Take antihypertensive medicine every day, why still can appear hypertensive nephrosis?

At the outpatient clinic last month, 41-year-old Xiao Li, who was a buyer at a company, came to me. Xiao Li found that his blood pressure had risen for 3 years, but he was the first time to see a doctor.

3 years ago, when Xiao Li passed the pharmacy, he saw that it was measuring blood pressure for free, so he went in and measured his blood pressure once, and found that the blood pressure was actually 160/110mmHg. He buys medicine, or the sphygmomanometer is bad. Xiao Li, who has traveled for many years, thinks that it must be a routine…

However, this matter always left a shadow in my heart, and I remember it from time to time. So after a month, Xiao Li measured the blood pressure several times in different places, and took the colleagues’ electronic blood pressure to measure it again, and found that each time the blood pressure was still so high.

He was a little flustered now, because he had heard that high blood pressure could be dangerous, so he asked his friends around him what to do? Can diet or physical therapy lower blood pressure?

Many friends nearby thought the same, and advised him not to take medicine so young. Of course, there are a few friends who say they should take some medicine, but it is recommended not to take good antihypertensive medicine, otherwise there may be no medicine available in the future, which is bad, and you have to leave some room for yourself when you are young. #甫谣#

Xiao Li sounded very reasonable, yeah, he was still so young, in case there is no medicine available in the future, then it is sad.

After consulting a lot of people, he made up his mind. After get off work, he found a pharmacy and asked the clerk to take one of the cheapest antihypertensive drugs “captopril”. This medicine was recommended by a colleague.

After the medicine was bought back, Xiao Li found that the instructions stated that he should eat 2-3 times a day, but he thought about it, as the saying goes: “It is a drug that is three-point poisoning”, and he has just started to develop high blood pressure, which can be less Eat less, so he decided to take only one capsule a day to maintain a basic level of blood pressure.

After taking antihypertensive drugs, he felt his heart and felt that everything was all right: high blood pressure, antihypertensive drugs, blood pressure will definitely come down, don’t worry about it.

The buyer’s work is indeed very busy, and there are a lot of entertainment and drinking. Although I insist on taking a captopril one antihypertensive drug every day, I have rarely had time to take blood pressure in the past few years. Because I don’t feel uncomfortable and don’t care too much, I feel comfortable: I should be too tired, just take a break.

However, last week the company went to the hospital for physical examination, and when Xiao Li measured his blood pressure, he found that the blood pressure was higher: 176/120mmHg, and a large amount of proteinuria had appeared in the urine test. The electrocardiogram showed that the heart had also enlarged.

He was very depressed and puzzled: He was taking antihypertensive drugs every day, why can’t he control his blood pressure?

In fact, Xiao Li entered the misunderstanding from the beginning, there are six major errors:

  1. First, what we usually say about good antihypertensive drugs refers not to expensive drugs, but to long-acting antihypertensive drugs, which can lower blood pressure smoothly for 24 hours, and the side effects are relatively small, and at the same time on the heart, kidneys, etc. Target organs have a certain protective effect. In other words, you can kill two birds with one stone.

In fact, many long-acting antihypertensive drugs are also very cheap. Many imported antihypertensive drugs now have domestic generic drugs, and they are very cheap through the national platform. They will not increase the financial burden of patients.
Short-acting antihypertensive drugs, such as captopril, heartache, etc., cannot maintain blood pressure stable for 24 hours and are prone to blood pressure fluctuations, so they are rarely used clinically.

  1. Antihypertensive drugs are different from antibiotics and will not produce drug resistance. The so-called “take poor drugs at first, and then take good drugs later” has no reason and no scientific basis. Many people think that poor antihypertensive drugs are actually old drugs decades ago, and many of them are short-acting or have more side effects and are not routinely recommended.

Of course, if there is no other antihypertensive drug, it can be used, but it must be taken according to the instructions of the doctor. If possible, we still recommend the use of long-acting antihypertensive drugs with good side effects and protection of target organs.

  1. Isn’t blood pressure monitored after taking antihypertensive drugs? This is of course wrong.

We often encounter this situation in the clinic. Many patients find that blood pressure rises very worried, but after taking antihypertensive drugs, they immediately feel safe and no longer monitor blood pressure. In fact, people’s blood pressure often fluctuates at different times and in different environments. Taking medicine does not mean that it can be controlled and stabilized. Even if the blood pressure is stabilized by using medicine, there may be fluctuations, such as weather changes or cold, cold, etc. Other conditions may cause blood pressure fluctuations.

If blood pressure is not controlled at a normal level, the risk of cardiovascular and cerebrovascular accidents (such as myocardial infarction, stroke, heart failure, arrhythmia, etc.) remains high.

Xinlu Xingchen: Therefore, it is very important to monitor blood pressure after taking the medicine. We recommend family self-testing blood pressure, measuring and recording, and giving it to the doctor when visiting the doctor. The doctor can adjust the amount and type of antihypertensive drugs according to the blood pressure.
The following is the blood pressure record table I made, you can refer to it.

Horizontal version of detailed records ↓↓↓:

  1. Unauthorized reduction of the amount of medicine.

Captopril is a short-acting antihypertensive drug that needs to be taken more often. For Captopril, it takes 2 to 3 times a day to maintain a relatively stable blood pressure, and Xiao Li takes one capsule a day, the drug effect can not be maintained for 24 hours, in fact, it may cause blood pressure fluctuations more obvious, which is more harmful to the condition .

Many patients take the concept of “can eat less and eat less” when taking medicine. We often encounter patients who have been prescribed medicine for one month and can eat for three months or even half a year, which often leads to aggravation of the condition, which is difficult to control.

  1. Once high blood pressure is found, medication should not be taken without authorization. After Xiao Li found that his blood pressure was high, it was wrong to consult his friends around him to buy medicine. This was not right, so he could not treat his specific condition.

We suggest that after finding high blood pressure, you should go to the hospital for treatment, and after a standardized examination, select and adjust the medicine accurately according to the condition.

There are many kinds of antihypertensive drugs, but the indications and side effects of each drug are different. High blood pressure medication pays attention to individualized programs. Selecting drugs according to specific conditions can achieve small dosage, good effect, and reduction. The purpose of side effects.

  1. Hypertension is a lifestyle disease. In addition to standardized antihypertensive medications, lifestyle adjustments also play an important role in antihypertensive treatments. According to research, developing good living habits can lower blood pressure by more than 10mmHg, such as quitting smoking, limiting alcohol, exercising more, low-salt, low-fat, high-fiber diet…

Xinlu Xingchen: It is a pity that although Xiao Li discovered an increase in blood pressure 3 years ago, due to the fact that the blood pressure has not been well controlled, the result has been hypertensive heart disease and hypertensive nephropathy. At this time, it is necessary to choose drugs more carefully. We usually need to choose drugs that can inhibit ventricular remodeling and protect kidney function.

For example, puli or sartans can also be used in combination with dipine drugs. For cases of fast heart rate or combined with angina pectoris, heart failure, etc., you can also consider using beta blockers… while for other Risk factors (hyperlipidemia, diabetes, etc.) also need to be intervened.
Standardized medication treatment and regular follow-up inspections can greatly reduce the incidence of cardiovascular accidents. Don’t take it lightly. In addition to taking medicine, hypertension is also important for monitoring.

Leave a Reply

Your email address will not be published. Required fields are marked *