8 common misunderstandings about taking antihypertensive drugs, the fifth one is made by many people

Hypertension is one of the most common chronic diseases, with about 245 million adults in my country suffering from it. Although good blood pressure control can greatly reduce the risk of cardiovascular and cerebrovascular diseases such as myocardial infarction and stroke, the current blood pressure control rate in my country is only 15.3%, and the situation is very serious.

The editor has summarized 8 common misunderstandings about the use of hypertension medications for your reference only.

Myth 1: Not taking medication

Misconception: Some patients believe that they do not have any discomfort symptoms or have had hypertension for a long time and their bodies have tolerated it, so they do not need to take medication.

Answer: Although there are no symptoms or tolerance has been achieved, it does not mean that there is no harm to the body. The treatment of hypertension mainly depends on the blood pressure level and the risk of related complications, and has nothing to do with whether there are symptoms. Therefore, as long as the patient's blood pressure level is higher than the standard value (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, 1 mmHg=0.133 kPa), it is necessary to start drug treatment on the basis of improving lifestyle, even for young people with newly diagnosed hypertension.

Myth 2: Take less medication

Misconception: Some patients believe that “all medicines are poisonous” and that taking antihypertensive drugs can cause liver and kidney damage. They are also worried about drug dependence and thus take less drugs.

Answer: Medicine is a double-edged sword. Although there are adverse reactions (such as dizziness, vomiting, drowsiness, etc.), it can treat diseases, and the adverse reactions of most antihypertensive drugs are relatively mild and controllable, and are probabilistic. Patients can go to the outpatient clinic regularly to check their liver and kidney function and monitor possible adverse drug reactions.

In addition, although hypertension is a chronic disease that can only be controlled but not cured, the use of antihypertensive drugs will not cause dependence. Most patients only need to follow the doctor's instructions, understand the indications and contraindications, and lower and maintain blood pressure within the normal range. There is no need to worry too much.

Myth 3: Taking medication late

Misconception: Same as Misconception 1, this group of people believe that they only need to take medicine when they feel strong discomfort.

Answer: No discomfort does not mean that blood pressure is normal and no treatment is needed. It is recommended that patients with hypertension measure their blood pressure regularly, such as at least once a week. Do not "follow your feelings" to estimate blood pressure. Do not wait until cerebral hemorrhage occurs before you "feel" something, because it is too late to take action at this time.

Myth 4: Stop medication early

Misconception: Some patients believe that they can stop taking medication once the discomfort disappears or blood pressure levels drop and remain normal for a short period of time.

Answer: For patients with hypertension, even if the blood pressure level drops to normal, it only means that the drug is effective, but it does not mean that hypertension has been "cured" and the drug can be stopped. It should be noted that patients with hypertension need to take medication for life. Generally, after the blood pressure stabilizes to normal, under the close observation of the doctor, the drug can be carefully reduced in small amounts as prescribed by the doctor, rather than directly stopping the drug. It is not recommended to stop the drug, so as to avoid a "rebound" in the blood pressure level and abnormal increase again.

Myth 5: Taking medication intermittently

Misconception: Some patients believe that antihypertensive drugs can be used to perform their functions. They take drugs when blood pressure rises, stop taking drugs when blood pressure remains at a normal level, and take them again when blood pressure rises again. Clinical practice shows that compared with other misconceptions, the problem of discontinuous medication is more common.

Answer: Hypertension is clinically known as the "silent killer". The reason for this title is that there will be a "false impression of blood pressure recovery". For example, even if the patient's blood pressure is as high as 200 mmHg, there will still be no symptoms. This situation is called adaptive hypertension. Patients think that asymptomatic means no problem. In fact, the high level of blood pressure has increased the risk of complications such as myocardial infarction, stroke, and kidney damage. At this time, drug treatment is particularly important. Antihypertensive drugs can help reduce the risk of the above complications and prolong life. Therefore, hypertensive patients should not "stop and go" during medication, as this will cause large fluctuations in blood pressure levels and cause great harm.

Myth 6: Never change the type of medication you take

Misconception: Some patients with hypertension believe that they cannot take "new" antihypertensive drugs to avoid "conflict" with previous antihypertensive drugs and no obvious antihypertensive effect.

Answer: The "old drugs" for antihypertensives generally have problems such as high adverse reactions and inability to maintain 24-hour drug efficacy, while the "new drugs" are mostly first-line antihypertensive drugs, which are taken once a day and can maintain drug effects for 24 hours. However, the specific choice of drugs still needs to be based on the doctor's advice.

In addition, if blood pressure levels are not properly controlled, or the combination of medications has little effect, or even serious adverse reactions such as dry cough, headache, edema, and increased blood creatinine occur, you should consider seeking medical attention in a timely manner and follow the doctor's advice to decide whether you need to change your treatment plan.

Myth 7: Change medication regularly

Misconception: Some patients think that choosing antihypertensive drugs is like shopping in a mall and comparing prices from three stores.

Answer: Although changing antihypertensive drugs appropriately can help you better understand which drugs are suitable for your own situation, frequent or random changes will lead to unstable blood concentrations of drugs, which in turn will lead to unstable blood pressure levels. It is recommended that patients continue to take antihypertensive drugs if they have achieved relatively satisfactory results after following the doctor's advice. If blood pressure fluctuates occasionally, you can consider whether it is caused by colds, fever, mood swings, excessive fatigue, etc., rather than directly changing antihypertensive drugs.

Myth 8: Taking cheaper medications

Misconception: Some patients with high blood pressure will ask doctors to choose cheap "ordinary drugs" when prescribing them in the early stage, and then upgrade the drugs later. This is because they are worried that if they use "good drugs" directly, they will have no drugs to use when the drugs "don't work" in the future.

Answer: In fact, the efficacy of antihypertensive drugs is not measured by price. The price of the drug only indicates the cost of the drug, and has little to do with the efficacy. Commonly used antihypertensive drugs can be roughly divided into 6 categories. Each category of drugs has a different mechanism of action and targets different groups of hypertensive patients. Patients with different disease types have different responses to antihypertensive drugs.

For example, calcium channel blockers are more effective for patients with isolated systolic hypertension accompanied by angina pectoris or those at risk of stroke; angiotensin II inhibitors or angiotensin II receptor blockers are more suitable for patients with diabetes, heart failure, and kidney disease; and beta blockers are more suitable for patients with coronary heart disease, angina pectoris, and other heart diseases. Therefore, the choice of drug is only related to the disease, not the price.

Text and layout丨Fu Yujie