Combination drug regimens for hypertension include angiotensin-converting enzyme inhibitors + dihydropyridine calcium channel blockers, angiotensin-converting enzyme inhibitors + thiazide diuretics, and so on.
1. Therapeutic drugs
(1) Diuretics: thiazides (e.g. hydrochlorothiazide), labeled diuretics (e.g. furosemide), and potassium-preserving diuretics (e.g. spironolactone).
(2) β-receptor antagonists: such as propranolol, which exerts antihypertensive effects by inhibiting myocardial contractility and slowing down heart rate.
(3) Calcium channel blockers (CCB): divided into dihydropyridines (nifedipine) and non-dihydropyridines (verapamil).
(4) Angiotensin-converting enzyme inhibitors (ACEI): such as enalapril, the onset of antihypertensive effect is slow, limiting sodium intake or the combined use of diuretics can lead to a rapid onset of action and enhancement of the effect.
(5) Angiotensin II receptor antagonist (ARB): such as valsartan, the antihypertensive effect is mainly through the blockade of tissue angiotensin II receptor, thus blocking the vasoconstrictor effect of angiotensin II.
2. Combination program: the main combination program in China includes ACEI/ARB + dihydropyridine CCB, ARB/ACEI + thiazide diuretics, dihydropyridine CCB + β-receptor antagonists.
Secondary combination regimens include β-receptor antagonists + diuretics, α-receptor antagonists + β-receptor antagonists, dihydropyridine CCBs + potassium-preserving diuretics, and thiazide diuretics + potassium-preserving diuretics. Combination therapy with three antihypertensive drugs must include a diuretic.
Hypertensive patients should not use medication on their own, but should standardize treatment and take medication regularly under the guidance of a doctor.