Clinical medication guidance on medication for hypertension is here!
1. What are the antihypertensive goals of the 2018 edition of the "Guidelines for the Prevention and Treatment of Hypertension in China"?
Table 1: Blood pressure targets for antihypertensive therapy in hypertensive patients
Strengthen antihypertensive concepts and measures
In patients at high risk of cardiovascular disease, a reduction in blood pressure to 130/80 mmHg is also beneficial;
For those with blood pressure ≥ 150/95 mmHg, combination therapy can be started;
The initial use of conventional dose antihypertensive drugs for patients with general hypertension; the target < 140/90 mmHg, and some patients who can tolerate it can be reduced to about 130/80 mmHg;
Active combination therapy.
Hierarchical indicator changes
Increased range of 130-139/85-89 mmHg;
Diabetes mellitus is divided into new diagnoses and treated but not controlled, based on blood glucose (fasting and postprandial) and glycosylated hemoglobin levels, respectively;
Change the diagnostic criteria for hyperhomocysteinemia in cardiovascular risk factors to ≥15 μmol/L, hyperhomocysteinemia as a risk factor for stroke;
Inclusion of atrial fibrillation in concomitant cardiac disease;
Stage CKD3 is target organ damage; stage CKD4 is a clinical complication (very high risk).
2. Is it okay not to take antihypertensive drugs when there are no symptoms?
No, be sure to stick to the medication. In fact, when the blood pressure exceeds the normal range, the blood pressure has begun to affect the heart, brain, and kidneys.
Some patients with hypertension usually do not take medication, when there is dizziness or blood pressure rise before taking antihypertensive drugs, once the symptoms disappear or blood pressure has returned to normal and do not take antihypertensive drugs, this practice is wrong and very dangerous. Because the blood pressure will rise again after stopping the antihypertensive drug, such repeated rise and fall will eventually lead to worsening of the condition.
The correct approach is that when the blood pressure drops to the normal range, the antihypertensive drugs can be adjusted under the guidance of the doctor to maintain the amount for a long time.
3. When do antihypertensive drugs generally choose to take?
The blood pressure level of patients with chronic hypertension is not constant for 24 hours a day, with two peaks and two troughs: 9 to 11 o'clock in the morning and 4 to 6 o'clock in the afternoon is the most hypertension in the whole day; 12 o'clock in the afternoon to 2 o'clock in the afternoon is the first low, and the blood pressure shows a slow downward trend after 8 p.m., and the lowest at 2 to 3 o'clock in the morning.
Therefore, to choose the time of medication, generally the first medication is at 6 to 7 o'clock in the morning, and the second medication is at 3 to 4 o'clock in the afternoon. Antihypertensive drugs that last for 24 hours can generally be taken once a morning.
4. What are the commonly used antihypertensive drugs?
Clinically, the first-line antihypertensive drugs are roughly divided into five categories:
(1) Angiotensin-converting enzyme inhibitors (ACE Inhibitors): Commonly used drugs include benazepril, captopril, enalapril, lisinopril, etc.;
(2) Angiotensin II receptor antagonists (ARB): commonly used drugs are valsartan, losartan, telmisartan, irbesartan, candesartan, etc.;
(3) Diuretics: commonly used drugs are hydrochlorothiazide, furosemide, spironolactone, indapamide, etc.;
(4) β receptor blockers: commonly used drugs are metoprolol, bisoprolol, sotalol, arollol, labetalol, etc.;
(5) Calcium antagonists (CCB): Commonly used drugs are nifedipine, amlodipine, felodipine, diltiazem, verapamil, etc.
Other types of antihypertensive drugs are:
(6) α receptor blockers: commonly used doxazosin, trazosin, piperazosin, etc.;
(7) Compound preparations: such as telmisartan hydrochlorothiazide, losartan potassium hydrochlorothiazide, compound antihypertensive tablets, etc.;
(8) Central antihypertensive drugs: such as clonidine, methyldopa, etc.;
(9) Direct vasodilators: such as minoxidil, hydralazine, etc.;
5. What are the common adverse reactions and precautions of first-line antihypertensive drugs?
(1) Angiotensin-converting enzyme inhibitor (ACE) & Angiotensin II receptor antagonist (ARB)
Common adverse effects of these two classes of antihypertensive drugs are hyperkalemia, elevated serum creatinine, and angioedema. When adverse reactions to cough occur with ACE inhibitors, alternative treatment with ARB preparations may be available. These two classes of drugs are contraindicated in patients with bilateral renal artery stenosis, pregnancy, and hyperkalemia.
(2) Diuretics
Large doses of diuretics can easily lead to electrolyte disorders, affecting the level of blood potassium, blood magnesium, blood calcium, in addition to the metabolism of uric acid and sugar has a certain impact, the use of this type of drug at the same time to pay attention to check the electrolyte, uric acid and blood sugar.
(3) β receptor blockers
Taking this class of drugs can slow down the heart rate, and severe bradycardia such as heart rate less than 50 beats per minute is contraindicated. Use with caution in bronchial patients to avoid exacerbating bronchospasm. The use of any β blocker should start with a small dose, gradually increase the dose until the desired therapeutic effect is achieved, and then switch to a maintenance dose. When stopping the drug, the dose should be gradually reduced, and the drug should not be stopped suddenly.
(4) Calcium antagonist (CCB)
Patients taking these drugs may have adverse reactions such as headache, facial flushing, palpitations, ankle edema, and gingival hyperplasia, usually occurring in the initial stages of medication and are generally mild and short-lived.
6. Why do hypertensive drugs advocate small dose combination application, rather than simply increasing the dose of a certain drug?
Monotherapy often fails to meet the antihypertensive goals, and blindly increasing the dose of a single drug is prone to adverse reactions. In order to increase the antihypertensive effect without increasing the adverse reactions, two or more antihypertensive drugs are used for combined therapy, the purpose is to add the therapeutic effects of the drug, and the adverse reactions can cancel each other out or at least do not increase the adverse reactions.
7. What are the advantages of antihypertensive drug extended-release tablets and controlled-release tablets? What are the special requirements for how to take it?
Extended-release tablets and controlled-release tablets have the advantages of reducing the number of medications taken, maintaining a stable and effective blood concentration, reducing toxic side effects and reducing the total amount of medication.
Controlled-release tablets, enteric-coated tablets, capsules, and most extended-release tablets should be swallowed with water in whole tablets, and should not be broken, pressed, or chewed to avoid affecting the efficacy of the drug. However, there are also some extended-release preparations that can be taken open, such as metoprolol extended-release tablets.
8. What is drug-induced hypotension?
Drug-induced hypotension causes a decrease in blood pressure (below 90/60 mmHg) after administration, and is accompanied by clinical symptoms such as dizziness, fatigue, drowsiness, lack of energy, dizziness, and even fainting. Some patients with hypertension have a rapid or excessive drop in blood pressure after medication, and symptoms of discomfort occur, and although the blood pressure does not reach the defined range, it can also be classified into the range of drug-induced hypotension.
9. What is orthostatic hypotension? How should orthostatic hypotension be prevented and managed?
Orthostatic hypotension is manifested by fatigue, dizziness, palpitations, cold sweat, nausea, and vomiting. Special care should be taken when taking combinations, taking α blockers for the first time, or increasing doses.
Prevention of orthostatic hypotension: avoid standing for a long time, especially in the first few hours after taking the drug; change posture, especially from the lying and sitting positions, the movement should be slow; the medication time can be selected to rest calmly, continue to rest for a period of time after taking the drug and then get out of bed; if you take the drug before going to bed, you should pay attention when you get up at night to urinate.
Postural hypotension should be laid flat when postural hypotension occurs, and the lower extremities may be elevated above the head to promote blood return from the lower extremities.
10. What is drug-induced hypertension? What are the drugs that can easily induce high blood pressure?
The clinical manifestations of drug-induced hypertension are hypertension after medication, or further increase in blood pressure or rebound or even hypertensive crisis during treatment in hypertensive patients. Generally, the disease is mild, which can be reversed after discontinuation, and occasionally serious complications such as hypertensive encephalopathy, cerebrovascular accident and renal insufficiency occur.
Drugs that are easy to cause increased blood pressure are: sodium-containing drugs, oral contraceptives, glucocorticoids, nonsteroidal anti-inflammatory drugs, monoamine oxidase inhibitors, erythropoietin, cyclosporine, licorice compounds and some compound cold preparations.
Patients with hypertension should inform the doctor who is present when taking these drugs that are prone to blood pressure to adjust the dose of antihypertensive drugs according to the situation.
11. What problems should elderly patients with hypertension pay attention to during treatment?
Elderly patients with hypertension should start in small doses in the initial treatment, and subsequent dose adjustment should be slower, because the elderly are more likely to have adverse reactions, especially in elderly and frail patients, it is advisable to choose a calm and slow preparation, antihypertensive can not be too fast, the degree of antihypertensive should not be too large. The dosage should not be adjusted and the variety of drugs should be changed casually, and when there is any doubt, it should be communicated with the doctor or pharmacist in time.
12. What are the principles for the selection of antihypertensive drugs in patients with hypertension and diabetes?
Patients with hypertension and diabetes mellitus are at high risk and need to actively prevent and mitigate the progression of kidney disease and cardiovascular risk. Antihypertensive drugs, ACE and ARB, prevent the appearance of microalbuminuria and diabetic nephropathy, and slow the progression of diabetic nephropathy. Therefore, these two types of antihypertensive drugs should be used as the basic treatment of patients with hypertension and diabetes mellitus, and then combined treatment with other antihypertensive drugs such as calcium antagonists and diuretics.
Attached: Introduction to the classification of common antihypertensive drugs
▎ Blood pressure age control table
Precautions for hypertensive diseases
1. Reasonable diet
1. The importance of diet for high blood pressure:
People take food as the day, a reasonable diet can make you not fat nor thin, cholesterol is not high or low.
2. Dietary taboos for patients with hypertension:
(1) Carbohydrate food:
Suitable food --- rice, porridge, noodles, noodles, kudzu powder, soup, taro, soft beans.
Foods to be avoided --- sweet potatoes (foods that produce stomach gas), dried beans, and biscuits with strong flavor.
(2) Protein food
Beef, lean pork, white meat fish, eggs, milk, dairy products (whipped cream, yeast milk, ice cream, cheese), soy products (tofu, natto, soybean flour, oil tofu)
Foods to be avoided--- fatty foods (pork belly of cattle, pigs, pork ribs, whales, herring, tuna, etc.), processed products (sausages)
(3) Fatty foods
Suitable food --- vegetable oil, a small amount of cream, salad dressing
Foods to avoid --- animal oil, raw pig fat, bacon, oil-soaked sardines
(4) Vitamin and mineral foods
Suitable food --- vegetables (spinach, cabbage, carrots, tomatoes, lily roots, pumpkins, eggplants, cucumbers) fruits (apples, oranges, pears, grapes, watermelons)
Seaweed and fungi should be cooked before eating.
Foods to avoid--- hard fiber vegetables (burdock, bamboo shoots, beans)
Irritating vegetables (spices, mangosteen, mustard, shallots, mustard)
(5) Other foods
Suitable food --- light fragrant tea, yeast milk drink
Foods to be avoided--- spices (chili peppers, curry powder)
Alcoholic beverages, salt-soaked foods (adult vegetables, adult roe)
Pickles, coffee
3. Dietary habits that patients with hypertension should pay attention to
(1) First of all, to control the intake of energy, advocate eating complex sugars:
Such as starch, corn, eat less glucose, fructose and sucrose, this kind of sugar belongs to the simple sugar, easy to cause elevated blood lipids.
(2) Limit fat intake:
When cooking, the use of vegetable oil, you can eat more marine fish, marine fish contain unsaturated fatty acids, can make cholesterol oxidized, thereby reducing plasma cholesterol, but also prolong the aggregation of platelets, inhibit thrombosis, prevent stroke, but also contain more linoleic acid, to increase the elasticity of microvessels, prevent blood vessel rupture, prevent hypertension complications have a certain effect.
(3) Moderate intake of protein:
The daily amount of protein in patients with hypertension is 1 g per kilogram of body weight. Eating fish protein 2-3 times a week can improve vascular elasticity and permeability, increase urinary sodium excretion, and thus lower blood pressure. If hypertension is combined with renal insufficiency, protein intake should be restricted.
(4) Eat more foods rich in potassium and calcium and low in sodium:
Such as potatoes, eggplant, kelp, lettuce. Foods high in calcium: milk, kefir, shrimp skin. Eat less broths, because the increase in nitrogen extracts in broths can promote the increase of uric acid in the body and increase the burden on the heart, liver and kidneys.
(5) Limit salt intake:
Daily should be gradually reduced to less than 6g, that is, after the ordinary beer cover removes the rubber pad, the salt of a flat lid is about 6g. This amount refers to the amount of salt, including the total amount of sodium contained in cooking salt and other foods converted into table salt. Proper reduction in sodium salt intake helps to lower blood pressure and reduce sodium water retention in the body.
(6) Multi-faceted fresh vegetables and fruits.
Eat no less than 8 pairs of fresh vegetables and 2 to 4 pairs of fruits every day.
(7) Appropriately increase the intake of seafood:
Such as kelp, seaweed, sea fish, etc.
2. Exercise in moderation
The importance of exercise for high blood pressure: There is a saying: "When you are young, you exchange health for money, and when you are old, you exchange exercise for health." "In addition to promoting blood circulation and reducing cholesterol production, exercise can also enhance the occurrence of muscle, bone and joint stiffness.
Exercise can increase appetite, promote gastrointestinal peristalsis, prevent constipation, and improve sleep. Have a habit of continuous exercise: It is best to do aerobic exercise to help. Aerobic exercise can lower blood pressure as well as weight loss, such as walking, jogging, tai chi, cycling and swimming are all aerobic exercises.
1. Precautions for exercise:
(1) Do not overdose or be too strong and too tired, and take a step-by-step approach to increase the amount of activity.
(2) Pay attention to the surrounding climate: summer: avoid the time of bright sunshine at noon; winter: pay attention to keep warm and prevent stroke.
(3) Wear comfortable sweat-absorbing clothes: It is necessary to choose cotton lining, sneakers, etc.
(4) Choose a safe place: such as a park, school, do not be in the laneway, roadside.
(5) When exercising, do not fast, so as to avoid hypoglycemia, should be 2 hours after meals.
2. Contraindications to exercise
(1) Stop exercising when you are sick or unwell
(2) Exercise should not be done when hungry or one hour after meals
(3) The movement cannot be stopped immediately, and the steps of the exercise procedure should be observed
(4) Any discomfort during exercise should be stopped immediately
3. Quit smoking and limit alcohol
Smoking can lead to high blood pressure. Studies have shown that heart rate increases by 5 per minute after smoking a cigarette
-20 times / min, systolic blood pressure increased by 10-25 mmhg. Why?
Because the tobacco leaf contains nicotine (niacin), it will excite the central nervous system and sympathetic nervous system, speed up the heart rate, and also promote the adrenal glands to release a large amount of catecholamines, causing the arterioles to contract, resulting in increased blood pressure. Nicotine also stimulates chemoreceptors in blood vessels, reflexively causing an increase in blood pressure. Long-term mass smoking will also promote atherosclerosis of the large arteries, and the inner membrane of the arterioles will gradually thicken, gradually hardening the entire blood vessels.
At the same time, due to the increase in the content of carbon monoxide hemoglobin in the blood of smokers, the oxygen content of the blood is reduced, the oxygen content of the arterial lining is hypoxic, and the oxygen content of the lipids in the arterial wall is increased, which accelerates the formation of atherosclerosis. Therefore, smoking cessation by people without high blood pressure can prevent the occurrence of high blood pressure, and people with high blood pressure should quit smoking.
The pros and cons of drinking alcohol to the body are controversial compared to smoking. From time to time, there are various reports, some saying that drinking a small amount of alcohol is beneficial, some saying that it is harmful, but it is certain that drinking a lot of alcohol is definitely harmful, and high concentrations of alcohol can cause arteriosclerosis and aggravate high blood pressure.
Fourth, psychological balance
The psychological manifestations of hypertensive patients are nervousness, irritability, and emotional instability, which are all triggers for increased blood pressure. Patients can change their behavior, cultivate good adaptability to the natural environment and society, avoid emotional agitation and excessive tension, anxiety, calm and composure in case of trouble; when there is greater mental pressure, they should try to release, pour out to friends and relatives or encourage participation in relaxed and pleasant leisure activities, pour their spirit into music or send their hearts to flowers, so that they can live in the best state, thereby maintaining stable blood pressure.
5. Self-management
1. Measure blood pressure regularly, at least once in 1-2 weeks;
2, the treatment of hypertension should adhere to, "three hearts", that is, confidence, determination, perseverance, only by doing so can prevent or postpone the damage of important organs of the body;
3. Take antihypertensive drugs regularly, do not reduce or stop the drug at will, you can adjust under the guidance of a doctor and according to the condition to prevent blood pressure from rebounding;
4. If conditions permit, you can prepare your own sphygmomanometer and learn to measure your blood pressure;
5. In addition to taking appropriate drugs, pay attention to the combination of work and leisure, pay attention to diet, appropriate exercise, maintain emotional stability, and sleep adequately;
6. The elderly should not be overly anxious to reduce blood pressure at 140-159mmhg to reduce the occurrence of cardiovascular and cerebrovascular complications;
7. Prevent orthostatic hypotension in the elderly and taking norepinephrinergic nerve ending blockers;
6. Seek medical attention on time
(1) Take the medicine
(2) Blood pressure is elevated or too low, and blood pressure fluctuates greatly
(3) If there is dizziness, dizziness, nausea and vomiting, blurred vision, hemiplegia, aphasia, impaired consciousness, difficulty breathing, limb weakness, etc., go to the hospital for medical treatment. If you are critically ill, request help from the 120 Emergency Center.
7. Precautions for hypotension disease
Patients with hypotension do not need to be treated with medication if they are mild and asymptomatic. The main treatment is to actively participate in physical exercise, improve physical fitness, increase nutrition, drink more water, eat more soup, and slightly more salt per day than ordinary people. Severe cases are accompanied by obvious symptoms, and must be given active treatment to improve symptoms, improve quality of life, and prevent serious hazards from occurring.
In recent years, the α receptor agonist tube pass (the main component is midodrine hydrochloride), which has the function of vascular tone regulation, which can increase peripheral arterial and venous resistance, prevent a large amount of blood stagnation in the lower limbs, and can constrict arterial blood vessels, achieve blood pressure, add blood supply to important organs such as the brain and heart, and improve the symptoms of hypotension, such as dizziness, fatigue, easy fatigue and other symptoms.
Other drugs include: midodrine, ritaline, ephedrine, dihydroergotamine, fludrocortisone, etc., and the effects and negative effects of traditional Chinese medicine treatment (raw pulse drink) need to be further investigated.
Prevent hypotension
Develop the habit of exercise, eat a balanced diet, cultivate a cheerful personality, and get enough sleep. Therefore, patients with low blood pressure should live a regular life.
When patients with low blood pressure enter the bath, they should be careful to prevent sudden rise and fainting, and the time of soaking in the hot spring should be shortened as much as possible.
Use with caution for vasodilators, sedative antihypertensives, etc.
People with orthostatic hypotension:
Elastic socks can be worn. It is advisable to move your limbs before getting up at night to urinate or get up in the morning, or stretch your waist, so that you can slowly get up after a few moments of activity, and do not get up suddenly as soon as you wake up to prevent transient cerebral ischemia. You can also close your eyes before standing, bend the neck to the maximum, and then slowly stand up, last for about 10 to 15 seconds and then walk around, you can achieve the purpose of preventing orthostatic hypotension.
Hypotension, preferably: meat and vegetarian combination.
Guiyuan, lotus seeds, jujubes, mulberries, etc., with the ability to strengthen the brain, should be eaten regularly, enhance physical fitness; low blood pressure caused by blood loss and menorrhagia, should pay attention to eating foods that provide hematopoietic raw materials, such as foods rich in protein, copper, iron - liver, fish, milk, eggs, beans and iron-rich vegetables and fruits, etc., to help correct anemia.
Patients with hypotension should choose high sodium
(Salt should be 12-15 grams per day), high-cholesterol diet, such as animal brain, liver, egg yolk, cream, roe, etc., so that the blood volume increases, the amount of blood excreted from the heart also increases, the arterial tension increases, and the blood pressure will rise accordingly.
Avoid raw cold and cold, deflated foods, such as spinach, radish, celery, cold drinks, etc. Never eat blood pressure-lowering foods such as corn!
Detailed explanation of medication for hypertension (29 articles)
When patients with hypertension take medication, they often worry about side effects and do not know how to overcome them; or feel that the antihypertensive effect is not good, but they do not know how to do it; or they do not understand why the doctor changes their own medicines, and they worry about the wrong use of drugs.
There are two commonly used calcium antagonists
Dihydropyridine: nifedipine extended-release tablets (伲福達), nifedipine controlled-release tablets (Bai xintong), felodipine (boidine), amlodipine (roxaxi, annezhen). Slepin, officially known as Lasidipine;
Non-dihydropyridines: verapamil (isopresent), diltiazem (tian erxin, hebeisso).
1. Do calcium antagonists "increase the risk of heart disease"?
For calcium antagonists , " there is an increased risk of heart disease " , it mainly refers to heartache. Studies have found that heartache may increase blood pressure fluctuations, speed up heart rate, and increase target organ damage. Therefore, if you need to take heartache for a long time, you should pay attention to monitoring and change the dressing if necessary.
2. Do calcium antagonists have an effect on liver and kidney function? Does nimodipine cause "hepatitis"? How can it be prevented?
Since many calcium antagonists are metabolized in the liver and excreted by the kidneys, patients with hepatic and renal insufficiency should not take too large doses. Nimodipine acts mainly on cerebrovascular smooth muscle, and there have been no reports of "hepatitis".
3. What is the difference between Boidine and Loyding and Heartache? Which is better? How to choose?
The U.S. Food and Drug Administration (FDA) stipulates that the valley/peak ratio of drugs exceeds 66% to meet the long-term antihypertensive requirements. Boiedine is 30% to 50%, 70% is happy, and heartache is set to be less than 30%. Obviously, boidine and heartache are not suitable for long-term antihypertensive therapy.
4. When taking amlodipine, is there any attention to the time? Before or after meals?
Amlodipine is quickly absorbed orally, 5 mg once a day, before and after meals. Some people have dizziness and redness after taking the drug, indicating that the absorption is too fast and can be taken after meals.
5. An elderly patient has been using nitrodipine, after being hospitalized due to "stroke", the doctor lets you change to nimodipine, can you not change it?
Nitrendipine and nimodipine are both calcium antagonists, but the sites of action are different. Nimodipine mainly dilates cerebral blood vessels, which is beneficial for the recovery of brain function and cognitive function in stroke patients. Nitrodipine mainly dilates the circulatory arteries of the body. Therefore, the dressing should be changed.
6. With long-term use of nifedipine controlled-release tablets, will the triglycerides and cholesterol in the blood be elevated?
The results of the survey showed that only about 5.9% of the blood lipids of such patients were affected.
7. What problems do I need to pay attention to when taking nifedipine for a long time?
Nifedipine is a short-acting calcium antagonist. It absorbs quickly, blood pressure drops quickly, which will lead to reflex tachycardia, induce myocardial ischemia, acute vasodilation, and because of rapid excretion, it needs to be taken multiple times a day, which cannot inhibit the peak of cardiovascular events in the morning. Therefore, it should not be taken for a long time.
8. Can it cause myocardial infarction? What problems should I pay attention to if I take it for a long time?
Luo Huoxi belongs to the third generation of calcium antagonists, which is a long-acting antihypertensive drug, which can control blood pressure for 24 hours by taking 1 tablet per day, and is suitable for patients with mild to moderate hypertension. It does not cause myocardial infarction. However, for long-term use, pay attention to whether there is gum swelling pain and foot and ankle edema.
9. An elderly person with hypertension and coronary heart disease, using verapamil. Recent examination revealed a left bundle branch block, and the doctor ordered the dressing to be changed. Is the condition serious? Or is the drug having big side effects? Does his wife have the same disease and need to change the dressing?
This has nothing to do with side effects. Verapamil is a non-dihydropyridine calcium antagonist with adverse reactions such as AV block and inhibition of cardiac function. The patient has left bundle branch block, so dressing should be changed. It can be exchanged for angiotensin II receptor antagonist (ARB) or calcium antagonist amlodipine. As for his wife, he does not have to change.
10. Patients with moderate hypertension also have gout, is it appropriate to use schleping to lower blood pressure?
The cause of gout is that the concentration of uric acid in the blood is too high, and uric acid crystals are formed and deposited in the tissues, causing pain. Serepine is a calcium antagonist, although there is no need to worry that it will cause gout, it is still recommended to switch to Hygea 62.5 mg once a day, which can both reduce blood pressure and reduce blood uric acid.
11. After a patient took Sanjing Serepine for 2 months, his body was puffy and severe, his limbs were cold and cold, and if he touched ice water, his hands were red and swollen and extremely itchy. Is this caused by Sanjing Serepine?
Triseric seropine can cause edema. If the patient is not currently co-ordinated with other diseases and is not taking other drugs, it is considered that it may be caused by schlepin, and it is recommended to add diuretics such as hydrochlorothiazide to reduce the symptoms of puffiness or switch to other antihypertensive drugs.
As for cold hands and feet, you can stop the drug first, or go to the rheumatology department to avoid the possibility of other diseases.
"Puli" class
Such drugs are angiotensin-converting enzyme inhibitors (ACE Inhibitors), commonly used are captopril (berthone), benazepril (lotinin), enalapril (eso), perdopril (Yasta), ramipril (Ritter), fosinopril (Mono) and so on.
12. After taking captopril, do you need to stop the drug if you feel headache and dizziness? After stopping the drug, what medicine to use?
First of all, we must find out whether headache and dizziness are symptoms of high blood pressure itself or adverse drug reactions. If the blood pressure rebound increases after stopping the drug, the headache and dizziness are reduced, and the above symptoms occur after taking captopril, which can basically be determined as adverse drug reactions. Other antihypertensive drugs can be used, such as calcium antagonists (amlodipine, nitrendipine), etc.; β receptor blockers (metoprolol, atenolol), etc.; can also be changed to angiotensin II receptor antagonists (ARB), such as losartan, valsartan, etc.
13. What drugs can captopril not be combined with? Can I combine ibuprofen with colds and fevers?
Captopril should be avoided in combination with potassium-sparing diuretics and potassium supplements, such as amposoplastin, triamterene, amiloride, potassium chloride, etc.; when combined with other antihypertensive drugs, pay attention to the fact that blood pressure should not be too low. Ibuprofen may still be used with colds and fevers, but the antihypertensive effect of captopril may be reduced.
14. What is the difference between Lottincin and Captopril? What are the side effects? Can it be used for a long time?
Lottinin is the trade name for benzalapril, which is part of the same category as captopril as an ACE inhibitor (ACE). However, captopril is a short-acting antihypertensive drug, while lotin is a long-acting antihypertensive drug. Therefore, captopril often needs to be taken 3 times a day, and lotincin can be taken once a day. The main side effects of Lottincin are cough, and other rare side effects are angioedema, constipation, gastrointestinal discomfort, rash, granulocytopenia, etc. If no side effects occur, it can be used for a long time.
15. What kind of medicine is Isu? Does it cause gout?
The common name of is enalapril, which is one of the angiotensin-converting enzyme inhibitors, which has a good antihypertensive effect and a protective effect on target organs such as the heart, brain and kidneys. However, it also has certain side effects, commonly as a dry cough, and does not cause gout.
"Satan" class
Such drugs are angiotensin II receptor antagonists (ARB), commonly used losartan (kosuya), valsartan (Daiwen), candesartan (Ville), irbesartan (ampoulevir), telmisartan (mecarin). If chlorothiazide is added to 12.5 mg, Kosuya becomes Haijieya, Daiwen becomes compound Daiwen, and Amperavier becomes Amporoault.
16. What are the side effects of long-term use of daiwen?
Daiwen is the trade name of valsartan, with fewer side effects and less frequent headaches, dizziness, gastrointestinal symptoms, rashes, etc. If there are no side effects, it can be used for a long time.
17. What is the difference between Kosoya and Daiwen and Hygea? How to choose?
Both Kosoya and Daiwen are angiotensin II receptor antagonists (ARBs). The former needs to be transformed by the liver, while the latter can be directly effective. Although both are long-acting antihypertensive drugs, they can generally be taken once a day. However, the Daiwen antihypertensive lasts longer than Kosuya.
Hygea is a compound anti-compressive agent of Kosoya hydrochlorothiazide, i.e. Kosoya. Its advantage is that the onset of action is faster than that of Kosu, the antihypertensive effect is stronger, and it is more suitable for patients with moderate hypertension.
diuretic
Such drugs are commonly used in the case of dihydrochlorizine, amiloride, indapamide (Shoubishan) and spironolactone.
18. What are the circumstances under which to consider taking Shoubishan? How to take it? Can it be taken for a long time?
Shoubishan (indapamide) is a long-acting diuretic antihypertensive drug with calcium antagonism, which can be used as a single drug for mild and moderate primary hypertension, and can also be combined with other antihypertensive drugs. It can start with 2.5 mg 1 time a day. After that, it can be adjusted according to the blood pressure situation.
Shoubishan can be taken for a long time. A small number of patients can cause dizziness, headache, insomnia, drowsiness, nausea, diarrhea, rash, etc. Individual patients can cause elevated blood uric acid, and even induce gout, and some will have low blood potassium, so long-term use should pay attention to monitoring. Patients with allergy to sulfonamides, severe hepatic insufficiency, and acute cerebrovascular accident should not be selected.
19. What should I do if I take diuretics for a long time and lack potassium? What happens? How to prevent it?
If potassium deficiency is caused by taking diuretics, patients will experience symptoms such as fatigue, muscle weakness, nausea, vomiting, decreased bowel movements, and arrhythmias. The prevention point is that when taking potassium-draining diuretics, blood potassium should be measured regularly and supplemented depending on the blood potassium level. Potassium-excreting diuretics can be discontinued once hypokalemia is produced, or or orally orally with potassium chloride (tonic) or magnesium potassium aspartate, or in severe potassium deficiency, intravenous potassium chloride is required.
In addition, diuretic antihypertensive drugs can cause hypokalemia in people, mainly thiazide potassium excretion diuretics. Potassium-sparing diuretics not only do not produce low potassium, but also increase blood potassium. Therefore, if necessary, the combination of two types of diuretics can also reduce blood potassium abnormalities.
β-receptor blockers
Such drugs are commonly used in metoprolol (betalak), bisoprolol (concor), carvedilol (Rod, Daliquan).
20. If you have eye pain while taking Betalek, what other medicines can you use? Is it true that long-term use of Betalek can cause Parkinson's syndrome?
Betalek has side effects such as headaches and eye pain. In this case, you can first stop taking Betarak to try. If the eye pain symptoms disappear after stopping the use of the drug for a period of time, and after taking betalok, the eye pain symptoms appear again, it means that it is related to betalek. At this time, under the guidance of a doctor, patients can switch to angiotensin II receptor antagonist (ARB), angiotensin-converting enzyme inhibitor (ACE Inhibitor) or diuretic according to the condition.
As for causing Parkinson's syndrome is rare. For patients, it is not necessary to sit in the right number.
"Proprietary Chinese medicine" and a combination of Chinese and Western medicines
21. Does compound robin cause gout? What are its side effects?
Compound robin is a compound preparation of Chinese and Western medicine, the components of which include rob hemp leaf, wild chrysanthemum, bihydrazine sulfate, hydrochlorothiazide and promethazine hydrochloride. Hydrochlorothiazide may cause increased blood uric acid, so patients with gout should not use compound robin. However, due to the fact that the amount of hydrochlorothiazide contained in compound robin is not large, if the patient's original uric acid is not high, it is not a big problem to take only 2 to 3 tablets a day. If you are worried, you can go to the hospital outpatient clinic to check for blood uric acid, and if it is not high, you can continue to take it.
In addition, excessive use of this product can also cause central sedative effects and symptoms of low potassium.
22. Is Zhenju antihypertensive tablet good? What are the side effects?
Chrysanthemum antihypertensive tablets are also a mixture of Chinese and Western medicines, each tablet contains 30 micrograms of clonidine, 5 mg of hydrochlorothiazide, and wild chrysanthemum flowers, nacre, locust rice and so on. It has the side effects of both diuretics and central antihypertensives, and the adverse reactions associated with the diuretics contained therein are associated with the diuretics it contains. Patients with mild hypertension (blood pressure 140 to 150/90 to 100 mm Hg) with dizziness may be tried with Chrysanthemum antihypertensive tablets.
23.What is the effect of The Antihypertensive Tablets of Eucommia? Is it credible to "take 1 year and no more antihypertensive drugs in this life"?
This drug is currently less commonly used, and there are no large-scale clinical trials to confirm that it is an effective antihypertensive drug. "Take 1 year and no longer need to take medicine in this life" is even more untrustworthy. High blood pressure without medication will rise up, so don't trust advertising.
24. Can reserpine be taken for a long time? What side effects do I experience?
Reserpine does not belong to the 6 categories of basic antihypertensive drugs, which can still be applied in view of national conditions. It has side effects such as nasal congestion (nasal congestion), mental depression, bradycardia, and peptic ulcer. If there are no side effects mentioned above during use, it can still be used for a long time.
25.What are the ingredients contained in Beijing Antihypertensive No. 0? What are the side effects of long-term use?
Beijing Antihypertensive No. 0 is a compound antihypertensive drug, which contains reserpine, hydrochlorothiazide, triamterene, dihydrazine, and lisonine. In 2004, the prescription was adjusted, the sedative component was reduced, and the name was changed to "No. 0 Antihypertensive Tablet". The main side effect of long-term use comes from reserpine (see the previous question for details), and due to the potassium-preserving diuretic triamenediene, it is necessary to pay attention to whether there is an increase in blood potassium.
26. What kind of drug is Eugenicin? What should I pay attention to when taking?
Eugenin is a mono-oxidase inhibitor whose hypotensive mechanism has not been fully elucidated. Taking this drug should pay attention to postural hypotension, sometimes dry mouth, gastrointestinal discomfort, insomnia, dreams and so on. This drug is generally used for moderate to severe hypertension. While taking this medicine, do not eat foods containing cheese, otherwise there will be a pheochromocytoma-like attack (sudden increase in blood pressure, twitching of the limbs).
27. Will long-term use of antihypertensive drugs affect sexual function? How to judge whether the decline in sexual function is caused by antihypertensive drugs?
Not all antihypertensive drugs reduce sexual function. Some antihypertensive drugs also have ameliorating sexual function, such as valsartan (Daiwen) and the like. At present, it is believed that β receptor blockers, diuretics (including Shoubishan), Anderson may have some effects on sexual function, while angiotensin II receptor antagonists (ARB), angiotensin-converting enzyme inhibitors (ACEIs), α blockers have less effect on sexual function.
To determine whether the decrease in sexual function is caused by the drug, the simplest way is to observe whether sexual function can be restored after 1 to 2 weeks of discontinuation. In general, the reduced function of antihypertensive drugs can be recovered after discontinuation.
28. A patient has a systolic blood pressure of 170 mm Hg and a diastolic blood pressure of 110 mm Hg. Take 1 tablet of Sanjing slepin 1 time in the morning and 1 time in the morning and 1 time, betalek, 2 times a day, 50 mg each time, and take 2 tablets of aspirin, 100 mg every morning, is it reasonable to take this?
Triple sperm slepin double taroko, if you can effectively control blood pressure, is a reasonable combination of drugs. However, it is not appropriate to take aspirin 100 mg in the morning, and the drug, as an antiplatelet aggregation drug, should be taken in the evening more reasonable, and it is necessary to take enteric-coated.
29. Is it reasonable to take captopril, betalunk, and Shoubizan at the same time? Approximately how long do I have to change my dressing?
Captopril is an ACE inhibitor, Betalek is a β receptor blocker, And Shoubizan is a diuretic antihypertensive, and the combination of 3 drugs is very reasonable. This reasonable combination of drugs is not "mixed use", it is a combination of use. If treatment is effective, it is not advisable to change the drug frequently. If the blood pressure reaches the target value and is relatively stable, one can be withdrawn. However, when to adjust the drug variety and dosage depends on blood pressure levels, risk factors, and the degree of organ damage associated with it, and consult a doctor.
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