An elderly friend told Huazi that his high blood pressure (systolic blood pressure) can reach 160mmHg, but his low blood pressure (diastolic blood pressure) is only 70mmHg.
Huazi's advice to him was to go to the hospital for examination first, and if there was no abnormality in kidney function and electrolyte levels, hydrochlorothiazide could be used under the guidance of a doctor. He said that he had taken this medicine before, but he didn't feel that it had any effect. Huazi said that hydrochlorothiazide has a weak antihypertensive effect when applied alone, but when combined with other antihypertensive drugs, it will produce a strong antihypertensive effect.
1. Hydrochlorothiazide is the first antihypertensive drug.
Hydrochlorothiazide is a diuretic invented in the 40s of the last century, which has the effect of promoting sodium ion and water excretion, and was used as a diuretic in the early days for edema caused by diseases such as heart failure, liver cirrhosis and kidney disease.
At that time, people found that high blood pressure was harmful to the body, but there was no effective way to control it. In 1957, it was discovered that hydrochlorothiazide could lower blood pressure in people with high blood pressure, and a series of tests later confirmed the antihypertensive effect of hydrochlorothiazide.
Since then, hydrochlorothiazide has been used as the first antihypertensive drug, ushering in a new era for hypertension.
Second, the combination of hydrochlorothiazide has a good effect.
The pharmacological effect of hydrochlorothiazide is to inhibit carbonic anhydrase in the renal tubules, reduce the reabsorption of sodium, potassium, bicarbonate, and can increase urine output. The short-term effect can lower blood pressure by reducing blood volume, and the long-term effect can lower blood pressure by reducing the sensitivity of blood vessels to vasoconstrictive substances by excreting sodium ions.
When used alone, diuretics have a weaker antihypertensive effect than antihypertensive drugs such as dipine, pril, sartan, and lol, so hydrochlorothiazide and other diuretics are not recommended when hypertension is used as a single drug**. However, hydrochlorothiazide can exert a strong antihypertensive effect when combined with other antihypertensive drugs.
3. It is suitable for hypertension in the elderly.
Hypertension in older age is characterized by elevated systolic blood pressure, normal or low diastolic blood pressure, and increased pulse pressure. This blood pressure characteristic is associated with a high degree of arteriosclerosis in the elderly, and the sensitivity of the elderly to antihypertensive drugs is reduced, and blood pressure is difficult to control, and two or more drugs are often required in combination to effectively control blood pressure.
In fact, after the use of hydrochlorothiazide in combination with other drugs, it can produce a good antihypertensive effect, especially for the elderly hypertension control effect with simply increased systolic blood pressure. Therefore, hydrochlorothiazide is often used as a basic drug, and a combination regimen with dipine, puli or sartan is often used in elderly patients with hypertension.
4. What should be paid attention to when using hydrochlorothiazide.
Hydrochlorothiazide and lol drugs will have an impact on glucose and lipid metabolism, and will increase the risk of hyperglycemia and hyperlipidemia when combined.
Hydrochlorothiazide contains sulfonamide groups and is contraindicated for those who are allergic to sulfonamides.
Hydrochlorothiazide interferes with uric acid excretion, so people with hyperuricemia and gout should use hydrochlorothiazide with caution.
Glucocorticoids and nonsteroidal anti-inflammatory drugs such as diclofenac, ibuprofen, and high-dose aspirin can weaken the effect of diuretics and should be avoided as much as possible.
Long-term use may lead to electrolyte imbalances, especially hypokalemia, so it is necessary to monitor electrolyte levels regularly, and potassium supplementation should be required if necessary, or combined with potassium-sparing drugs, and those with hypokalemia should not be used.
Hydrochlorothiazide is a photosensitizing drug, which is exposed to direct sunlight during the medication, which is easy to cause damage, inflammation, and increase the risk of potential cancer, so it is necessary to do a good job of sun protection and avoid light when taking medicine.
In summary, hydrochlorothiazide is a commonly used diuretic antihypertensive drug, which is suitable for the elderly hypertension with simply elevated systolic blood pressure. However, the intensity of antihypertensive effect is low when used alone, and it is usually necessary to combine it with other antihypertensive drugs to exert a significant antihypertensive effect. During medication, it is important to pay attention to electrolytes and potassium in the blood.
The drug should be used under the guidance of a doctor, if you have any doubts about the medication, please consult a doctor or pharmacist. I am Pharmacist Huazi, welcome to follow me and share more health knowledge.