What Are Antihypertensive Drugs?

Antihypertensive drugs are also called antihypertensive drugs. Is a class of drugs that can control blood pressure and are used to treat hypertension.

Antihypertensive drugs are also called antihypertensive drugs. Is a class of drugs that can 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.

Chinese name

Antihypertensive drugs

Foreign name

antihypertensive drugs

nickname

Antihypertensive drugs

Western medicine antihypertensive

Diuretic antihypertensive drugs

Diuretic antihypertensive drugs

Thiazines: such as hydrochlorothiazide

Diuretic antihypertensive drugs 2

Potassium diuretics: Ampicillin

Calcium antagonists

Short-acting dihydropyridines: nifedipine

Calcium antagonists 2

Long-acting dihydropyridines: L-Amlodipine

Calcium antagonists 3

Non-dihydropyridines: diltiazem,

Antihypertensive drugs

1. Diuretic antihypertensive drugs:

(1) Thiazines: such as hydrochlorothiazide

(2) Potassium diuretics: Ampicillin, Amiloride

(3) aldosterone antagonists: spironolactone, etc.

(4) Diuretics: Furosemide, etc.

2. Sympathetic inhibitors

(1) Central antihypertensive drugs: such as clonidine, rimenidine and so on.

(2) Ganglion blocking drugs: such as camphorsulfide and the like.

(3) Norepinephrine nerve terminal blocking drugs: such as reserpine and guanethidine.

(4) Adrenergic receptor blockers: such as propranolol.

3. Renin-angiotensin system inhibitor

(1) Angiotensin-converting enzyme (ACE) inhibitors: such as perindopril (long-acting), captopril (short-acting), etc.

(2) Angiotensin II receptor blockers: such as losartan and candesartan.

(3) Renin inhibitors: such as remiclin.

4. Calcium antagonists:

(1) Dihydropyridines: Nifedipine (short-acting), L-Amlodipine (long-acting), etc. ^[1-2]

(2) Non-dihydropyridines: diltiazem, verapamil, etc. ^[3]

5. Vasodilators: such as hydralazine and sodium nitroprusside.

Antihypertensive drug knowledge

1. Why should you take medicine for hypertension?

Generally speaking, hypertension is a chronic disease. Most patients require long-term medication to effectively control blood pressure to a target level (generally, blood pressure is required to be lower than 140 / 90mmHg). This can not only reduce cardiovascular and cerebrovascular events, such as preventing stroke, coronary disease The occurrence and progression of heart disease, heart failure and kidney disease can effectively reduce the risk of death.

2. What are the common antihypertensive drugs? Drug selection principles in different situations

With the advancement of medical science and technology in the past 40 years, new antihypertensive drugs have been continuously introduced, and they have undergone scientific evaluation of large-scale clinical trials. The first-line antihypertensive drugs commonly used in China are mainly diuretics (such as common hydrochlorothiazide and furosemide), beta-blockers (such as "betaloc"), angiotensin-converting enzyme inhibitors (ACEI) (such as "Captopril"), angiotensin II receptor blocker (ARB) (such as "Diazya" "Diovan"), calcium antagonists (CCB, such as "Shi Huida", "Luohuoxi"), etc. Five categories. ^[1]

As the name implies, the common effect of antihypertensive drugs is to lower blood pressure, but different types of antihypertensive drugs have their own focuses due to different antihypertensive mechanisms. These focuses are the basis for doctors to choose different antihypertensive drugs for patients with different conditions.

1) Thiazine diuretics (such as hydrochlorothiazide) can reduce systolic blood pressure better than diastolic blood pressure. It is more suitable for elderly patients with simple systolic hypertension or patients with heart failure. Care should be taken to avoid hypokalemia in the application. At the same time, if you have hyperuricemia or gout, be sure to tell your doctor to avoid using these drugs.

2) -blockers are suitable for patients with hypertension with angina pectoris, myocardial infarction, heart failure, tachyarrhythmia, glaucoma and pregnancy, but do not use these drugs if you have asthma or peripheral vascular disease. At the same time, these drugs will also affect the metabolism of glucose and lipids, which can increase the risk of diabetes.

3) ACEI and ARB drugs (such as Dizhiya) are more suitable for patients with insulin resistance, diabetes, left heart failure, heart failure, myocardial infarction. At the same time, ACEI and ARB are helpful to prevent the progression of kidney disease, but not For pregnant women.

4) Long-acting CCB (such as "Baixintong") has better effects on preventing stroke, vascular dementia and anti-atherosclerosis, and has no effect on the metabolism of glucose, lipids and electrolytes.

5) Molecular long-acting CCB (such as "Shi Huida" and "Luohuo Xi"), in addition to the advantages of dosage form long-acting CCB, do not increase heart rate when such drugs lower blood pressure, can smoothly control blood pressure for 24 hours, and effectively correct abnormal blood pressure rhythms, Reduce cardiovascular risk. ^{[1] [4]}

6) Alpha blockers (not mentioned above, but more commonly used) are suitable for elderly patients with benign prostatic hyperplasia or lipid metabolism disorders.

3. About monotherapy and low-dose principles

When hypertension is not severe, treatment can be started with a small dose of a drug, which not only understands the patient's response to the efficacy and tolerability of a drug, but also minimizes adverse reactions. If the small dose is not effective, you can increase the dose or change the drug (especially for elderly patients to lower blood pressure slowly). If the blood pressure is still uncontrollable, it is necessary to consider a combination of drugs.

4. Why should several antihypertensive drugs be used in combination?

For most patients with hypertension, if the above-mentioned single drug treatment still fails to control blood pressure, and the increase in drug dosage is often accompanied by exacerbation of adverse reactions (such as cough caused by ACEI), the patient is often unbearable. At this time, according to different types of antihypertensive drugs The synergistic effect of the antihypertensive mechanism can increase the antihypertensive effect without increasing or increasing the adverse effects. We generally choose a small dose of two or more antihypertensive drugs in combination to achieve blood pressure. Combination medication is the mainstream concept and method of controlling blood pressure, so you don't have to worry too much about whether multiple drugs will produce more adverse reactions. But keep in mind that the combination of drugs, not the same type of antihypertensive drugs, is used repeatedly because the efficacy is not good and the risk of adverse reactions is increased.

5. Is a fixed combination also a combination? What are the common compound antihypertensive drugs?

Another very common form of combination medication is a fixed compound antihypertensive drug. Although we cannot adjust the dose of different components of the drug, it is convenient for patients.

6. Which are long-acting antihypertensive drugs? Why use long-acting antihypertensive drugs?

Generally speaking, long-acting antihypertensive drugs are divided into two types: molecular long-acting and dosage form long-acting. Molecular long-acting drugs are mainly due to the long half-life of the drug itself, which can better control the effects smoothly without being affected by diet, such as our common Shi Huida (L-Amlodipine Besylate Tablets) and Lohuxi (Amlodipine Besylate Tablets). ^[5] Antihypertensive drugs with slow-release or controlled-release indicated on the prescription or on the kit are all long-acting dosage forms, such as our common diazya (candesartan medoxomil), Baixin The same (nifedipine controlled-release tablets), G6 lectin, boidin (felodipine sustained-release tablets), Pell (Nicardipine hydrochloride sustained-release capsules) and so on. Generally, long-acting antihypertensive drugs are more expensive than ordinary preparations, so why use them? Because doctors found in clinical practice that stabilizing blood pressure within the target range 24 hours a day can effectively prevent sudden death, stroke or heart attack from low blood pressure at night to sudden rise in blood pressure in the morning, and can reduce the risk of high blood pressure. Organ damage, and the frequency of medication once a day can also prevent the patient from forgetting to take the medication, making the blood pressure reach the requirements of effective, stable and long-term control.

7. What are the adverse reactions of antihypertensive drugs, and how should we treat them?

Adverse reactions are "side effects" in our general sense. As the saying goes, "Three drugs are poison". While antihypertensive drugs control blood pressure, they may also have some adverse effects on our body. For example, the diuretic hydrochlorothiazide can reduce blood potassium and increase uric acid; ACEI drugs (such as captopril) may cause cough and angioedema; calcium antagonists may also cause headache, edema, flushing and so on. So what should patients think of these adverse reactions? First, don't be frightened by the adverse reaction entries in the instructions and not dare to take medicine to delay the illness; second, don't ignore the adverse reactions that occur, write down your feelings, and inform your doctor if necessary or at the follow-up Help you adjust your treatment plan from a professional perspective. In general, our commonly used antihypertensive drugs have been tested by long-term multi-center clinical practice, and their safety is still relatively high.

8. When is the best time to take antihypertensive drugs?

Generally speaking, our daily blood pressure levels fluctuate regularly: there are two peak blood pressure times at 24 h, that is, 6 to 10 am and 4 to 8 pm (the so-called "spoon curve"). Then taking the medicine half an hour before these two peaks, the antihypertensive effect will be better. But there are some special cases, such as some patients with high blood pressure in the early morning, you need to take medication before going to bed. But then again, most people's blood pressure drops about 20% when they fall asleep at night compared to daytime, so taking antihypertensive drugs before going to bed can easily lead to a large drop in blood pressure and cause insufficient blood supply to the organs such as the heart, brain, and kidneys. Before going to bed, be sure to consult your doctor based on blood pressure monitoring.

9. Do antihypertensive drugs need to be adjusted or changed?

Our blood pressure is affected by various factors such as diet, work environment, interpersonal communication and other factors, such as busy work, emotional excitement, cold weather, and sometimes even eating more animal fats will increase blood pressure. Since the blood pressure changes, the drug naturally needs to be adjusted, but this does not mean that it needs to be adjusted at any time. Generally, the "old patients" are in the long-term medication process, and at the same time under the guidance of a doctor, they have found out a set of adjustment strategies that are suitable for them. , But in the case of "new patients" or major changes in conditions, you still need to seek medical treatment in a timely manner, and ask your doctor to re-draw the plan for you. But remember not to stop the drug at will, especially after some patients have achieved good antihypertensive effect, they begin to be paralyzed. They do not monitor blood pressure often and often take antihypertensive drugs. What's more, they are stopped after regular medication. I found that my blood pressure was still normal for a few days, and I thought that I was healed. In fact, this is just a follow-up effect of the antihypertensive drugs that have not been metabolized in the body. Therefore, do not stop the medicine at will.

The issue of antihypertensive drugs is also the focus of frequent discussion. In general, although there are many types of antihypertensive drugs, generally your doctor will choose the best individual optimized treatment plan for you according to the characteristics of different types of antihypertensive drugs and your own clinical experience. However, some patients are worried that taking antihypertensive drugs for a long time will produce "resistance" like antibiotics. After a long time, they start worrying. In fact, it is not necessary to think so. Hypertension itself is a long-term treatment process, as long as it is under the guidance of a doctor. Medication is still relatively safe. As for whether to replace the antihypertensive drug, it generally depends on several factors such as the efficacy of the drug, the patient's tolerance for adverse reactions, changes in the condition, and the availability of the drug. If there are no problems with these points, you don't need to change your medicine at will.

10. What common drugs can raise blood pressure?

In daily life, we often encounter high blood pressure drugs: licorice, oral contraceptives, steroid hormones, non-steroidal anti-inflammatory drugs (such as acetaminophen, ibuprofen), cocaine, amphetamine , Erythropoietin and cyclosporin. If you are about to take or are taking these medications, be sure to tell your doctor so that he can adjust your blood pressure regimen even if you are.

11. Which antihypertensive drugs should not be used by pregnant expectant mothers?

Antihypertensive drugs that should not be used by pregnant women in general are ACEI and ARB antihypertensive drugs (such as captopril and valsartan), which may cause fetal growth retardation, oligohydramnios, neonatal renal failure, fetal malformation, etc. Situation; Second, diuretics, because it can further reduce blood volume and make fetal hypoxia worse.

12. Avoid taking antihypertensive drugs with milk.

Because milk is rich in tyramine, when an enzyme that breaks down tyramine in the human body is inhibited by antihypertensive drugs, tyramine will accumulate in large quantities, causing a sudden rise in blood pressure, arrhythmia, and severe cases will cause a continuous increase in blood pressure .

In addition, the particles of milk molecules are very delicate, and they are taken with antihypertensive drugs. The molecular particles are easily wrapped on the surface of the drug molecules, which affects the efficacy.

Principles of use of antihypertensive drugs

Do not rush to take antihypertensive drugs. The blood pressure should not be too fast. It should be gradually and smoothly.

Antihypertensive drugs should choose molecular long-acting drugs to control the two peaks of blood pressure in the morning and afternoon smoothly, and molecular long-acting drugs have good compliance and can cover occasional missed doses. ^[1]

The choice of drugs should be different for each person, and the right medicine.

The first treatment should start with a single drug and stepwise add drugs. The exception is severe hypertension.

Combination therapy is superior to high-dose monotherapy.

Familiar with and insist on using several drugs, new drugs, expensive drugs, imported drugs may not be the best.

Do not stop the drug abruptly or stop it suddenly.

Dosage should be sufficient according to the prescribed dose.

Use medicines that do not affect mood and thoughts.

Drug treatment for most patients must be continued unless there is a need to change the treatment regimen.

Antihypertensive medicine

1. Apocynum: mild astringent taste, Pinggan antihypertensive, clearing heat and diuretic.

2. Thin Yarrow: bitter cold, Qufeng Tongluo, clearing heat and lowering blood pressure.

3. Prunella vulgaris: bitter cold, clearing liver, loosening sputum, reducing phlegm, reducing blood pressure.

4. Uncaria: slightly sweet cold, clearing heat and calming the liver, relieving wind and stopping spasm.

5. Eucommia: sweet and warm nature, nourishing liver and kidney, strengthening bones and bones, reducing blood pressure.

6. Cassia seed: sweetness and coldness, clear liver and eyesight, moisturize intestines and laxative, reduce blood fat and blood pressure work, prevent vascular sclerosis.

7. Shi Jue Ming: salty cold, clear liver eyesight, Pinggan Qianyang effect.

8. Weiwei Zi: Sweet and slightly cold, promoting blood circulation and regulating menstruation, cooling the eyesight and lowering blood pressure.

9. Aoki fragrance: bitter and slightly cold.

10. Earth dragon: earthworm, tastes salty and cold, lowers blood pressure.

11. Pueraria: cool and sweet, improve dizziness, headache, numbness and tinnitus.

12. Raw sophora flower: bitter bitter cold, lower blood pressure and improve capillary fragility.

13. Scutellaria: bitter cold, lower blood pressure, improve headaches, chest tightness, irritability and other symptoms.

14. Hawthorn: acid and sweet lukewarm, digestion and accumulation, blood circulation and blood pressure.

15. Epimedium: Weixingan, warm, kidney and aphrodisiac, rheumatism, blood pressure.

16. Fructus Evodia: tastes hard, hot, relieves liver qi, disperses cold and relieves pain.

17. Indus leaves: tastes bitter and cool, expelling rheumatism and reducing blood pressure.

18. Salvia: Salvia miltiorrhizae relieves pain, promotes blood circulation, has the effects of dilating blood vessels, antithrombosis, and improving microcirculation; Pueraria relatatus muscle, rising sun, and Shengjin have blood pressure, slow heart rate, expand coronary arteries, and reduce myocardial consumption. Oxygen, improving microcirculation, and heart and brain blood supply

19. Sheng Dihuang: can clear heat and cool blood, nourish yin and promote fluid, and Sheng Dihuang has strong physiological activity on the cardiovascular system.

20. Panax notoginseng: activating blood and dispersing blood stasis, acting as an obvious endothelin antagonist on cardiovascular and cerebrovascular vessels, expanding blood vessels, increasing myocardial blood supply, slowing heart rate, reducing heart load, reducing myocardial oxygen consumption and increasing myocardial oxygen utilization effect.

21. Kumbu: It has the effect of supplementing potassium and absorbing and discharging, and has a mild antihypertensive effect, and the antihypertensive effect is indeed reliable. Combining the raw materials together can play the functions of nourishing yin and strengthening kidney, relieving liver and stagnation, stabilizing blood pressure, and preventing blood vessel concomitant complications.

22. According to the Ming Dynasty Li Shizhen's Compendium of Materia Medica, the ninth volume records "gypsum is also known as fine stone, also known as" cold water stone ", which treats cold and heat in strokes, has muscle-relieving sweating, removes dry mouth and coke, headache and toothache, It is a good medicine to dispel fever and relieve heat. "In China, people have long used natural plaster to make pillows. In the Tang Dynasty, Xue Fengyou had a poem" gypsum pillow ". On the bed, I'm afraid that the wind will sell well. "According to the theory of traditional Chinese medicine and folk use, high blood pressure is fever, gypsum cold, plaster plaster Laozhuang health care pillow made of gypsum, which regulates brain nerves with cold heat energy. With the normal temperature of the human brain, the cerebral blood vessels can work normally, which can effectively control the increase in blood pressure. If you continue to use it for a long time, you can gradually lower the blood pressure to normal levels.

How to use antihypertensive drugs

1. A single large-dose medication is prone to drug resistance and long-term single-dose medication, which reduces the efficacy. If you simply rely on increasing the dose, it is easy to produce adverse reactions.

2. Medications before going to bed When going to sleep at night, the blood pressure of the human body will drop by about 20% compared with that during the day. Taking antihypertensive drugs before going to bed in patients with hypertension can easily lead to a large drop in blood pressure, cause insufficient blood supply to organs such as the heart, brain, and kidneys, and even induce cerebral thrombosis or myocardial infarction.

3. Intermittent and random medication. Some patients take the medicine when their blood pressure rises, and stop taking the medicine when the blood pressure drops. Other patients don't take the medicine when their symptoms disappear. This is very dangerous.

Seven Mistakes of Antihypertensive Drugs

Misunderstanding 1: take medicine before you feel bad

Eating and stopping will cause blood pressure to rise and fall, not only is not conducive to blood pressure stability, but also easily cause cardiovascular and cerebrovascular accidents.

Misunderstanding 2: I would rather believe in advertising than trust a doctor

Patients with hypertension should consult a doctor to avoid delays and suffer financial losses.

Misunderstanding 3: Dressing back and forth

In fact, there is a process for any medicine to treat diseases. Those who lower blood pressure too quickly are not necessarily good medicines.

Misunderstanding 4: Old stare at side effects

In fact, side effects are just "special tips" for some special patients or special situations, not everyone will encounter.

Sometimes it works well and side effects can also be therapeutic. For example, dihydropyridines, represented by nifedipine, may increase heart rate and cause side effects such as palpitations while lowering blood pressure.

Misunderstanding 5: The time of medication is wrong

Blood pressure fluctuates constantly according to time, so taking antihypertensive drugs should pay attention to "time". Many people are prone to spikes in blood pressure after waking up in the morning, which induces an acute attack of cardiovascular and cerebrovascular disease. Such patients, the first thing in the morning is to take antihypertensive drugs, but many people prefer to finish morning exercises, or take medicine after breakfast, it is easy to cause accidents. Jian Jian does two 24-hour ambulatory blood pressure monitoring every spring, summer, autumn and winter seasons to understand his blood pressure changes. Only by tailoring can he achieve the ideal blood pressure reduction effect.

Myth 6: Taking blood pressure without taking blood pressure

To test whether the antihypertensive drug is effective and whether the dosage is appropriate, not only should you observe whether the symptoms are reduced, but a more scientific method is to measure blood pressure every day. Patients with hypertension should measure their blood pressure at least once a day, and it is more accurate to take measurements every morning after getting up.

Myth 7: Follow the trend and take medicine

Some patients don't go to the doctor, they go to the pharmacy to buy medicine, or they eat what they eat, and some people like to inquire about prescriptions, buy a step-down cap, and a step-down belt. These practices will delay the illness. Hypertension is a "personal" disease, and everyone's blood pressure levels, risk factors, and other accompanying diseases are different, and treatment options are different. Therefore, what medicine to choose and how to take it all require specific guidance from the doctor, and you can't decide for yourself.