Hypertension complicated by hyperlipidemia Drug guidance:
Hypercholesterolemia and hypertension are often two interrelated diseases. In a survey of 51million hypertensive patients in the United States, it was found that 40% of patients had a serum total cholesterol level higher than 62 mmol / L, while 46% of hypercholesterolemic patients with a serum total cholesterol level higher than 6.2 mmol / l also had hypertension. The higher the blood pressure, the greater the risk of coronary heart disease. The increase of serum total cholesterol level will have a synergistic effect on the risk of coronary heart disease in patients with hypertension. However, lowering blood pressure and serum total cholesterol levels can reduce the risk of coronary heart disease.
Cholic acid chelators, nicotinic acid and its derivatives, fibric acid derivatives and statins can be used to treat patients with hyperlipidemia and hypertension. But when using these lipid-lowering drugs, we should pay attention to the interaction between them and antihypertensive drugs. Bile acid chelators can reduce the absorption of thiazide diuretics and propranolol (propranolol). Therefore, these antihypertensive drugs must be used 1 hour before or 4 hours after taking bile acid chelators.
It should be noted that nicotinic acid can enhance the vasodilatory effect of antihypertensive drugs, which leads to the decrease of blood pressure. Fibric acid derivatives may cause myopathy in some patients with renal failure. Therefore, the dose of such drugs should be small, and patients should be followed up regularly. There is no special interaction between statins and antihypertensive drugs, which can be used to treat patients with hyperlipidemia and hypertension. In addition, there is no special interaction between lipid-lowering drugs such as dosenkang, fish oil lipid-lowering pills and antihypertensive drugs, which can also be used for lipid-lowering treatment of patients with hyperlipidemia and hypertension.
When choosing antihypertensive drugs, they should be matched reasonably. Long term use of diuretics and some antihypertensive drugs containing diuretic components, such as hydrochlorothiazide (hydrochlorothiazide), compound antihypertensive tablets, may lead to increased blood lipids. While long-term use β Receptor blockers, such as propranolol (propranolol), may also increase the level of triacylglycerol. Therefore, hypertensive patients with high blood lipids should choose a new generation of antihypertensive drugs under the guidance of doctors, such as amlodipine, captopril, benazepril, etc. these drugs can stabilize blood pressure for 24 hours, do not affect blood lipid metabolism, and have protective effects on heart, brain, and kidney.