Through the rational use of antihypertensive drugs, on the one hand, we can further strengthen the control of hypertension, improve the compliance rate of blood pressure, and reduce the cardiovascular, cerebrovascular, renal and other health hazards caused by long-term high blood pressure. On the other hand, through the rational use of antihypertensive drugs, some antihypertensive drugs, from the perspective of action mechanism, have a little targeted organ protection. Such antihypertensive drugs are of course hypertensive patients, and should be given priority in combination with 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 kidney.
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, olmesartan, etc., all of which belong to this kind of drugs. In 20021year, the domestic approved mesartan potassium,
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 type of antihypertensive drug, mesartan can irreversibly bind with angiotensin receptor, and its action time is longer. Just like other sartans, it can be taken once a day, and its antihypertensive effect is more stable within 24 hours.
In terms of antihypertensive strength, mesartan has a complex chemical structure compared with other similar old-fashioned drugs, with four binding sites to angiotensin receptor, which is the most binding site among all 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 targeted 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. Compared with other similar drugs, clinical studies also show that mesartan has the effects of stabilizing atherosclerosis, inhibiting myocardial fibrosis, improving insulin resistance, etc. Therefore, this drug has its own advantages and characteristics in addition to effectively lowering blood pressure and protecting targeted organs of heart and kidney.
After talking about the advantages, let's talk about the precautions. Like other similar drugs, there are 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 drug.
When it comes to antihypertensive drugs such as calcium channel antagonists, people are probably 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 not only act on the L channel of calcium ions, but also act on the T channel. At the same time, its fat solubility is more closely combined with the cell membrane, and it belongs to a membrane-bound long-acting calcium channel antagonist. Compared with amlodipine, which is also a long-acting drug, benidipine still has drugs stored in the cell membrane when the plasma concentration of drugs 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 and stable antihypertensive effect and is independent of the change of plasma drug concentration. Its antihypertensive effect is more clear, and it can also achieve long-acting drugs taken once a day.
The research data show that compared with nifedipine, the affinity of benidipine to vascular smooth muscle cells is about 0/4 times that of nifedipine and 0/9 times that of amlodipine, so its role in relaxing blood vessels is more clear, and it has a clear role in dilating blood vessels and improving blood flow for coronary arteries. For people 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.
In addition to the protective effect on patients with coronary heart disease, benidipine can also protect the kidney by antagonizing T channels, and it also has a slight protective effect on kidney health. Compared with common drugs, benidipine has less influence on heart rate. Therefore, as a new antihypertensive drug, benidipine's advantages in antihypertensive effect and medication safety can not be ignored.
It should be noted that people with severe liver dysfunction should not use benidipine. At the same time, we should also pay attention to the risk of blood pressure rebound caused by the sudden withdrawal of benidipine.
In terms of drug classification, fenelidone, like spironolactone, belongs to a new generation of aldosterone receptor antagonists, which can not only be used for rational regulation of hypertension, but also be beneficial to the treatment of diabetic nephropathy and chronic nephropathy.
Some patients with hypertension still can't lower their blood pressure by taking conventional antihypertensive drugs together, especially if their blood pressure remains high under the premise of using diuretics in sufficient amount, so we should consider the possibility of refractory hypertension, and the over-activation of aldosterone system and the increase of primary aldosterone are all important reasons for the increase of blood pressure. For refractory hypertension, the use of fenelidone aldosterone receptor antagonists can further improve the blood pressure compliance rate on the basis of the original antihypertensive drugs.
Compared with its big brother spironolactone, fenelidone is a new generation of non-steroidal selective mineralocorticoid receptor antagonist. This drug also has mild potassium retention and diuretic effect, and can also antagonize the activity of aldosterone receptor, thus achieving the effect of controlling hypertension. Compared with spironolactone, fenelidone has less influence on male function and the risk of increasing blood potassium is relatively low.
For refractory hypertensive patients with aldosteronism, diabetic nephropathy complicated with hypertension, and chronic renal insufficiency complicated with hypertension, fenelidone is a new generation of aldosterone receptor antagonists that can be considered. 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 for preventing and improving chronic heart failure.
Unfortunately, at present, fenelidone has not been approved for listing in China, but according to the news of the Food and Drug Administration, relevant manufacturers have already applied for the listing of fenelidone. I believe that in the near future, domestic patients with diabetic nephropathy and chronic nephropathy complicated with hypertension can also use this new drug to strengthen blood pressure regulation and protect renal function.