How to reduce the dosage of diazepam, lol, and sartan when the blood pressure is low?

A friend told Huazi that she was using a combination of three antihypertensive drugs: dihydrotestosterone, sartan, and loral. Her blood pressure has been low recently, with the systolic pressure at around 110 mmHg and the diastolic pressure at around 60 mmHg. She wants to reduce the dosage of antihypertensive drugs. What should she do?

Hua Zi said that when patients with hypertension are taking antihypertensive treatment, they should be careful not to lower their blood pressure blindly. If blood pressure is lowered too low, "hypertensive poor perfusion syndrome" may occur, so blood pressure should be controlled to not be lower than 110/60 mmHg. When blood pressure is too low, the dosage of the drug can be appropriately reduced.

1. What is hypotensive malperfusion syndrome? Elderly people who have suffered from hypertension for a long time have reduced vascular elasticity, weakened contraction and relaxation capabilities, and may also have atherosclerotic plaques and stenosis. When maintaining blood supply to important organs such as the heart, brain, and kidneys, it is necessary to maintain a certain blood pressure value. If the blood pressure is too low, it may cause insufficient blood supply to important organs.

The best blood pressure control target for the elderly is 130/80 mmHg. However, if it is lower than 110/60 mmHg, symptoms such as blackouts, syncope, limb control failure, angina, arrhythmia, and acute renal failure may occur. Therefore, when controlling blood pressure, it is recommended to control the high pressure between 110 and 130 mmHg and the low pressure between 60 and 80 mmHg. For elderly people over 65 years old, if the cerebral artery stenosis is severe, the target blood pressure can be appropriately increased.

2. Which antihypertensive drug should be reduced first? In antihypertensive treatment, diazepam, sartan and loratin are three commonly used drug combinations, suitable for patients with hypertension and heart disease. While lowering blood pressure, they can improve the blood supply to myocardial cells, slow down the heart rate, and reduce myocardial oxygen consumption, and have a good cardiovascular protective effect.

If you have coronary heart disease, myocardial infarction, heart failure and other diseases, it is recommended to maintain the dosage of loratadine as much as possible. This is because loratadine is effective in controlling heart rate and reducing cardiac oxygen consumption. Moreover, when loratadine is suddenly reduced or stopped, there may be a "rebound phenomenon", so as long as the heart rate is not lower than 55 beats per minute, you can temporarily not reduce loratadine.

Dihydrotestosterone has a strong effect on vasodilation and inhibits the contractility of myocardial cells, which can prevent angina attacks. Therefore, it is not recommended for people with coronary heart disease to reduce the dose of dihydrotestosterone first.

Sartan drugs can lower blood pressure and protect cardiovascular system by inhibiting the action of angiotensin 2. Their action is mild and lasting, and they do not have a direct impact on the heart. Therefore, sartan drugs can be used as the first antihypertensive drug to be adjusted.

It takes 3 to 6 weeks for blood pressure to stabilize after the dose of sartan drugs is adjusted, so the same amount of time needs to be observed after the dose is reduced. If blood pressure is still low, then consider reducing the dose of dihydropyridine drugs and then observe for another 10 days. Lolamine drugs can be adjusted last.

3. The dosage can be adjusted but it is not recommended to stop the drug completely. The normal order of reducing the dosage of drugs is "sartan" first, then "dipine" and finally "lol". But it also depends on the actual situation. For example, if the heart rate is already lower than 55 beats per minute, the dosage of lol drugs can be reduced first. If the blood pressure is too low and symptoms of severe heart and brain ischemia have appeared, "sartan" and "dipine" can also be reduced at the same time.

Hypertensive patients should understand that low blood pressure is the result of drug treatment, not that hypertension has been cured, and they cannot completely get rid of the help of drugs. Therefore, the dosage of antihypertensive drugs can be reduced, but it is not recommended to stop taking the drugs completely. If blood pressure is still low when the lowest treatment dose is reduced, you should see a doctor to rule out other diseases that cause low blood pressure.

To sum up, for people with high blood pressure, if they use the three drugs of "dipine", "sartan" and "lol" for combined treatment, if they find that their blood pressure is low during the treatment, they usually reduce "sartan" first, then "dipine", and finally "lol". But it should be noted that it is okay to reduce the dosage, but it is not recommended to stop the medication completely. Drugs should be used under the guidance of a doctor. If you have any doubts about the use of drugs, you need to consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and share more health knowledge.