First, several kinds of antihypertensive drugs and their indications
1. angiotensin converting enzyme inhibitors (ACEI, Puli) and angiotensin II receptor antagonists (ARB, sartans)
All kinds of hypertension without complications can choose ACEI/ARB as the first-line drug, and patients with arteriosclerosis, diabetes, diabetic nephropathy or hypertensive nephropathy, or metabolic syndrome can also choose ACEI/ARB to lower blood pressure.
However, pregnant women, people with hyperkalemia and bilateral renal artery stenosis cannot choose ACEI. The common side effects of ACEI include dry cough and angioedema (edema in face, ankle and other parts), and ACEI/ARB antihypertensive drugs cannot be used when these side effects occur.
Compared with ACEI, ARB antihypertensive drugs have fewer side effects such as dry cough and angioneurotic edema. If you can't tolerate ACEI because of these two side effects, you can choose ARB.
2. Calcium antagonists (CCB, including horizon, verapamil and diltiazem)
It is also a very good first-line antihypertensive drug with few side effects. Except for hypertension without complications, people with left ventricular hypertrophy, angina pectoris, peripheral arterial disease and other problems, it is suggested that CA antihypertensive drugs should be the first choice.
Patients with second or third degree atrioventricular block and heart failure can't choose CA antihypertensive drugs. In addition, some CA drugs, such as diltiazem, verapamil, nicardipine, etc., may interact with some statins through cytochrome CYP3A4 metabolism, so the elderly should pay attention when taking drugs together.
3. Beta blockers (BB, Lore, various Leke)
Hypertension patients with persistent atrial fibrillation or rapid heart rate can choose BB antihypertensive drugs first.
Patients with asthma or second and third degree atrioventricular block cannot use BB.