There are five commonly used antihypertensive drugs,they are pril (such as captopril, enalapril, benazepril, etc.),sartans (valsartan, irbesartan, telmisartan, etc.), dipine (nifedipine controlled-release tablets or sustained-release tablets, amlodipine, Levamlodipine), diuretics (hydrochlorothiazide, indapamide, etc.),β-blockers (metoprolol, bisoprolol, carvedilol, etc.).
Due to the different action characteristics of different drugs,it is necessary to consider many factors for which antihypertensive drugs should be used in patients with hypertension.Generally speaking, all kinds of drugs can be used if the patients only have hypertension and have no complications (such as heart, brain, kidney lesions) or other diseases (such as diabetes).If patients have other diseases at the same time, antihypertensive drugs can be selected according to the following principles.
1. With left ventricular hypertrophy, the first choice is dipyridamole, pril or sartan.
2. In patients with coronary heart disease, the first choice is dipyridamole, pril, Sartan or β-receptor blockers.
3. Pril, Sartan or β-blockers are the first choice for patients with a history of myocardial infarction.
4. In patients with heart failure, pril, sartan, diuretics or b-blockers are the first choice.
5. For patients with atrial fibrillation, pril or sartan should be the first choice.
6. For patients with cerebrovascular disease, the first choice is dipyridamole, pril, sartan or diuretics.
7. When there are carotid intimal thickening or plaques, the first choice is horizon.
8.If the patient is complicated with proteinuria or microalbuminuria, the first choice is puliler or sartanUrinary.
9. In elderly patients with hypertension, the first choice is dipine, pril, sartan or diuretics.
10. For patients with diabetes mellitus, pril or sartan is the first choice.
11. In patients with hyperlipidemia, pril or sartan is the first choice.
Most patients with hypertension need to use two or more antihypertensive drugs in combination to make blood pressure reach the standard, which combination mode should be determined according to the specific situation of patients.The best combination regimens are the combination of dipine and sartan, the combination of dipine and pril,the combination of sartans and diuretics, the combination of pril and diuretics, etc.If the blood pressure can not be controlled satisfactorily after the combination of the two drugs,the combination of dipyridamole, pril (or sartan) and diuretics should be considered first. In general, do not use the combination of pril and sartan.If there is no heart failure, do not use a combination of pril andβ-blockers,and do not combine sartans withβ-blockers.
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