What are the advantages of using "sartan" and "thiazide" together? What types of hypertension are they suitable for?

An elderly friend with high blood pressure asked Huazi that he was currently taking an antihypertensive drug, irbesartan hydrochlorothiazide. He wanted to know what kind of antihypertensive drug it belonged to and whether there were any precautions when taking it.

Huazi told him that this antihypertensive drug is a combination of "Irbesartan" and "Hydrochlorothiazide" to form a compound antihypertensive drug. In addition to synergistically lowering blood pressure, the two antihypertensive drugs can also "complement each other's shortcomings", improve the antihypertensive effect, and reduce the occurrence of side effects. It is mainly used for senile hypertension and secondary hypertension.

1. The combination of "sartan" and diuretics You may have seen them in pharmacies. There are actually many kinds of compound drugs composed of "sartan" and diuretics, such as irbesartan hydrochlorothiazide, valsartan hydrochlorothiazide, telmisartan hydrochlorothiazide, losartan potassium hydrochlorothiazide, etc., which are all compound antihypertensive drugs of "sartan" plus diuretics (hydrochlorothiazide).

In fact, taking two drugs separately can achieve the same blood pressure lowering effect. However, in the drug treatment of hypertension, medication compliance is a "difficulty". Many people cannot take medication according to doctor's orders, especially the elderly who have decreased memory. If too many types of medication are taken, it is possible to miss a dose of the medication. Therefore, combining two drugs into one pill can simplify the medication process and improve medication compliance.

2. The "synergy" and "complementarity" of the two antihypertensive drugs From the perspective of pharmacological action, sartan drugs are angiotensin II receptor blockers. Angiotensin II is the strongest substance in the human body that constricts blood vessels. Sartan drugs block the corresponding receptors on vascular smooth muscle, causing vasodilation and lowering blood pressure.

Thiazide diuretics inhibit the sodium-chloride co-transporter on the renal tubules, which reduces the reabsorption of sodium ions and water by the renal tubules and increases the excretion of water and sodium ions. They can effectively reduce blood volume and lower the sodium ion level that can cause high blood pressure, thus lowering blood pressure.

Synergy: After the two drugs are used together, because of their different mechanisms of action, they lower blood pressure through multiple pathways, thus increasing the antihypertensive effect.

Complementarity: Sartan drugs have a potassium-sparing effect and have the side effect of causing elevated blood potassium; while thiazide diuretics increase the excretion of potassium ions while promoting diuresis, which has the side effect of causing hypokalemia. Therefore, after the two are used together, their effects on blood potassium can complement each other, thereby reducing the incidence of side effects of the two drugs.

3. What types of hypertension are suitable for? It should be noted that the combination of "sartan" and diuretics is usually not suitable for the initial medication of patients with hypertension. Because diuretics have significant side effects and affect the metabolism of blood sugar, blood lipids, and blood uric acid, antihypertensive drugs containing diuretics are usually used for patients who cannot fully control their blood pressure when using sartan drugs alone, such as elderly hypertension and secondary hypertension.

The characteristics of senile hypertension are that the high pressure increases, the low pressure remains unchanged or decreases, and the pulse pressure (the difference between the high pressure and the low pressure) increases. Secondary hypertension is mostly caused by other diseases that lead to increased aldosterone and cause high blood pressure. Both types of hypertension will have obvious water and sodium retention and are sensitive to sodium salt. The combination of "sartan" and diuretics can produce a better effect of controlling blood pressure.

4. Attention during use: Since it is a compound drug composed of two antihypertensive drugs, adverse reactions of both drugs may occur. However, the impact on blood potassium will be reduced due to the "complementary" effect of the two drugs. However, during medication, blood potassium and other electrolyte levels should still be monitored to prevent serious adverse reactions. In the early stage of medication, because the two drugs work together, blood pressure may drop sharply, so it is necessary to start with a small dose and reduce the dosage of other antihypertensive drugs.

Sartan drugs have the function of protecting the kidneys, but they cannot be used for patients with bilateral renal artery stenosis. Renal function should be monitored in the early stage of medication. If the blood creatinine level increases by more than 35%, the drug needs to be discontinued. During medication, patients with angioedema need to be banned for life. Thiazide diuretics are sulfonamide derivatives, so they are banned for patients who are allergic to sulfonamide drugs.

In summary, the combination of "sartan" and thiazide-type drugs is a compound antihypertensive drug suitable for elderly hypertension and secondary hypertension. It produces a synergistic antihypertensive effect through different mechanisms, and in terms of the impact on blood potassium, the two drugs can "complement each other" and reduce the occurrence of side effects. The drug needs to be used under the guidance of a doctor. If you have any questions about the use of the drug, you should consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and share more health knowledge.