This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Which antihypertensive drugs protect kidney function?Which blood pressure medications have an effect on blood sugar?Which antihypertensive drugs are long-acting?
Saltan antihypertensive drugs are the first-line preferred antihypertensive drugs, which belong to selective angiotensin II receptor (AT1 subtype) antagonists, which inhibit vasoconstriction and the release of aldosterone by selectively blocking angiotensin II and AT1 receptors, thereby producing antihypertensive effects, which have little effect on heart rate when lowering blood pressure. In addition, irbesartan can also reduce cardiac load, improve heart failure, prevent and treat vascular wall thickening and myocardial hypertrophy complicated by hypertension, protect kidney function, promote urinary sodium and uric acid excretion, significantly reduce proteinuria, significantly delay the process of end-stage renal disease, especially suitable for hypertensive patients with microproteinuria and proteinuria, and can also be used for** Diabetic nephropathy, preli-class antihypertensive drugs are also the first-line preferred antihypertensive drugs, which belong to angiotensin-converting enzyme inhibitors, mainly by inhibiting tissue and circulating angiotensin-converting enzymes, reducing the production of angiotensin II, and inhibiting kinase, reducing bradykinin degradation, increasing vasodilation and lowering blood pressure, and at the same time improving insulin resistance and reducing proteinuria, and has a better effect on hypertension patients with obesity, diabetes and target organ damage such as heart, brain and kidney, and can be used for **diabetic nephropathy.
Lassidipine, sipinidipine, manidipine, and benidipine are first-line antihypertensive drugs, which are calcium channel blockers, which can act on the calcium channels of smooth muscle with high selectivity, mainly dilating peripheral arteries, reducing peripheral resistance and lowering blood pressure. Lasidipine increases renal blood flow without affecting glomerular filtration rate and can produce transient but insignificant diuretic and natrinoextory effectsCicedipine can reduce intraglomerular pressure and protect renal function;The biggest feature of manidipine is that it has higher selectivity for renal blood vessels, improves renal blood circulation in patients with hypertension, and increases renal blood flow and glomerular rate filtrationBenidipine can significantly increase renal blood flow in patients with essential hypertension, and in patients with chronic renal insufficiency with hypertension, it can significantly increase creatinine clearance and urea nitrogen clearance to maintain renal function.
Saltan and purl antihypertensive drugs can inhibit fat formation, reduce visceral fat, prevent obesity induced by high-fat diet, reduce triglycerides, improve insulin resistance, and are especially suitable for patients with hypertension with type 2 diabetes or metabolic syndrome.
Receptor antagonists (metoprolol, bisoprolol, etc.) are first-line antihypertensive drugs that lower blood pressure by inhibiting the central and peripheral renin-angiotensin-aldosterone system, inhibiting myocardial contractility and slowing the heart rate. These drugs can increase insulin resistance, affect blood glucose stability, mask and prolong hypoglycemic reactions such as tachycardia and tremor, and delay recovery from hypoglycemia.
Hydrochlorothiazide is a first-line antihypertensive drug, which is a diuretic, mainly by excreting sodium, reducing blood volume, reducing peripheral vascular resistance and lowering blood pressure, can inhibit insulin release, reduce glucose tolerance, increase blood glucose, diabetic patients may need to adjust the dose of insulin and oral hypoglycemic drugs when using hydrochlorothiazide.
One of the basic principles of the application of antihypertensive drugs is to optimize long-acting antihypertensive drugs, that is, drugs that are administered once a day and have a continuous 24-hour antihypertensive effect, which can effectively control morning peak blood pressure and night blood pressure, and more effectively prevent cardiovascular and cerebrovascular complications.
In addition to captopril, other pulip drugs have a long half-life, among which the half-life of pedopril is the longest (30-120 hours), this kind of drug has strong efficacy, long action time, although the onset of action is slow, but the effect is stable and long-lasting, the antihypertensive effect is clear, and it has good target organ protection and cardiovascular event prevention effectAll sartan drugs have a long half-life, of which telmisartan has the longest half-life (greater than 20 hours), the antihypertensive effect of this kind of drugs is slow, 3-4 weeks to achieve the maximum effect, but stable and long-lasting, with the increase of dose antihypertensive effect enhanced, with the characteristics of strong, long-acting, safe, etc., the higher the basal blood pressure, the greater the blood pressure lowering amplitude.
Nifedipine controlled-release tablets, amlodipine, levamlodipine, felodipine sustained-release tablets, lasidipine, lecardipine, verapamil sustained-release tablets, and diltiazine sustained-release tablets have a long half-life, strong antihypertensive effect, large amplitude, and the antihypertensive effect is slow, stable and long-lasting. Among them, levamlodipine has the longest half-life (35-50 hours), which has the characteristics of both strong and long-term antihypertensive characteristics, and even if it is missed once, it has no obvious effect on the antihypertensive efficacy.
Atenolol, bisoprolol, and metoprolol succinate extended-release tablets have a long half-life, and the antihypertensive effect is strong and rapid. Among them, metoprolol succinate sustained-release tablets or sustained-release microcapsules have the longest half-life (12-24 hours), and the drug is slowly released outward at a constant rate, and the antihypertensive effect is stable and long-lasting. Indapamide tablets (14-18 hours) and indapamide extended-release tablets (12-24 hours) have a long half-life, and the antihypertensive effect is smooth, slow, long-lasting, and long-lasting.