In the daily outpatient work, there are often some hypertensive patients will ask: "Dr. Zhang, antihypertensive drugs need to be changed regularly?" Because he has been asked this question many times, Dr. Zhang knows that this question is representative. Today, Dr. Zhang to give you an answer to this question, hoping to be able to always ask whether the antihypertensive drugs need to be changed regularly for those friends to solve the doubts in their minds.

First of all, Dr. Zhang clearly told you that for those patients who are taking oral antihypertensive drugs for hypertension, as long as the current antihypertensive treatment program can give you a smooth reduction in blood pressure, that is to say, the current antihypertensive drugs can effectively control the blood pressure, then there is no need to adjust or change the medication. If your current antihypertensive treatment program is not effective in controlling your blood pressure, or if your blood pressure fluctuates greatly, you may consider changing your medication under the guidance of your doctor.

Secondly, in the choice of antihypertensive drugs, Dr. Zhang to say a few words: hypertension antihypertensive treatment to reduce the heart, brain, kidney and other target organ damage has a significant protective effect, which has been proved by many tests. In the prevention of cerebral infarction, myocardial infarction and other cardiovascular and cerebrovascular diseases, the blood pressure level of the standard than the choice of a particular antihypertensive drug is more important. At this stage, the long-term efficacy and safety of the various antihypertensive drugs recommended by the guidelines are basically convergent, and the key to the problem is still to choose the antihypertensive drug that is suitable for one's own situation. Each person's situation is different, and the choice of medication is also different.

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I think that antihypertensive drugs should not be changed frequently, to let the patient to say, by taking medication without side effects, and blood pressure is in a stable state does not need to be replaced, if there is unstable blood pressure should consider changing other varieties. If a drug is taken all the time, the body may develop resistance to it and it will not play a stabilizing role. There are also patients who have a cough when taking xylazine tablets should consider changing their medication. Because you have not had hypertension, what you say is not unique. My wife has been sick for more than ten years, but the blood pressure medicine changed many times are not stabilized, and then swallowed powdered wild asparagus, a period of time after the blood pressure also in a stable state, nearly six or seven years from not taking antihypertensive medication, and there is nothing wrong. Recently, I measured her blood pressure and it remained between seventy-five and one hundred and thirty-two degrees, which seemed normal. But if someone else, this sentence also dare not say, change or not change the drug, only the patient has the experience. Thank you!

Thanks for the invite.

Hypertension (mainly essential hypertension) is a major health problem in China, with a conservative estimate of at least 270 million people suffering from the disease. Regular diagnosis and treatment of hypertension is crucial, and its treatment includes lifestyle improvement and comprehensive treatment with drugs.Antihypertensive drugs are currently the most effective treatment for high blood pressure, and in principle there is no drug resistanceIt is only with the increase in the time of use that the patient will gradually adapt to the antihypertensive drug and develop tolerance, at which time the dose can be increased appropriately.Drug treatment for hypertensive patients should adhere to the regular use of drugs under the guidance of specialists, and can not be replaced arbitrarily, as long as this antihypertensive drug treatment is effective, blood pressure long-term standard, there is no need to change.Let's talk about medication for hypertension today。The principle of hypertension treatment is to reach the standard, smooth and comprehensive management, we firstly need to control the blood pressure to reach the standard, and secondly need to lower the blood pressure smoothly, and ultimately achieve the long-term stability of blood pressure... Treatment of hypertension should be individualized and selected according to the patient's age, blood pressure level, and the presence or absence of comorbidities. Long-acting antihypertensive medications are preferred, and are usually often initiated with a starting effective dose, but starting with a small dose is recommended for patients of advanced age, heart failure, and those at high risk for postural hypotension.We recommend that all people with hypertension start lifestyle intervention as soon as they are diagnosed and initiate antihypertensive medication at the same time. However, for people who are diagnosed with hypertension for the first time, have a blood pressure <160/100 mmHg and do not have a combination of underlying diseases such as coronary heart disease, heart failure, stroke, or renal pathology, lifestyle intervention can be carried out according to the patient's wishes for a maximum of 3 months, and then antihypertensive medication can be initiated if the blood pressure is still higher than normal.Currently, commonly used antihypertensive drugs include ACEIs and ARBs (abbreviated as A), beta-blockers (abbreviated as B), CCBs (abbreviated as C), and diuretics (abbreviated as D).The use of antihypertensive drugs should be tailored to specific conditionsThe details are as follows: ① For patients with simple hypertension without comorbidities: if the blood pressure is <160/100mmHg, single-drug treatment (C or A or D or B) is preferred, and if the blood pressure is still not up to the standard after 2-4 weeks, the dosage can be increased or another drug can be changed or two kinds of drugs can be used (C + A or A + D or C + D or C + B); if the blood pressure is >160/100mmHg, the combination of two kinds of drugs is preferred; ② if If the blood pressure is still not up to standard after the use of two drugs, three drugs can be used in combination (such as C + A + D or C + A + B); ③ If the blood pressure is still not up to standard after the use of the three drugs in full dosage for 2 to 4 weeks, it is necessary to actively consult the hospital to clarify the cause of the disease.

Thanks for reading and I wish you all good health. Medications are essential for high blood pressure treatment, and we must use them under the guidance of a doctor to achieve long lasting and smooth blood pressure control. This article was originally written by General Practice Sweeper on Today's Headlines & Wukong Q&A.

If the initial high blood pressure can be captopril this ordinary antihypertensive drugs can be, but ate a few years after the blood pressure will continue to rise, it is necessary to change the drug, usually with long-acting nifedipine extended-release tablets can be The drug is stable price is not high, the long-term use of the can Because of the father and mother have high blood pressure, so I have become half of the doctor hahahaha, I am just in accordance with the parents of the experience of the medication, I do not know if it is able to help you. I'm not sure if I can help you, thanks for asking!

Thank you, antihypertensive drugs do not need to be changed often, the doctor in the application of drugs to lower blood pressure is to follow certain principles and for the patient's specific diseases and complications to judge, rather than antihypertensive drugs do not listen to the doctor, but to listen to the neighbors, other people effective antihypertensive drugs may not necessarily be suitable for you, and sometimes may be harmful to your health.

Today, we will briefly recognize a few types of blood pressure lowering medications with you:

1. Renin-angiotensin system (RAS) inhibitors:This class of drugs includes ACEIs, ARBs.

Advantages: Kidney protection: effectively reduces intra-glomerular pressure, can reduce urinary protein.

Disadvantages: Can cause elevated blood potassium and renal impairment, usually occurring at 1-2 weeks after oral therapy; therefore, serum creatinine and blood potassium levels need to be rechecked.

Common ACEI Drugs:Captopril, Perindopril Tablets (AstraZeneca); Fosinopril (Mono); Benadryl Tablets (Lotensin)

Common ARB drugs: valsartan (Devon), chlorthalidomide (Cosuya); temesartan (Mecasin); olmesartan (Otan); irbesartan (Ambevi)

2. Calcium channel blockers (CCBs):This class of antihypertensive drugs has a definite antihypertensive effect and fewer adverse effects, disadvantages: note the occurrence of edema.

Common drugs for CCB: amlodipine benzenesulfonate (Lovoxil); nifedipine controlled-release tablets (Bexsynthroid); felodipine extended-release tablets (Boyd's)

3. Beta-blockers:Use with caution: bradycardia, diabetes mellitus

Beta-blockersr Common drugs: metoprolol tartrate (Betalix); metoprolol succinate extended-release tablets (Betalix); bisoprolol fumarate (CombiTech/Bosu); propranolol (Xanax)

4. Diuretics: Spironolactone Tablets (Antibiotics)

Finally re-emphasize one point: the above four categories of drugs, for our patients only to understand, can remember the name of the drug can be, specific antihypertensive drugs and how to start using drugs and how to combine the use of professional doctors to do things, as little as possible to listen to friends and neighbors, their situation is not necessarily suitable for you.

Dr. Chen Zhou, signed with Wukong Q&A, graduated from the Second Military Medical University with a master's degree in medicine, specializing in nephrology. Dr. Chen mainly focuses on acute and chronic nephritis, nephrotic syndrome, uremia, urinary stones, diabetic nephropathy, IgA nephropathy, membranous nephropathy, FSGS, high uric acid kidney injury and other diseases, as well as the popularization of kidney health. Please feel free to leave a message to us.

Hello, I am Dr. Hui. There is no such thing as resistance to antihypertensive drugs, and they don't need to be changed often.

When choosing antihypertensive drugs, you should start with the principle of individualization, which means that each person is suitable for different antihypertensive drugs. For example, patients with diabetes mellitus are preferred to angiotensin-converting enzyme inhibitors, that is, Prilosec-type drugs, and older people with cerebrovascular disease can prefer calcium channel antagonists, that is, diphenhydramine-type drugs.

Once the appropriate medication has been selected and the patient has taken it without any uncomfortable reactions and with a good antihypertensive effect, it needs to be taken consistently with monitoring of blood pressure.

However, blood pressure is not constant, that is, some people may experience a resurgence of blood pressure after taking a medication. At this point, it is necessary to assess the cause of the increase in blood pressure, such as lifestyle changes, or other factors that have led to the increase in blood pressure, and it may be necessary to increase the dosage of the medication or increase the type of medication.

During the use of antihypertensive drugs, it is not recommended to change the type of drug at any time or frequently. If the drug is changed frequently, the concentration of this drug accumulated in the body will change, which will affect the effectiveness of the drug.

In conclusion, the principle of using medication for hypertensive patients is individualization, make sure you do not take antihypertensive medication on your own, please go to the hospital and the doctor will evaluate and decide.

long-term use of antihypertensive drugs.Frequent changes in antihypertensive drugs are not recommended if they are effective in lowering blood pressure and have few adverse effects。

During the course of treatment, if the blood pressure is controlled within the normal range, theSuddenly change an antihypertensive drug, due to the change of its mechanism of action, or the change of intensity and duration of lowering blood pressure, blood pressure will rise again, it may take weeks to months for the body to bring blood pressure up to standard again.Causes fluctuations in blood pressure during changes in antihypertensive medication, since our goal in controlling blood pressure is to lower it smoothly and reduce fluctuations in blood pressure to minimize complications, theTarget organ damage may be exacerbated if blood pressure continues to be suboptimal during antihypertensive drug changesThe development of hypertensive emergencies, such as cerebral hemorrhage and myocardial infarction, may even be complicated by the occurrence of hypertensive emergencies.

Secondly, as for the questioner's concern about drug resistance, there is no such thing as drug resistance to antihypertensive drugs. Drug resistance refers to the long-term use of antimicrobial drugs, such as antibiotics, antifungal drugs, etc., bacteria, fungi and other pathogens to antibiotics to reduce the response, decreased efficacy. When using hypertension drugs, the antihypertensive effect may decrease after long-term use in some patients. At this time.Within the permitted dosage range, the dosage can be increased and, if necessary, combined with another antihypertensive drug with a different pharmacological effect, which not only achieves rapid compliance, but also reduces the incidence of adverse effects.

Thanks for reading!

I study medicine, familial hypertension, in 1997 began to take antihypertensive drugs so far, but also often guide patients, friends, friends of friends to take medication to lower blood pressure, want to say on common problems. 1, on the current level of medical science, hypertension is a lifelong disease (except for a small number of secondary hypertension), taking medication for a long time or even lifelong (which many patients can not accept or do not want to accept, once they heard that there is a 'root cause' or do not have to take medication for life, will 'try', but the vast majority of people are not what they want). 2, there are many people who can not 'break the root' or do not have to take medication, will 'try', but the vast majority of people are not the same). This is also many patients can not accept or do not want to accept, once heard that there can be 'cut off the root' or do not have to take medication for life, will 'try the law', but the vast majority of people are not what they wish). 2, there are a lot of patients who do not want to lower their blood pressure, part of which is to say that although their blood pressure is high, but they do not have any feeling, and do not feel uncomfortable, so do not have to lower it! But he does not understand that his body's early warning mechanism out of the problem, and long-term hypertension if not controlled, will seriously affect the function of important target organs (heart, brain, kidney, etc.), if the damage is serious to consider lowering blood pressure, it will be too late; Secondly, a considerable number of patients are very worried about the side effects of antihypertensive drugs, afraid of affecting normal physiological functions; here should be frankly told, 'medicine is three times poisonous,' want to To find drugs without any side effects, including Chinese herbs, basically impossible, should be under the strict guidance of the physician, choose the right medicine for yourself, to achieve the best antihypertensive effect and as few side effects as possible. 3, antihypertensive is a long-term process, antihypertensive drugs hundreds of kinds of suitable for other people is not necessarily suitable for you, there is no best, only the most suitable! Once you find your own suitable methods and drugs, it is best not to change often or arbitrarily, otherwise it will affect the antihypertensive effect and the protection of target organs. Of course, if there is a change in the course of treatment, you should be familiar with your condition under the guidance of your physician to find out the reasons and adjust or change the treatment plan.4. Regular review is very important, but there is no need to be overly panicked, some patients measure their blood pressure more than 10 times a day, which is not necessary in the long-term stabilization of blood pressure in the patient, too much attention, it may be a straw man, a cup of tea, not conducive to the stabilization of blood pressure!

Antihypertensive medications should not be changed as long as they are effective, much less frequently! However, beware that many people have the highest blood pressure during the first test, and usually the outpatient doctor only measures once and thinks that the medication you have taken before is not effective, then change the medication. However, in the following cases, you can consider changing your medication:

1. Produce an allergic reaction must be changed! Dry cough to the Pulse class of drugs ACEI, taking more than two weeks still end stop, and I can hardly tolerate can change the drug, such as sartans, or other antihypertensive drugs.

2. Young and middle-aged hypertension combined with sinus tachycardia, or heart rate is not more than 100 beats / min since feel uncomfortable not use betablocker mountain agent can be replaced with betablocker to lower blood pressure.

3. Hyperuricemia or high blood sugar, diabetic hypertensive patients have used diuretics or compound preparations with diuretic components should stop taking diuretics for other drugs, such as compound preparations should be discontinued after the choice of two kinds of drugs or double dose of the same kind of drug replacement.

4. has been diagnosed with cardiac insufficiency of hypertensive patients such as no diuretics first change a diuretic or add diuretics, if you need 2-4 antihypertensive drugs to reach the standard in addition to diuretics can be added to the class of ACEI or sartans ARB. if the doctor recommended the use of betablockers must be a small dose of the beginning of the no-payment effect (aggravation of heart failure) can be gradually increased.

5. The World Health Organization WHO has long pointed out that about 2/3 of patients with hypertension (if you use the 2017 ACC's new standard of 130/80mmHg) may be more hypertensive patients to use 2-4 antihypertensive drugs in order to make the blood pressure standard. Many people who can't get a drug down to the standardized line (to assess the effect of a drug should be at least more than its 5 half-life, in simple terms, once a day should be taken for 5 days and then assessed) like to change the drug, I would suggest to double the dose for 5 days before deciding to change or not to change the drug, if after doubling the dose it can't be tolerated or the payoff is large it should be changed. If you can't tolerate it or it's not working after doubling, you may want to use more than 2 antihypertensive medications.

6. If the patient has taken 2-4 kinds of antihypertensive drugs, and the blood pressure measured in the hospital or measured by yourself (at least 2-3 times and 3-5 minutes interval, it is unlikely in the hospital) is still high, it is recommended to do an ambulatory blood pressure (24-hour blood pressure monitoring can be taken home, which doesn't affect the work, and it can more objectively reflect different environments, including the blood pressure during sleep). If the ambulatory blood pressure is significantly lower than that in the hospital or at home, it means that you are particularly sensitive to the sympathetic nervous response to blood pressure measurement (some subconscious nervousness can not be felt at all). Instead of adding more antihypertensive medication, you should add Dilaudid (1-2 tablets per day) or half a Valium tablet 2-3 times per day as an anxiolytic. This is just like the fourth ingredient in the tablet, Librium.

7. Dynamic blood pressure is the most objective, the most valuable, the most bang to help judge, analyze, guide, observe, develop for your hypertension treatment plan and judge the efficacy of the treatment, to prevent excessive lowering of blood pressure during sleep vascular damage or vascular events. Now our understanding of its knowledge and understanding is relatively shallow, the patient is also too much trouble, relative to hypertension is a chronic and even lifelong disease this trouble is nothing, can not just take the medicine to do the ostrich boring not to see it.

8. If the use of 3, 4, kinds of antihypertensive drugs is still ineffective, dynamic blood pressure more than 3/4 at a very high level both to exclude the renal function vein stenosis or other secondary hypertension, such as: chronic renal hypertensive caused by substantial lesions, primary or secondary aldosterone increase (hypertension and hypokalemia) Coxsackie's syndrome, pheochromocytoma, sleep apnea syndrome, and so on, of course, including the spirit, emotionally generated high blood pressure.

2018.5.19

Thanks for the invite!

People often ask questions like, "Doctor, will I become drug resistant if I always take one antihypertensive medication?". The question is often asked, "Will I be resistant to taking one antihypertensive medication?".

Long-term oral antihypertensive drugs do not develop resistance, which is different from antibiotics. If you take an antihypertensive drug for a long period of time and feel that it is not as effective as it used to be, it is not due to drug resistance.

If the oral antihypertensive medication you are currently taking is well tolerated (not many side effects) and your blood pressure is under ideal control, you do not need to think about changing your medication at all, just continue to take it on time for a long period of time!

And when do you need to change or adjust your medication?

1. Suboptimal blood pressure control.Nowadays, the rate of awareness and treatment of hypertension is not high, and a large proportion of people taking blood pressure-lowering medication do not have their blood pressure controlled to the target value. And the only way to achieve the goal of preventing and treating the complications of hypertension is to have the blood pressure up to the target. If the effect of taking one antihypertensive drug suggestion is not satisfactory, then it is necessary to change or add drugs!

2. Inability to tolerate side effects.Blood pressure-lowering medications, despite being safe, still have side effects, and if a particular side effect is intolerable, consider switching medications.

3. a change in condition that requires other medication that conflicts with current antihypertensive medication.It also needs to be changed.

4. Some other special reasonsIf the medication habits, economic conditions, or the availability of new antihypertensive medications that are more convenient to take or better suited to the current condition, it is possible that the medication may need to be adjusted.

In these cases, it is important to be guided by your doctor on how to adjust your antihypertensive medication. Never hear that a certain drug used by others is quite effective and try it yourself. Drug reaction has individual differences, the same high blood pressure, each person's physical condition underlying disease is not exactly the same. The same drug, each person's reaction to it is not exactly the same, suitable for others may not be suitable for you.

Also, without all of the above, antihypertensive medications must beRegularly every day on timeTake it, and occasionally miss a dose, if it's not almost time for your next dose.