How to choose antihypertensive drugs for patients with gout and hyperuricemia

  1, angiotensin II (Ang II) receptor antagonist: increase renal blood flow, accelerate the discharge of urine, uric acid. No significant effect on blood sugar, blood lipids, the heart, kidney, brain and other organs have a protective effect, the representative drugs are cloxacin, my experience, to promote urinary uric acid excretion, reduce blood uric acid.  2, angiotensin converting enzyme (ACE) inhibitors: Most scholars believe that ACE inhibitors have dilated peripheral and visceral blood vessels, reduce the role of peripheral and visceral vascular resistance, there is a significant increase in renal blood flow, promote uric acid excretion, is a good treatment for hypertension with gout or hyperuricemia. However, some people have questioned this, and they believe that such drugs only dilate part of the renal artery, and the total renal blood flow decreases instead after using the drug, which reduces uric acid excretion and can induce or aggravate gout. My experience, did not reduce the blood uric acid level.  3, calcium antagonists calcium antagonists: nifedipine, nicardipine and other long-term use can make the blood uric acid rise significantly; Nifedipine has a slightly smaller effect on blood uric acid; amlodipine, levamlodipine, etc. have almost no effect on blood uric acid.  4, beta-blockers: such as propranolol has a greater effect on blood uric acid; betaxolol, generally does not raise blood uric acid.  5, diuretics: tab diuretics, thiazide diuretics and compound preparations have adverse effects such as raising blood uric acid and increasing uric acid deposits in the kidneys, so hypertension with gout, kidney stones, diabetes mellitus and other diseases, try not to use.  The specific medication should be combined with the clinical situation and guided by the doctor’s face-to-face consultation.