Which antihypertensive drug is best for high blood pressure? Cardiologist: Mastering 5 principles, choosing medicines is not difficult

For all hypertensive patients, the blood pressure should be achieved by improving the lifestyle or drugs. Of course, the level of reaching the target is different for each patient. There are many types of antihypertensive drugs used clinically. There are five major types of antihypertensive drugs in the first-line clinical practice, and there are second-line antihypertensive drugs. There are domestic and imported ones. There are cheap and expensive ones. Eat two or three times a day, which one should you choose? In the selection of drugs, at least the following five principles must be followed, and drug selection and medication will not be so difficult.

Blood pressure

For those who just started using antihypertensive drugs, or adjust antihypertensive drugs in the process of blood pressure lowering, they should start from the regular dose, so as to avoid the adverse effects of blood pressure dropping too low or too fast.

Especially for the elderly and the weaker patients, it may be necessary to start with a small dose. Do not increase the dose of the drug because you want to lower blood pressure as soon as possible. For example, the usual dose of amlodipine is 5 mg per tablet. Although the instructions say that it can be used up to 10 mg per day, everyone's response to the drug It is not the same, and the maximum dose cannot be used directly. Only after a period of use, the effect is not enough, and the dose can be gradually increased slowly.

Dosage Principle

The currently used antihypertensive drugs are divided into short-acting, medium-acting and long-acting drugs according to the length of their half-life.

Long-acting drugs, due to their long half-life, can cover 24 hours or even longer. They only need to be taken once a day. They are convenient to take, have good compliance, and can easily control blood pressure and reduce cardiovascular complications.

Long-acting drugs are preferred

For patients with moderate or higher hypertension or with a blood pressure value greater than the target value of 20 mmHg, combined medication can be considered. The combination of different types of drugs can enhance the antihypertensive effect, and can reduce the side effects of a single drug in large doses. Including the use of some commonly used single-piece compound preparations, it is also a combination drug.

Combination medication

Different types of drugs are selected according to the different ages of patients, combined risk factors, and underlying diseases, such as diabetes, coronary heart disease, kidney disease, and cerebrovascular disease. It should also observe the patient's response to a certain drug, whether it has efficacy, tolerance, and whether there are related side effects.

individualize

Although the primary purpose of choosing antihypertensive drugs is to lower blood pressure, hypertension is a long-term chronic disease. Most patients need long-term oral antihypertensive drugs, and many patients with hypertension also have other The disease needs to take medicine at the same time, and economic issues have to be considered at this time, especially for some patients with poor economic conditions. Try to choose some cost-effective drugs,

For example, for some domestic generic drugs, the difference in efficacy between them and imported drugs is not as big as the price difference. We need to identify these cheap and effective drugs.

Consider economic factors

The choice of antihypertensive drugs is not the more expensive the better, nor the newer the better. A certain type of drug is effective for a specific group of people, but not necessarily suitable for all groups of people. Therefore, the choice of antihypertensive drugs should be based on the above five principles to choose a suitable drug, which can control blood pressure stably and reduce complications.