What Kinds Of Medicines To Treat Hypertensive And Diabetes
2019-04-06 14:49
Diabetes mellitus and hypertension are both risk factors for cardiovascular diseases, and they often coexist. The prevalence of cardiovascular diseases in these groups is more than twice that of patients with simple hypertension/diabetes mellitus. They belong to the "extremely high risk" group of cardiovascular diseases. They also accelerate the progress of retinopathy and kidney diseases, and greatly increase the risk of renal failure and death. Therefore, drug control is more important for patients with diabetes mellitus, hypertension and nephropathy.
In the process of choosing antihypertensive drugs, patients should consider not only the antihypertensive effect and side effects of drugs, but also the effects of drugs on glucose and lipid metabolism, electrolytes and renal function.
1. ACEI/ARB (Sartans) - Preferred Drugs
Puli and sartan antihypertensive drugs can not only effectively reduce blood pressure, but also increase the sensitivity of muscle and fat to insulin, improve glycolipid metabolism and insulin resistance. They can also reduce urinary protein and protect kidney, and delay the process of kidney damage.
Both pril and sartan can increase blood potassium, but pril can also cause dry cough, and sartan can be used in patients with intolerance. Two kidney and renal artery stenosis, hyperkalemia and pregnancy women are forbidden to use these two drugs.
2. ACEI/ARB combined with CCB (horizon drugs) - combined hypotension
If the effect of single use of sartan or pril is not good, the combination of horizon drugs (such as amlodipine and lacidipine) is more conducive to improving vascular endothelial function, insulin resistance and protein-lowering effect. Diabetic patients with hypertension complicated with coronary heart disease can choose combined hypotension. The main side effects of horizon drugs are headache, tachycardia, ankle edema and so on.
3. Diuretics
Low-dose diuretics can significantly reduce the incidence of stroke, but high-dose diuretics have an impact on sugar, lipid, electrolyte, etc., which is not conducive to the control of blood sugar.
4. Receptor blockers
Receptor blockers include alpha blockers and delta blockers. Long-term use of non-selective R blockers may reduce insulin sensitivity. Diabetic patients with hypertension have faster heart rate and angina pectoris can take high-selective 1 receptor blockers such as metoprolol in small doses; diabetic patients with simple systolic hypertension can choose long-acting alpha1 receptor blockers such as doxazosin when taking low-dose diuretics or combined antihypertensive effect is not good. Increase the antihypertensive effect.
In addition, most of the hypoglycemic drugs such as metformin, glimepiride and acarbose have no adverse effects on blood pressure, so they can choose the most beneficial hypoglycemic drugs according to doctor's advice. Patients should also take statins to control blood lipid during the treatment.
In addition to drug treatment, many patients with diabetes and hypertension are closely related to their lifestyle, dietary habits, emotions and other controllable factors. Patients should bear in mind the importance of non-drug treatment while taking drug treatment. Reasonable dietary structure and habits (such as regular meals, low-salt and low-fat diet, total calorie intake control, etc.), smoking cessation, weight loss, proper exercise and emotions. Xu stability and so on, if each can persist in the treatment of patients will benefit a lot.
Adhering to the combination of drug treatment and non-drug treatment, controlling blood pressure, blood sugar and blood lipid can achieve twice the result with half the effort, greatly reducing the risk of cardiovascular diseases and renal failure, improving the quality of life, and patients can live a healthy and long life.
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