What is the difference between "sartan", an antihypertensive drug, and adding hydrochlorothiazide?

A friend who suffers from high blood pressure left a message to Huazi, saying that he found that many sartan antihypertensive drugs also added hydrochlorothiazide. What is the difference between this and pure sartan drugs? When should "sartan" be used and when should "sartan + thiazide" be used?

Hua Zi said that "sartan" with hydrochlorothiazide is actually a compound preparation of two antihypertensive drugs. Because most people's high blood pressure cannot be well controlled with only one antihypertensive drug, multiple antihypertensive drugs need to be used in combination. Sartan drugs and hydrochlorothiazide are a commonly used antihypertensive drug combination.

1. Sartans have fewer adverse reactions

Sartan drugs can block the renin-angiotensin-aldosterol system (RAAS) by blocking angiotensin 2 receptors on blood vessels to lower blood pressure. Sartan drugs can also be used to treat heart failure by preventing angiotensin 2-induced fibroblast proliferation and ventricular remodeling.

On the sympathetic nerve synapses, there are the same receptors that can also be blocked by sartan drugs, which can reduce sympathetic nerve tension. It is suitable for young people with high blood pressure caused by excessive excitement of sympathetic nerves due to excessive stress and long-term negative emotions.

Among the first-line antihypertensive drugs, both prils and sartans can inhibit RAAS, but prils have the adverse reaction of causing dry cough, while sartans do not. People who cannot tolerate the adverse reaction of dry cough caused by prils can use sartans as a substitute.

In clinical trials, the adverse reactions caused by sartan drugs were similar to those in the placebo group. It can be said that as long as there is no drug allergy and there are no contraindications such as pregnancy, severe liver and kidney dysfunction, bilateral renal artery stenosis, etc., most people can safely use sartan drugs.

2. Hydrochlorothiazide is suitable for people with high blood pressure

Hydrochlorothiazide is a medium-acting diuretic that lowers blood pressure by excreting sodium and water and reducing blood volume. Long-term use can also reduce the sodium ion level in the extracellular environment, reduce the excitability of vascular smooth muscle, and lower blood pressure. In addition, by reducing fluid retention, it can also reduce the heart load and treat heart failure.

Types of hypertension such as senile hypertension and refractory hypertension all have high systolic pressure (over 160 mmHg). Most of them are sodium-sensitive and volume-type hypertension patients.

For people with high blood pressure, the control effect of systolic blood pressure (high blood pressure) is particularly significant after using diuretics. In the elderly hypertensive population, diuretics are the basis of common treatment plans.

3. Benefits of adding hydrochlorothiazide to sartan drugs

1. Synergistic therapeutic effect: Sartan drugs and hydrochlorothiazide can jointly lower blood pressure through different pharmacological mechanisms, which can produce a synergistic antihypertensive effect. A smaller dose of the drug can produce a better antihypertensive effect.

2. Complementary adverse reactions: When using sartan drugs, it may cause hyperkalemia, and hydrochlorothiazide will excrete some potassium ions while excreting sodium, which will cause hypokalemia. The two complement each other and can reduce the impact on blood potassium.

3. Improve medication compliance: When treating hypertension, patients missing medication is a common factor leading to treatment failure. The more types of medications and the more complicated the medication regimen, the more likely it is to fail. Using compound drugs can turn two drugs into one pill, which can improve medication compliance and enhance control of hypertension.

However, combination drugs are more expensive. People with good memory can buy two drugs separately and take them at the same time, which can also produce the same effect and has the best cost-effectiveness.

In summary, after sartan drugs are added with hydrochlorothiazide, they can play a synergistic and complementary role to increase the control of blood pressure. The specific use of drugs needs to be carried out under the guidance of a doctor. If you have any questions about the use of drugs, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.