Patients with hypertension are often worried about side effects and don’t know how to overcome them when they use medication; or they feel that the effect of lowering blood pressure is not good but don’t know what to do; or they don’t understand why their doctor is changing their medication and are worried about using the wrong medication, etc.
Please see how the experts explain these problems you encounter –
Calcium antagonists
There are two types of calcium antagonists commonly used.
Dihydropyridines: Nifedipine extended-release tablets (Niftar), Nifedipine controlled-release tablets (Baysin), Felodipine (Boydin), Amlodipine (Lopressor, Anezin). Silapine, formally known as lacidipine
Non-dihydropyridines: Verapamil (Isoptin), Diltiazem (Tenelheart, Hepesol).
1. Do calcium antagonists “increase the risk of heart disease”?
The term “increased risk of heart disease” for calcium antagonists mainly refers to cardiac painkillers. Studies have found that cardiac pain relievers may increase blood pressure fluctuations, accelerate heart rate, and increase target organ damage. Therefore, if you need to take cardioplegia for a long time, you should pay attention to monitoring and change the medication when necessary.
2. Do calcium antagonists affect liver and kidney function? Can nimodipine cause “hepatitis”? What should I do to prevent it?
Since many calcium antagonists are metabolized in the liver and excreted through the kidneys, patients with hepatic and renal insufficiency should not take too large a dose. Nimodipine mainly acts on cerebrovascular smooth muscle and has not been reported to cause “hepatitis”.
3.What is the difference between Boeotin, Loxodine and Cardiac Pain? Which one is better? How to choose?
The U.S. Food and Drug Administration (FDA) stipulates the valley/peak ratio of drugs: the valley/peak ratio exceeds 66% to meet the long-term antihypertensive requirements. Boydin is 30% to 50%, Loxodren 70%, and Cardiac Pain is below 30%. Obviously, Boydin and Cardiac Pain are not suitable for long-term antihypertensive treatment.
4.Is there any time requirement for taking Amlodipine? Should I take it before or after meals?
Amlodipine is taken orally and absorbed quickly, once a day, 5 mg each time, before and after meals. Individuals who experience dizziness and redness after taking the drug indicate that it is absorbed too quickly and can be taken after meals.
5.An elderly patient has been using nifedipine, but after being hospitalized due to “stroke”, the doctor asked him to change to nimodipine, can he not change it?
Although nifedipine and nimodipine are both calcium antagonists, their action sites are different. Nimodipine mainly dilates cerebral blood vessels, which is beneficial to the recovery of brain function and cognitive function in stroke patients. Nifedipine mainly dilates the arteries of body circulation. Therefore, the drug should be changed.
6.Will triglycerides and cholesterol in blood rise with long-term use of nifedipine controlled-release tablets?
The results of the survey showed that only about 5.9% of such patients’ blood lipids were affected.
7.What do I need to pay attention to when taking nifedipine for a long time?
Nifedipine is a short-acting calcium antagonist. It is absorbed quickly and blood pressure drops quickly, which can lead to reflex tachycardia and induce myocardial ischemia and acute vasodilation; and because of fast excretion, it needs to be taken several times a day and cannot suppress the peak of cardiovascular events in the early morning. Therefore, it should not be taken for a long time.
8.Will Loxodren cause myocardial infarction? What do I need to pay attention to if I take it for a long time?
Lopressor is a third generation calcium antagonist, a long-acting antihypertensive drug, which can control blood pressure for 24 hours by taking one tablet daily, and is suitable for patients with mild to moderate hypertension. It does not cause myocardial infarction. However, for long-term use, attention should be paid to the presence of gum swelling and ankle edema.
9. An old man suffers from hypertension and coronary artery disease with verapamil. A recent examination revealed a left bundle branch conduction block and the doctor asked to change the medication. Is it a serious condition? Or is the drug having a lot of side effects? Does his partner, who has the same disease, need to change his medication?
It has nothing to do with side effects. Verapamil is a non-dihydropyridine calcium antagonist with adverse effects such as atrioventricular block and inhibition of cardiac function. This patient has existing left bundle branch block, so she should be switched. The patient could be switched to an angiotensin II receptor antagonist (ARB) or the calcium antagonist amlodipine. As for his elderly partner, no change is necessary.
10.Is it appropriate to lower blood pressure with selapine in patients with moderate hypertension who also have gout?
The cause of gout is the high concentration of uric acid in the blood, which forms uric acid crystals in the tissues and causes pain. Although there is no need to worry about it causing gout, it is still recommended to switch to Hedgehog 62.5 mg once a day, which can both lower blood pressure and lower blood uric acid.
11. After a patient took Sanjing Slurpee for 2 months, his body was swollen, his limbs were cold and easy to chill, and if he touched ice water, his hands were red and itchy. Is this caused by Sanjing Slupin?
Sanjen Slepine can cause edema. If the patient is not combining other diseases or taking other medications now, it is considered that it may be caused by Serapine. It is recommended to add diuretics such as hydrochlorothiazide to reduce the swelling symptoms or change to other antihypertensive drugs.
As for the cold hands and feet, stop the medication or go to the rheumatology department to exclude the possibility of other diseases.
”Prilosec
These drugs are angiotensin-converting enzyme inhibitors (ACEI), commonly used are captopril (Kaipotong), benazepril (Lortin), enalapril (Esu), perindopril (Asterix), ramipril (Ritex), fosinopril (Monox), etc.
12.After taking captopril, do I need to stop taking it if I feel headache and dizziness? After stopping the medicine, what medicine should be used?
First of all, we need to find out whether the headache and dizziness are symptoms of hypertension itself or adverse drug reactions. If the blood pressure rebounded after stopping the drug and the headache and vertigo decreased, and the above symptoms appeared again after taking Captopril, it can be basically determined as an adverse drug reaction. You can change to other antihypertensive drugs, such as calcium antagonists (amlodipine, nicardipine); beta-blockers (metoprolol, atenolol), etc.; you can also change to take angiotensin II receptor antagonists (ARB), such as cloxacin, valsartan, etc.
13.What drugs should not be combined with captopril? Can I combine ibuprofen with flu and fever?
Captopril should be avoided in combination with potassium-protective diuretics and potassium-replenishing preparations, such as Amisulpride, Aminopterin, Amiloride, Potassium Chloride, etc. When combining with other antihypertensive drugs, pay attention to the blood pressure should not be lowered too low. Ibuprofen can still be used for fever, but the antihypertensive effect of captopril may be reduced.
14.What is the difference between Lortinex and Captopril? What are the side effects? Can they be used for a long time?
Lortensin is the trade name of benazepril, which is an angiotensin-converting enzyme inhibitor (ACEI) with captopril. However, Captopril is a short-acting antihypertensive drug, while Lortensin is a long-acting antihypertensive drug. Therefore, Captopril is often taken three times a day, while Lotensin can be taken once a day. Other rare side effects include angioneurotic edema, constipation, gastrointestinal discomfort, skin rash, and granulocytopenia. If no side effects occur, it can be used for a long time.
15.What kind of medicine is Essilor? Does it cause gout?
It is one of the angiotensin-converting enzyme inhibitors with good antihypertensive effect and protective effect on target organs such as heart, brain and kidney. However, it also has some side effects, such as dry cough, and does not cause gout.
”Satan” class
These drugs are angiotensin II receptor antagonists (ARB), commonly used are Coxsartan (Coxswain), Valsartan (Devon), Candesartan (Vilja), Irbesartan (Ambrovir), and Telmisartan (Mecarbil). If hydrochlorothiazide 12.5 mg is added, Cosuccia becomes Hedzia, Dextran becomes Fodavin, and Ambrovir becomes Amprenox.
16.What are the side effects of long-term use of Dextran?
The side effects are less frequent and milder, such as headache, dizziness, gastrointestinal symptoms and rash. If there are no side effects, it can be used for a long time.
17.What is the difference between Cosulya, Dextran and Hedgehog? How to choose?
Both Cozoa and Dextran are angiotensin II receptor antagonists (ARB). The former requires hepatic conversion, while the latter works directly. Although both are long-acting antihypertensive drugs, they can be taken once a day. However, the duration of maintenance of blood pressure lowering is longer for Dextran than for Corsoia.
Hedzia is a combination of Cozoa and hydrochlorothiazide, i.e., Cozoa’s antihypertensive formulation. Its advantage is that it has a faster onset of action and stronger antihypertensive effect than Cozoa, and is more suitable for patients with moderate hypertension.
Diuretics
This class of drugs commonly used are dihydrochlorothiazide, amiloride, indapamide (Shoubisan) and spironolactone.
18.What are the conditions to consider taking Shoubisan? How to take it? Can I take it for a long time?
Shoubishan (indapamide) is a long-acting diuretic antihypertensive drug with calcium antagonism, which can be used alone for mild to moderate essential hypertension, or in combination with other antihypertensive drugs. It can be started at 2.5 mg once daily. After that, it can be adjusted according to the blood pressure condition.
Sulbactam can be taken for a long time. A few patients may cause vertigo, headache, insomnia, drowsiness, nausea, diarrhea, and rash. Individual patients may cause elevated blood uric acid and even induce gout, and some may develop hypokalemia, so long-term use should be monitored. Allergy to sulfonamides, severe liver insufficiency, acute cerebrovascular accident patients should not be used.
19.What about potassium deficiency when taking diuretics for a long time? What phenomenon will it produce? How to prevent it?
If potassium deficiency is caused by taking diuretics, patients will experience weakness, muscle weakness, nausea, vomiting, weakened intestinal motility, cardiac arrhythmia and other symptoms. The main point of prevention is that when taking potassium-depleting diuretics, blood potassium should be tested regularly and supplementation should be given depending on the level of potassium. Once low potassium is produced, potassium detoxification diuretics can be stopped, or oral potassium chloride (Tadalisin) or potassium magnesium menthylate can be used to correct the problem; in case of severe potassium deficiency, intravenous potassium chloride should be given.
In addition, diuretic antihypertensive drugs can cause hypokalemia in those who are mainly thiazide potassium-removing diuretics. Potassium-conserving diuretics not only do not produce hypokalemia, but can also raise blood potassium. Therefore, the combination of both types of diuretics, if necessary, can also reduce blood potassium abnormalities.
Beta-blockers
Commonly used drugs in this category are metoprolol (Betaxolol), bisoprolol (Conco), and carvedilol (Lodex, Dariquan).
20.What kind of other drugs can I switch to if I have eye pain from taking Betaloc? There are reports that long-term use of Betaloc can cause Parkinson’s syndrome, is it true?
Betalac has side effects such as headache and eye pain. In this case, you can try to stop taking Betalac first. If the eye pain disappears after stopping it for a period of time, and the eye pain reappears after taking Betalac again, it is related to Betalac. At this time, patients can switch to angiotensin II receptor antagonist (ARB), angiotensin-converting enzyme inhibitor (ACEI) or diuretics under the guidance of a doctor, depending on their condition.
As for causing Parkinson’s syndrome is rare. For patients, it is not necessary to be right.
”proprietary Chinese medicine” and the combination of Chinese and Western medicine
21.Does compound rooibos cause gout? What are its side effects?
Compound rooibos is a combination of Chinese and Western medicines, whose ingredients include rooibos leaves, wild chrysanthemum, dihydralazine sulfate, hydrochlorothiazide and promethazine hydrochloride. Among them, hydrochlorothiazide may cause an increase in blood uric acid, so gout patients should not use compound rooibos. However, since the amount of hydrochlorothiazide contained in compound rooibos is not large, if the patient’s original uric acid is not high, it is not a big problem to take only 2 to 3 tablets a day. If you are worried, you can go to the hospital outpatient clinic to check the blood uric acid, and continue to take it if it is not high.
In addition, overdose of this product can also cause central sedative effects and low potassium symptoms.
22.Is Zhenju Antihypertensive Tablets good? What are the side effects?
Jenju Antihypertensive Tablets is also a mixture of Chinese and Western medicines. Each tablet contains 30 micrograms of colistin, 5 mg of hydrochlorothiazide, and wild chrysanthemum, pearl layer, and acacia rice. It has the side effects of both diuretics and central antihypertensive drugs, and the adverse reactions that occur with high doses of the drug are related to the diuretics it contains. Patients with mild hypertension (blood pressure 140-150/90-100 mmHg) with dizziness and pain can try Zhenju antihypertensive tablets.
23, a patient 40 years old, height 1.60 meters, weight 70 kg, diet has been very moderate, but the weight can not be reduced. Now he is taking Niuhuang Antihypertensive Pills, and he feels fine, but his blood pressure has not come down and has been at 160/100 mmHg. Please ask the expert to guide me.
The body mass index (weight ÷ height2) has exceeded 27 (normal 23 to 24), so the patient’s hypertension is related to obesity. Niuhuang hypotensive pill is a Chinese medicine preparation, the effect of lowering blood pressure is moderate, single use is difficult to control blood pressure. It is recommended that this patient go to the hospital to check the cause of obesity and related risk factors such as blood glucose and blood lipids, and preferably also exclude secondary hypertension, which can check the kidneys, renal blood vessels and adrenal glands.
While dieting, increasing exercise, reducing weight and controlling risk factors, this patient is recommended to use calcium antagonists, angiotensin II receptor antagonists (ARB), angiotensin converting enzyme inhibitors (ACEI) or diuretics to lower blood pressure to the desired level first. Alternatively, compound preparations such as Hedgehog can be used, one tablet each time, once a day.
24.How does Baihua Duzhong blood pressure lowering tablet work? Is it credible that “you don’t need to take antihypertensive drugs for the rest of your life if you take it for 1 year”?
This drug is not very common at present, there is no large-scale clinical trials to confirm that it is an effective antihypertensive drug. It is not credible to say that “you can take it for 1 year and never take it again”. High blood pressure will rise again without medication, so do not believe the advertising.
Other antihypertensive drugs
25.Can I take blood pressure medicine for a long time? What side effects can occur?
Lixin is not one of the 6 basic antihypertensive drugs, but it can still be used in view of the national situation. It has side effects such as nasal congestion (nasal congestion), mental depression, bradycardia and peptic ulcer. If there are no such side effects during the use, it can still be used for a long time.
26.What are the ingredients of Beijing Antihypertensive 0? What are the side effects of long-term use?
Beijing Antihypertensive No. 0 is a compound antihypertensive drug, which contains Risperdal, hydrochlorothiazide, aminopterin, dihydralazine and Librium. 2004, the prescription was adjusted to reduce the sedative component and renamed “Antihypertensive No. 0”. The main side effects of long-term use are from reserpine (see previous question); because it contains the potassium-protecting diuretic aminopterin, it is important to pay attention to whether there is an increase in blood potassium.
27.What kind of medicine is Uralin? What should I pay attention to when taking it?
Eugenol is a monooxygenase inhibitor, and its antihypertensive mechanism has not been fully elucidated. You should pay attention to postural hypotension, sometimes dry mouth, gastrointestinal discomfort, insomnia, dreaminess, etc. This drug is generally used for moderate to severe hypertension. While taking this drug, you should not eat food containing cheese, otherwise pheochromocytoma-like attacks (sudden increase in blood pressure and twitching of limbs) may occur.
28.Will long-term use of antihypertensive drugs affect sexual function? How can I tell if the decline in sexual function is caused by antihypertensive drugs?
Not all antihypertensive drugs will reduce sexual function. Some antihypertensive drugs also have the effect of improving sexual function, such as valsartan (Dextran). Currently, it is believed that beta-blockers, diuretics (including Shoubisan), and eugenol may have some effect on sexual function, while angiotensin II receptor antagonists (ARB), angiotensin-converting enzyme inhibitors (ACEI), and alpha-blockers have less effect on sexual function.
To determine whether the decrease in sexual function is caused by drugs, the easiest way is to stop the drug for 1 to 2 weeks and observe whether sexual function can be restored. Generally speaking, the decrease in sexual function caused by antihypertensive drugs can be recovered after stopping the drugs.
Combined medication
29. A patient has a systolic blood pressure of 170 mmHg and a diastolic blood pressure of 110 mmHg. He takes 1 tablet each of triptanseropine and betalactam twice a day at 50 mg in the morning and evening, and also takes 2 tablets of aspirin at 100 mg every morning, is this reasonable?
Triptanseropine plus betalactam is a reasonable combination of medications if it can effectively control blood pressure. However, it is not appropriate to take aspirin 100 mg in the morning. As an anti-platelet aggregation drug, it is more reasonable to take it in the evening and to take the enteric type.
30.Is it reasonable to take captopril, betalactam and sulforaphane at the same time? About how long must I change the medication?
Captopril is an angiotensin-converting enzyme inhibitor, betalactam is a beta-blocker, and Sobiesan is a diuretic antihypertensive drug, so the combination of the three drugs is very reasonable. This reasonable combination of drugs is not a “mix”, but a combination. If the treatment is effective, it is not advisable to change the drugs frequently. If the blood pressure reaches the target value and is more stable, you can try to withdraw one. However, when to adjust the type and dose of medication depends on the blood pressure level, risk factors and the degree of related organ damage, and consult with your doctor.