3 times a day.
Affliction: I eat it once a day.
All right. How can this way of eating lower blood pressure?
Let's start with these two drugs
Both of these drugs belong to the "single-tablet compound preparation" in antihypertensive drugs.
Valsartan hydrochlorothiazide, captopril hydrochlorothiazide, both hydrochlorothiazide, but the front one is "satan" and one is "puly".
Therefore, the common denominator of these two drugs is that they are both composed of two antihypertensive drugs, and both contain hydrochlorothiazide, a diuretic antihypertensive drug. Two or three antihypertensive drugs synthesize 1 tablet of the drug, medically called "single tablet compound preparation". Therefore, take medicine can not look at a few tablets, to look at the medicine inside.
When lowering blood pressure, the advantage of using a monolithic compound preparation is that the antihypertensive effect is good and convenient to take, so the patient's compliance is good. Compliance is the case when the patient listens to the doctor's words and takes medication according to the doctor's instructions. In this way, originally to eat 2 or 3 tablets of antihypertensive drugs, now take 1 tablet on the line, patients are easy to accept, but also to prevent patients from arbitrarily reducing drugs, affecting the efficacy of antihypertensive efficacy.
"Puli" and "satan", acting on the same large system, are generally not used.
In the occurrence of hypertension, there is a large system in the body that plays an important role, including causing increased blood pressure, arteriosclerosis, myocardial hypertrophy, kidney damage, heart failure, etc., which is the renin-angiotensin-aldosterone system. Therefore, medicine has developed drugs for inhibition of this system.
"Puly" class: acts on angiotensin-converting enzymes, inhibits the conversion of angiotensin from inactive to active to lower blood pressure. This is the more upstream link in the system ("Puli" and "Satan", the good "brother" of the pressure reduction, the first look at the brother "Puli").
"Sartan" class: acts on receptors of angiotensin. Blocking the receptor, so that it does not accept the "command" of angiotensin, blood pressure is reduced (not only antihypertensive, but also organ protection, the younger brother "satan" came later!). ）。
It is precisely because of the same large system that it is generally not advocated for joint use. Moreover, drugs acting on the same system have the same side effects, and the adverse reactions of combination drugs will also increase. Of course, the specific mechanism of drug action is much more complicated, and there are other differences, so it is not absolutely impossible to use.
One thing to note here is that among the "pry" drugs, captopril is a short-acting drug. The advantage of short-acting drugs is that the onset of action is fast, but the duration of action is short, so it is necessary to take the drug 2 to 3 times a day. You should take the drug 2 to 3 times a day, you only take 1 time a day, then the blood pressure fluctuations are inevitable and imaginable.
Hydrochlorothiazide, a diuretic antihypertensive drug, and "puly" and "sartan" synergistic and complementary effects.
Many people are anxious when they hear diuretics, why do you give me diuretics for high blood pressure? In fact, diuretics are a good hand in antihypertensive therapy. When the diuretic is just eaten, it will have a bit of diuretic effect, but the long-term is to reduce the water and salt in the blood vessel wall, improve the elasticity of the blood vessel wall, make the blood vessels easy to relax, coupled with the reduction of water and salt, the blood volume is reduced, and the blood pressure is reduced.
Diuretics and "puly" or "sartan" can also complement each other in action. For example, diuretics can reduce blood volume, it is easy to cause the angiotensin system to be active, "Puli" or "sartan" will come out to block, "Puli" and "sartan" will store potassium in the body, causing blood potassium to rise, thiazide diuretics will help to get rid of ("sartan" + diuretic, combined with antihypertensive 1 pill to get it done!). ）。
The effect of diuretics in lowering systolic blood pressure (high pressure) is better, and the effect is better for high blood pressure that eats more salt, hypertension in the elderly, and hypertension in fat people.
Let's talk about eating
As mentioned earlier, the two drugs have different points of action. "Puly" inhibits angiotensin-converting enzymes, "sartan" inhibits angiotensin receptors, today's Puly, tomorrow's sartan, "east a hammer, west a stick", which antihypertensive target is not continuously controlled, the antihypertensive effect is of course not good.
Valsartan hydrochlorothiazide should be taken once a day to maintain a stable effect. But the next day to eat, the effect of the drug can not be maintained, the efficacy can not be connected.
And captopril is still a short-acting drug, generally eat 3 times a day to control high blood pressure, the next day 1 time of course is more uncontrollable.
Understand down, medicine, there are doctors to prescribe, there are their own to buy; eating, is their own thoughts.
Patients with hypertension who take antihypertensive drugs must be carried out under the guidance of a doctor.
(All rights reserved, may not be reproduced without my authorization!) ）