Principles of hypertension drug therapy

  What are the principles of pharmacological treatment of hypertension (1) To control blood pressure to an appropriate level, eliminate all the discomfort caused by hypertension, and ensure the quality of life of patients.  (2) Minimize the damage of hypertension to the heart, brain, kidneys and other important organs, and strive to gradually reverse the damage that has already developed.  (3) While lowering blood pressure treatment, other risk factors for cardiovascular and cerebrovascular complications, such as left ventricular hypertrophy, hyperlipidemia, diabetes mellitus, hyperinsulinemia, insulin resistance and obesity, should be prevented and treated.  (4) The program should be as easy as possible and able to be adhered to for a long time.  (5) Insist on individualization and make the program for each patient’s specific situation.  (6) Advocate early treatment with disease and early prevention without disease, and emphasize close cooperation between patients, hospitals and families.  (7) Start with a low dose, and if the blood pressure fails to reach the control target, the dose of the drug should be increased according to the dosing situation.  (8) If the first drug is ineffective, a reasonable combination of drugs should be administered, usually with a small dose of the second antihypertensive drug, rather than increasing the dose of the first drug. The effective five types of combination drug combinations are: diuretics + beta-blockers; diuretics + ACE inhibitors (or angiotensin II receptor antagonists); calcium antagonists + beta-blockers; calcium antagonists + ACE inhibitors; alpha-blockers + beta-blockers.  (9) If the first drug is very ineffective or intolerable, change to another type of antihypertensive drug instead of increasing the dose of the first drug or adding a second drug.