What medicine to use for systolic blood pressure
Recently, drug selection for the treatment of hypertension, especially systolic blood pressure control, has become a hot topic. With the deepening of medical research and the accumulation of clinical practice, more and more patients and doctors are paying attention to how to effectively lower systolic blood pressure and reduce the risk of complications. The following is a compilation of content related to the treatment of hypertension that has been hotly discussed on the Internet in the past 10 days, and combined with authoritative guidelines to analyze the medication regimen for systolic blood pressure.
1. The importance of systolic blood pressure control
Elevated systolic blood pressure (high pressure) is an important risk factor for cardiovascular and cerebrovascular diseases. Recent studies have shown that for every 10mmHg decrease in systolic blood pressure, the risk of stroke can be reduced by 27% and the risk of heart failure by 28%. Therefore, rational selection of antihypertensive drugs is crucial.
2. Classification and characteristics of commonly used antihypertensive drugs
| drug class | Representative medicine | Applicable people | Things to note |
|---|---|---|---|
| Calcium channel blockers (CCB) | Amlodipine, nifedipine | Elderly patients, isolated systolic hypertension | May cause edema of lower limbs |
| Angiotensin-converting enzyme inhibitor (ACEI) | Enalapril, Perindopril | Combined with diabetes and kidney disease | Be aware of side effects of dry cough |
| Angiotensin receptor blockers (ARBs) | Valsartan, Losartan | ACEI intolerant people | Contraindicated during pregnancy |
| diuretics | Hydrochlorothiazide, indapamide | salt sensitive hypertension | Pay attention to electrolyte monitoring |
| beta blockers | Metoprolol, Bisoprolol | Combined with coronary heart disease | Asthma patients should use with caution |
3. The latest research hotspots in 2023
1.SPRINT study follow-up analysis: Intensive blood pressure lowering (target systolic blood pressure <120mmHg) can reduce the risk of cardiovascular events by 25%, and is especially suitable for high-risk patients.
2.Drug combination therapy trends: When single drug control is not good, a combination of CCB+ACEI/ARB is recommended. Recent data shows that it can increase the blood pressure compliance rate by more than 30%.
3.New antihypertensive drugs: ARNI drugs (such as sacubitril-valsartan) have shown advantages in refractory hypertension and have become the focus of recent academic conference discussions.
4. Individualized medication recommendations
| patient type | drug of choice | target systolic blood pressure |
|---|---|---|
| Elderly patients (>65 years old) | CCB or diuretic | 130-140mmHg |
| diabetics | ACEI/ARB | <130mmHg |
| Chronic kidney disease patients | ACEI/ARB (GFR＞30) | <130mmHg |
| coronary heart disease patients | Beta blockers + ACEI | 120-130mmHg |
5. Medication precautions
1.Regular monitoring: It is recommended to self-measure blood pressure at home and record the blood pressure values in the morning and before going to bed.
2.avoid misunderstandings: Medication should not be stopped without authorization after blood pressure is normal. The "intermittent medication method" that has been hotly discussed on the Internet recently lacks scientific basis.
3.lifestyle intervention: Salt restriction (<5g per day), weight loss (BMI<24), and regular exercise can enhance the effect of the drug.
6. Latest opinions of experts
The latest "Guidelines for the Prevention and Treatment of Hypertension in China (2023 Revised Edition)" released by the Cardiovascular Disease Branch of the Chinese Medical Association emphasizes that for most patients, priority should be given to long-acting preparations to achieve 24-hour stable blood pressure reduction; for patients with simple systolic hypertension, CCB drugs can be the first choice.
In summary, drug selection for systolic blood pressure needs to take into account age, comorbidities, and drug properties. It is recommended that patients develop a personalized plan under the guidance of a specialist and regularly evaluate efficacy and safety to achieve optimal blood pressure control.
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