1. What is high blood pressure and its treatment goals?
Hypertension refers to the systolic blood pressure exceeding 140mmHg or the diastolic blood pressure exceeding 90mmHg. It is caused by the increased tension of peripheral vascular smooth muscle. This will increase the resistance of the arterioles and decrease the volume of the venous system. The goal of antihypertensive therapy is to reduce cardiovascular and renal morbidity and mortality. The target blood pressure for the treatment of hypertension is systolic blood pressure less than 140mmHg and diastolic blood pressure less than 90mmHg.
2. Which antihypertensive drug has the strongest antihypertensive effect?
On the whole, angiotensin II receptor blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, diuretics and Ξ²-receptor blockers have similar antihypertensive effects. Therefore, there is no obvious difference in strength between them. However, specific to each person, the antihypertensive effect of different drugs may be significantly different. For example, some people use angiotensin II receptor blockers to have a significant blood pressure lowering effect, but some people have very little blood pressure reduction after using it. There may be significant differences in the response to antihypertensive drugs between individuals. When starting to take antihypertensive drugs, medication should be administered under the guidance of a doctor.
3. How much can an antihypertensive drug reduce blood pressure?
The degree of blood pressure reduction of the drug mainly depends on the current blood pressure. For example, the patient's blood pressure is 140/90mmHg, and the blood pressure reduction after taking an antihypertensive drug generally does not exceed 10/5mmHg. The blood pressure of another patient is 180/110mmHg and the blood pressure may drop by 20/10mmHg after medication.
In general, the higher the current blood pressure, the greater the drop in blood pressure after medication.
4. If the patient's systolic blood pressure is very high and the diastolic blood pressure is close to normal, will the diastolic blood pressure drop too low after using antihypertensive drugs?
It is possible. However, the decreasing level in systolic blood pressure and diastolic blood pressure are not the same. If the systolic blood pressure is reduced by 10mmHg, the diastolic blood pressure may only be reduced by 5-6mmHg. So, although the systolic blood pressure and the diastolic blood pressure will drop after the medication, the diastolic blood pressure drop is relatively small.
5. Will antihypertensive drugs be resistant?
Generally not. Some people use the same antihypertensive drug for several years and their blood pressure is well controlled, but it has recently increased again. Is it because of drug resistance? It is generally not. As we age, our systolic blood pressure will gradually increase. The reason why blood pressure is not well controlled is that your blood pressure is higher than before, rather than drug resistance. In this case, it is generally necessary to add another medicine or increase the dose of original medicine, instead of trying to change another medicine.
6. After a period of medication, the blood pressure becomes normal. Can the medication be stopped?
If your blood pressure is not too high before the medication and you have been exercise, weight loss and less salt recently, you can try to stop the medication after a few months and monitor blood pressure closely. Some patients can maintain their blood pressure at normal level. If the blood pressure rises again after stopping the drug, you need to re-administer the drug and do not try to stop the drug by yourself.
7. Does an antihypertensive drug need to be replaced after being used for a long time?
Some people worry about side effects of a kind of antihypertensive medicine after being used for a long time. Therefore, they will ask for changing another drug. In fact, it is not necessary. The side effects of antihypertensive drugs generally appear within a few weeks to a few months of the medication. If there are no side effects after that, it indicates that it can be well tolerated. As long as the blood pressure is well controlled, there is no need to change the medication.
8. Should antihypertensive drugs be taken before or after a meal?
Follow the instructions, different medicines have different requirements. If there is no special requirements on the instructions, they are usually eaten after a meal.
9. Antihypertensive drugs that are taken once a day should be taken in the morning or at night?
Most people can take it in the morning. It is best to do 24-hour ambulatory blood pressure monitoring. If blood pressure is high at night or in the morning, you can take medicine at night. If blood pressure is high during the day, you can take medicine in the morning. If you drink frequently at night, it is best to take medicine in the morning. It is because alcohol may has interaction with the drugs.
10. How long does it have the effect after taking antihypertensive drugs?
It is different. Sublingual drugs can begin to exert a blood pressure-lowering effect within a few minutes (although the effect is fast, it can cause fatal and serious adverse reactions. Generally, it is only used for critical acute attacks). Oral short-acting drugs usually take effect after one or two hours. Long-acting drugs may need to be administered continuously for one to two weeks to gradually exert their maximum effect (although it is slow, but blood pressure fluctuations are small, which is good for hypertensive patients).
11. Will antihypertensive drugs hurt the liver and kidneys?
Most drugs have the potential to damage liver or kidney function. However, the overall safety of commonly used antihypertensive drugs in clinical practice is very good. Proper medication under the guidance of a doctor will generally not have a significant adverse effect on liver or kidney function.
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