There are four misunderstandings in the use of antihypertensive drugs

Hypertension is the most common chronic disease, long-term hypertension may lead to heart disease, stroke, renal failure, fundus lesions and even blindness and other consequences. Data show that 69 per cent of patients with myocardial infarction have high blood pressure, 77 per cent of patients with stroke have high blood pressure, and 74 per cent of patients with heart failure have high blood pressure.Therefore, hypertension is the most important risk factor for cardiovascular disease. Statistics from the World Health Organization (WHO) show that about 17 million people die from cardiovascular diseases each year, accounting for about 1/3 of the total deaths. Of these, 9.4 million died from complications of high blood pressure. 

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Antihypertensive therapy is one of the most effective methods to reduce the harm of cardiovascular and cerebrovascular diseases. Professor Jiang Lixin, assistant director of the National Cardiovascular Disease Center and vice president of Fuwai Hospital of the Chinese Academy of Medical Sciences, believes that many people have misunderstandings about the use of drugs for high blood pressure, the most typical of which is that there are four misunderstandings. 

Myth one: “liver injury”, “kidney injury” cannot be eaten. 

All drugs must be verified by a series of clinical trials before they can be put on the market, and their safety and efficacy can be fully observed in both healthy people and patients, so they are safe and secure. Patients should not be frightened by the adverse drug reactions listed in the drug instructions. The drug is allowed on the market, indicating that the adverse reactions have little impact on the human body, or the incidence of adverse reactions is very low. For example, any adverse reaction in any of the 10,000 people would have been recorded in the manual, but the probability of it happening was very low. 

Drugs have to pass through the liver, kidney metabolism out of the body, but not the side effects of injury to the liver and kidney can not be taken. If the patient’s liver or kidney itself has a problem, the doctor will choose the drug according to the characteristics of the drug and the patient’s liver and kidney conditions. Generally speaking, the harm of adverse reactions caused by taking hypertension drugs is far less than that caused by myocardial infarction, cerebral infarction and other diseases caused by not taking hypertension drugs. Therefore, patients should follow the doctor’s advice to take hypotensive drugs, when suspected adverse drug reactions occur, timely inform the doctor, adjust the use of drugs, and do not stop drugs by themselves. 

Myth 2: taking “Xintongding” to reduce Blood pressure quickly. 

Some patients get so nervous when their blood pressure rises suddenly from time to time, such as systolic blood pressure exceeding 200mm HG, that they choose drugs such as nifedipine under the tongue to get their blood pressure down quickly, for example, by taking nifedipine under the tongue. 

This should be prohibited because it is dangerous to the patient. The reason is that the drug directly absorbed into the blood through the sublingual vein, the blood drug concentration increases rapidly, which may lead to a sharp drop in blood pressure in a short period of time. As a result, some patients have symptoms such as sudden fainting and insufficient blood supply to the brain. 

Remind broad patient attention, appear abrupt rise of blood pressure, should seek medical treatment as soon as possible when accompany with apparent symptom especially. Because when hypertension patients with different diseases, blood pressure treatment strategy is not the same, self-medication at home is not safe. 

Myth # 3: do not monitor blood pressure during medication. 

Some patients only in the emergence of headache, dizziness and other symptoms before taking antihypertensive drugs, once the symptoms disappeared on the withdrawal of drugs. Still have a patient to be able to insist on taking medicine for a long time, but oneself do not monitor blood pressure on time, think as long as the head does not ache does not faint to be ok. None of this is right. 

Hypertension is called “silent killer,” because most patients do not have any symptoms, but elevated blood pressure to cardiovascular harm is persistent, can not be based on the presence of symptoms or not to decide whether to take medicine. At the same time, one of the treatment principles of hypertension is long-term stable hypotension, if you take medicine for a while do not take, will cause blood pressure fluctuations. Therefore, it is recommended that the first choice of long-term drugs, to ensure that 24 hours a day, the body has a certain concentration of drugs, so that blood pressure is stable control. However, long-acting drugs are usually more expensive, if economic conditions do not permit, some cheap medium- and long-term drugs can also play a role in the smooth lowering of blood pressure. For example, nitrendipine and atenolol are used in combination with one tablet each morning and evening. 

In addition, blood pressure treatment is not to take drugs on everything, but also to see whether the drugs taken can effectively control blood pressure, that is, doctors often referred to the blood pressure “up to standard.” It is generally believed that hypertension patients should keep their blood pressure below systolic 140mmHg and diastolic 90mmHg, and that systolic blood pressure can be relaxed below 150mmHg if they are older, such as over 80 years old.Therefore, patients should take blood pressure on a regular basis, with or without symptoms. Its purpose is to know whether blood pressure is up to standard or if abnormal fluctuations have occurred, in order to adjust medication in time and reduce the risk of complications. 

Myth # 4: don’t stop taking drugs for a long time. 

High blood pressure medication is indeed long-term, unless there is a well-defined cause of hypertension (such as renal vascular stenosis). Essential hypertension can not be cured, must take medicine for life, blood pressure control at the ideal level, minimize the possibility of complications, this is the best treatment. But this is not “drug dependence,” but the characteristics of chronic diseases like high blood pressure require long-term treatment. 

Realistically speaking, antihypertensive drugs are not a day to stop, nor is it the end of the day. For example, hot summer weather, vasodilation, coupled with a large amount of sweating, blood volume decline, blood pressure levels may be appropriately reduced, blood pressure drugs can be reduced or discontinued for a period of time. Cold winter weather, vasoconstriction, blood pressure rise, to restore the original dose of drugs in time. Therefore, patients need to pay attention to monitoring blood pressure, regular follow-up.

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