Do people with high blood pressure only need to take antihypertensive drugs?

  Patients with hypertension, in addition to taking antihypertensive drugs, still need to take aspirin tablets enteric coated (anti-platelet), statins (lipid regulation, anti-atherosclerosis).  1, aspirin tablets enteric soluble long-term application in the 10-year risk of cardiovascular events 6-10% of the population to prevent the first cardiovascular events (cardiovascular guidelines clearly recommended).  Men >40 years old with two or more risk factors, >50 years old with one or more risk factors; women >50 years old with two or more risk factors, >60 years old with one or more risk factors, whose 10-year cardiovascular disease risk is estimated to be around 6-10%, need to use aspirin orally for primary prevention.  Among the risk factors were: hypertension, diabetes, hyperlipidemia (CHOL ≥ 6.2 mmol/L; LDL ≥ 4.1 mmol/L or HDL < 1.0 mmol/L), obesity (body mass index ≥ 28 KG/M2 ), smoking and family history of coronary heart disease (first-degree relatives, men < 55 years old and women < 65 years old, with a history of coronary heart disease).  Patients with hypertension, when blood pressure is satisfactorily controlled, usually within 150/90 mmHg, with age >50 years, with target organ damage, such as stroke, creatinine >115 umol/L, etc. and one of the diabetic conditions, use aspirin, and when not tolerated can use clopidogrel instead. However, application of small doses of aspirin can increase upper gastrointestinal events by 2-4 times. Then bleeding versus benefit should be evaluated before using aspirin in such high-risk groups and considered when benefit > risk of bleeding.  For hypertensive patients who must take aspirin, assess their risk factors and combine with a proton pump inhibitor or H2 receptor antagonist to reduce the risk of bleeding if they have a previous history of ulcer disease or ulcer complications, or if they have gastrointestinal bleeding or dual antiplatelet therapy or combined anticoagulation, or if they are older than 60 years, take corticosteroids, have dyspepsia or GERD symptoms with more than 1 of these risk factors Bleeding risk (e.g., ranitidine, etc.); if clopidogrel is used, it is better not to use proton pump inhibitors, especially omeprazole (which can reduce the antiplatelet effect); if HP infection is present, HP treatment must be eradicated.  For some clinical patients who are considered to be at relatively high risk of bleeding (low to moderate risk), clopidogrel may be considered instead of antiplatelet or aspirin at an appropriate dose reduction, such as 75 mg/d (because the higher the dose, the greater the risk of bleeding between 75-325 mg/d of aspirin, but a lower dose does not reduce the benefit).  Discontinue antiplatelet agents such as aspirin for patients at high risk for bleeding, such as those who have already had gastrointestinal bleeding and have some hematologic disorders.  For hypertensive patients who are taking aspirin and need to undergo general surgery discontinue the drug just 48 hours before surgery (considering that aspirin tablets are irreversible antiplatelet drugs and can only regenerate themselves after 1 week, if the risk of bleeding is high or the location is important, it can be extended appropriately) 2. Statins can reduce the incidence of various vascular events (coronary heart disease, myocardial infarction, stroke, etc.) in hypertensive patients by 20- 25%, but also has the effect of lowering blood pressure, can use simvastatin or atorvastatin calcium.