Through rational use of antihypertensive drugs, on the one hand, we can further strengthen the control of hypertension, improve the blood pressure compliance rate, and reduce the health hazards such as cardiovascular and cerebrovascular diseases and kidneys caused by long-term hypertension. On the other hand, through the rational use of antihypertensive drugs, some antihypertensive drugs have a little targeted organ protection from the perspective of action mechanism. Such antihypertensive drugs are of course hypertensive patients, and they should be preferred according to their own conditions. Today's popular science article will introduce three relatively new antihypertensive drugs, which can not only effectively strengthen blood pressure control, but also better protect the heart and kidneys.
Among all kinds of first-line antihypertensive drugs, angiotensin receptor antagonists are very commonly used first-line antihypertensive drugs. The names of these drugs all have the word "sartan". Many friends are familiar with valsartan, losartan, irbesartan, candesartan and olmesartan. , all belong to this kind of drugs, 202 1 approved mesartan potassium in China can be said to be
In terms of antihypertensive intensity, angiotensin receptor antagonists can reduce vascular tension, relax blood vessels and lower blood pressure by competitively binding with angiotensin receptor. As a new antihypertensive drug, mesartan can bind to angiotensin receptor irreversibly for a long time. Just like other sartans, once a day, the antihypertensive effect is more stable within 24 hours.
Compared with other similar drugs, the chemical structure of mesartan is complex, and there are four binding sites with angiotensin receptor, which is the most binding sites among all the sartans. Therefore, this drug has stronger antihypertensive strength than other sartans, and has certain advantages over other sartans in terms of antihypertensive efficiency in different hypertensive people.
In terms of target organ protection, mesartan, like other similar drugs, has certain cardiovascular protection and renal protection, and has clear benefits in improving microalbuminuria and preventing ventricular hypertrophy caused by hypertension. Clinical studies also show that compared with other similar drugs, mesartan has the effects of stabilizing atherosclerosis, inhibiting myocardial fibrosis and improving insulin resistance. Therefore, this drug not only can effectively lower blood pressure and protect target organs such as heart and kidney, but also has its own advantages and characteristics.
After talking about the advantages, let's talk about the precautions. Like other similar drugs, there is bilateral renal artery stenosis, and pregnancy is a taboo for this drug. People with renal insufficiency and high blood potassium risk should also actively evaluate the potential risks and carefully choose the dosage before taking the medicine.
When it comes to antihypertensive drugs such as calcium channel antagonists, people may be most familiar with nifedipine and amlodipine, but in fact, in addition to these common drugs, some newer drugs such as benidipine also have their own unique advantages.
Compared with traditional single-channel calcium channel antagonists such as amlodipine, benidipine is a dual-channel calcium channel antagonist, which can act not only on L channel of calcium ion, but also on T channel. At the same time, its fat solubility is more closely combined with cell membrane, which belongs to membrane-bound long-acting calcium channel antagonist. Compared with amlodipine, which is also a long-acting drug, benidipine still has drugs stored on the cell membrane when the blood concentration of the drug decreases. Continue to play the role of antagonizing calcium channels and relaxing arterial blood vessels. This long-term effect belongs to membrane-mediated long-term effect, which can maintain long-term stable antihypertensive effect, independent of the change of blood drug concentration. Its antihypertensive effect is more clear, and it can also be a long-acting drug taken once a day.
The research data show that, compared with nifedipine, the affinity of benidipine to vascular smooth muscle cells is about 14 times that of nifedipine and 19 times that of amlodipine, so its vasodilation effect is more clear, and it has a clear role in dilating blood vessels and improving blood flow of coronary artery. For patients with coronary heart disease, angina pectoris and hypertension, taking benidipine can not only effectively strengthen blood pressure control, but also improve coronary blood supply and relieve angina pectoris.
Benidipine not only has protective effect on patients with coronary heart disease, but also can protect kidney by antagonizing T channel, and also has a slight protective effect on kidney health. Compared with commonly used drugs, benidipine has little effect on heart rate. Therefore, as a new antihypertensive drug, benidipine's advantages in antihypertensive effect and drug safety can not be ignored.
It should be noted that benidipine is not suitable for people with severe abnormal liver function. At the same time, we should also pay attention to the risk of blood pressure rebound caused by the sudden withdrawal of benidipine.
According to the classification of drugs, fenanone, like spironolactone, belongs to a new generation of aldosterone receptor antagonists, which can be used not only for the rational regulation of hypertension, but also for the treatment of diabetic nephropathy and chronic nephropathy.
Some hypertensive patients combined with routine antihypertensive drugs still can't lower their blood pressure, especially under the premise of adequate use of diuretics, and their blood pressure remains high. To consider the possibility of refractory hypertension, the overactivation of aldosterone system and the increase of primary aldosterone are important reasons for the increase of blood pressure. For refractory hypertension, on the basis of the original antihypertensive drugs, the use of aldosterone receptor antagonists can further improve the blood pressure compliance rate.
Compared with its big brother spironolactone, fenidone is a new generation of non-steroidal selective mineralocorticoid receptor antagonist. The drug also has mild potassium retention and diuretic effects, and can antagonize the activity of aldosterone receptor, thus achieving the effect of controlling hypertension. Compared with spironolactone, fenanone has little effect on male function, and the risk of increasing blood potassium is relatively low.
Fenenone is a new generation of aldosteronism receptor antagonist that can be considered for refractory hypertensive patients with aldosteronism, diabetic nephropathy complicated with hypertension and chronic renal insufficiency complicated with hypertension. It can not only protect renal function and delay the process of renal failure, but also has a certain cardioprotective effect, and is also a commonly used drug to prevent and improve chronic heart failure.
Unfortunately, fenelidone has not been approved to be listed in China, but according to the news of the Food and Drug Administration, relevant manufacturers have applied for the listing of fenelidone. It is believed that in the near future, patients with diabetic nephropathy and chronic nephropathy complicated with hypertension in China can also use this new drug to strengthen blood pressure regulation and protect renal function.