For elderly patients with simple elevated systolic blood pressure, will it be effective to use antihypertensive drugs that cost 4 cents per tablet?

"What? A bottle of 100 antihypertensive pills costs only 4 yuan, which is equivalent to only 4 cents per pill. Can it have a blood pressure lowering effect?" The question was raised by an elderly patient with hypertension. When he went to pick up the medicine, he found that the antihypertensive medicine prescribed by the doctor was too cheap. He suspected that the doctor did not give him a "good medicine" and was full of doubts.

Huazi told him that the doctor prescribed hydrochlorothiazide, a diuretic antihypertensive drug. Although the price of this drug is very cheap, the effect of antihypertensive drugs is not measured by price. Diuretic antihypertensive drugs are the first choice for elderly patients with hypertension whose high blood pressure is increased and whose low blood pressure is unchanged or low.

1. Why can diuretics lower blood pressure? In the classification of antihypertensive drugs, diuretics are included, and commonly used drugs include hydrochlorothiazide, indapamide and other drugs. The working principle of this type of drug is to directly inhibit the function of sodium-chloride co-transporter in the renal tubules and reduce the reabsorption of sodium and water in the primary urine by the renal tubules. In other words, diuretics can increase the excretion of sodium and water and increase urine.

The discharge of water will reduce the body's blood volume and extracellular fluid, reduce cardiac output, and lower blood pressure. The discharge of sodium will put arterial smooth muscle cells in a mild hyponatremia state, reducing the sensitivity of smooth muscle cells to vasoconstrictor substances such as norepinephrine and angiotensin, causing vasodilation and lowering blood pressure.

2. Types of hypertension suitable for diuretics In elderly patients with hypertension, due to the hardening of the large arteries, the resistance when the heart contracts and pumps blood is large, so the high blood pressure rises significantly. However, during diastole, due to the hardening of the large arteries and the lack of elasticity of the contraction, the low blood pressure remains unchanged or is low.

Elderly people generally have increased blood volume and increased salt sensitivity, so the pharmacological properties of diuretics can reduce blood volume and excrete sodium, which has a significant effect on the control of elderly hypertension. When preventing stroke in elderly hypertensive people, the effect of using diuretics as antihypertensive drugs is higher than other types of antihypertensive drugs.

Therefore, diuretics are commonly used antihypertensive drugs and are the first choice for elderly patients with hypertension with simple hypertension. The treatment plan for many elderly patients with hypertension is based on diuretics, combined with other drugs.

In addition to elderly hypertension, patients with refractory hypertension, hypertension combined with congestive heart failure, and salt-sensitive hypertension often have water and sodium retention and increased blood volume. These hypertensive patients are also suitable for the use of diuretics, which can promote water and sodium excretion, reduce blood volume and lower blood pressure.

3. Note when using diuretics When diuretics are used as antihypertensive drugs, they are usually not used alone, but in combination with other antihypertensive drugs such as dihydropyridines, prils, or sartans. Low-dose combination therapy of two drugs will produce better antihypertensive effects than high-dose therapy of one drug alone, and the incidence of side effects is lower.

Since both diuretics and loreta-like drugs have an effect on glucose and lipid metabolism, their combined use may increase the risk of diabetes and hyperlipidemia, so unless necessary, the two should be avoided in combination. When taking the medication, the minimum dose should be used to reduce the occurrence of side effects.

There are two types of diuretics commonly used to reduce blood pressure. One is the "thiazide diuretics" represented by hydrochlorothiazide, which contain a thiazine ring in their structure; the other is the "thiazide-like diuretics" represented by indapamide, which do not contain a thiazine ring in their structure but can exert similar effects to thiazide drugs. Both contain sulfonamide groups and are contraindicated for those who are allergic to sulfonamide drugs.

Diuretics interfere with uric acid excretion, so people with gout should use diuretics with caution. Glucocorticoids, as well as nonsteroidal anti-inflammatory drugs such as diclofenac, ibuprofen, and high-dose aspirin, weaken the effects of diuretics and should be avoided in combination. Long-term use may cause electrolyte imbalance, especially hypokalemia, so electrolyte levels should be monitored regularly, and potassium supplements should be taken when necessary, or it can be used in combination with potassium-sparing drugs.

In summary, diuretic antihypertensive drugs are cheap and have significant antihypertensive effects. They are the first choice for elderly hypertension with simple high blood pressure. They have a significant protective effect on the brain and heart of elderly hypertensive patients. However, you need to be wary of adverse reactions and interactions with other drugs when using them. Don't take them without authorization just because they are cheap. Use them under the guidance of a doctor to ensure safety. I am pharmacist Huazi. Follow me to share more health knowledge.