What is the difference between "sartan" and "sartan plus thiazide" in antihypertensive drugs?

A friend left a message to Huazi, saying that he was taking sartan drugs to control his blood pressure, but he also found that the same sartan drugs were added with hydrochlorothiazide. He was a little confused. What was the difference between the same sartan drug and the sartan drug with "thiazide" added? Which one should he choose?

Huazi told him that hydrochlorothiazide is a commonly used diuretic and antihypertensive drug, and the drug he saw was actually a single-tablet compound preparation of two drugs, "sartan" and "thiazide".

1. Combination of Sartan and Thiazide Using Sartan drugs together with hydrochlorothiazide can produce a synergistic antihypertensive effect and reduce adverse drug reactions. More than 70% of hypertensive patients cannot effectively control their blood pressure with only one antihypertensive drug. They need two or even more antihypertensive drugs to effectively control their blood pressure. Sartan and Thiazide are a commonly used combination.

Hydrochlorothiazide is a diuretic that has the effect of excreting water and sodium, reducing the total blood volume, but it can increase renin activity, leading to increased production of angiotensin 2 through the renin-angiotensin-aldosterone system (RAAS). Moreover, when sodium ions are excreted, due to the presence of a sodium-potassium exchange mechanism in the renal tubules, potassium ion excretion will increase, and hypokalemia may occur.

Sartan drugs can block the binding of angiotensin 2 to receptors on the blood vessel wall, inhibit RAAS, eliminate the effects of angiotensin 2, and increase potassium ion levels. Therefore, the combined use of "sartan" and "thiazide" can produce a synergistic antihypertensive effect, inhibit the latter's activation of RAAS, and also reverse the side effect of diuretics in lowering blood potassium.

The two drugs are made into a single-tablet compound preparation, which increases the convenience of taking medicine. Because many patients with hypertension are elderly, if they take too many types of medicine, they may forget to take it. Turning "two pills" into "one pill" can improve medication compliance and increase control of hypertension.

2. Applicable to elderly hypertension If the degree of hypertension is not high and the blood pressure is below 160/100 mmHg, generally a single "sartan" can be selected. When the blood pressure exceeds 160/100 mmHg, a combination of "sartan" and "thiazide" can be selected. The combination of these two drugs is more suitable for elderly hypertension.

The characteristics of senile hypertension are that the high pressure increases, the low pressure remains unchanged or decreases, and the pulse pressure increases. Most of them are volume-type hypertension, which is sensitive to sodium ions. Hydrochlorothiazide can reduce blood volume and body sodium ion levels through diuretic effect, excretion of sodium and water. When used in combination with "sartan", it not only increases the antihypertensive effect, but also reduces the adverse reactions of "thiazide".

3. How to correctly use "sartan" plus "thiazide". If there is bilateral renal artery stenosis, sartan drugs cannot be used; hydrochlorothiazide contains a sulfonamide group, and people who are allergic to sulfonamide cannot use hydrochlorothiazide; hydrochlorothiazide will interfere with uric acid excretion, so people with hyperuricemia should use it with caution; hydrochlorothiazide will increase blood calcium levels, so people with hypercalcemia or who are taking calcium preparations or vitamin D should pay attention to monitoring blood calcium levels during medication.

Hydrochlorothiazide can cause increased urination. In order to avoid affecting sleep, it is recommended to take the medicine in the morning. Hydrochlorothiazide may interfere with sugar and lipid metabolism. People with diabetes and hyperlipidemia need to adjust hypoglycemic and lipid-lowering drugs according to actual conditions. Hydrochlorothiazide may cause electrolyte disorders. Pay attention to monitor electrolyte levels during medication. Taking hydrochlorothiazide may cause photosensitivity dermatitis. Be careful to avoid direct sunlight.

In summary, "sartan" plus "thiazide" is a combination of two different antihypertensive drugs, suitable for people with high blood pressure, especially for the elderly with better control of hypertension. Not only can it synergistically lower blood pressure, but it can also reduce adverse drug reactions. Drugs should be used under the guidance of a doctor. When taking medication, pay attention to relevant contraindications and requirements. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.