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1、Antihypertensive drugs,hypertension,Mean arterial blood pressure is higher than the normal range, in the case of not taking blood pressure drugs ： Systolic blood pressure 18.7kPa(140mmHg)and（or） Diastolic blood pressure 12.0kPa(90mmHg) Divided into primary hypertension （90%95%） And secondary hyperte
2、nsion,complications,Heart failure Coronary heart disease (CHD) Cerebrovascular accident Renal failure,Antihypertensive drugs,Reasonable application of antihypertensive drugs,Control of blood pressure,Delay the formation and development of atherosclerosis,Reduce the complications such as brain, heart
3、 and kidney,Reduce the mortality rate, prolong life,Blood pressure,- The factors influencing blood pressure ： Cardiac output :heart rate, myocardial contraction force, change of blood volume, etc.; Peripheral resistance: the length of the blood vessels and blood viscosity, blood vessels, radius, etc
4、. - Nerve - fluid system on blood pressure regulation 。,1.Nervous regulation: the sympathetic nervous system,Peripheral neurotransmitter release,The postsynaptic membrane receptor,Second, humoral regulation: renin angiotensin aldosterone system,Kidney adjacent ball Beside the machine,-R blockers,ren
5、in,Angiotensin original,angiotensin,invertase,ACEI,angiotensin ,Small artery contraction,losartan,Aldosterone secretion,Water sodium retention,diuretic,(thiazides),Classification,Diuretic The sympathetic nervous depressants (1) central blood pressure medication (2) the ganglion block (3) noradrenali
6、ne can nerve endings block (4) the adrenaline receptor blockers Affect the renin - angiotensin system medicine A gleam of antihypertensives: diuretic, calcium antagonist medicine, beta receptor blockers and ACEI,Diuretic,On the basis of (a line) blood pressure medication Effect in the thiazide diure
7、tic is most commonly used, antihypertensive effect is mild, persistent, long-term application of no significant resistance Features: Antihypertensive effect is weak, by an average of 10% 2 3 weeks after the majority of patients in medical work Can be used for various high blood pressure (basic blood
8、 pressure medication) Mild - alone, medium and severe - share Can make the elderly hypertension patients complicated with stroke, the incidence of left heart failure and mortality is left,Hydrochlorothiazide,Early antihypertensive mechanism With sodium diuresis, reduce the extracellular fluid and bl
9、ood volume Long-term antihypertensive mechanism Diuretic row sodium to Na + left aortic smooth muscle cell, cell Na + / Ca2 + exchange left - intracellular Ca2 + left, reduce vascular smooth muscle of norepinephrine (NE) reactivity,disadvantages :,- Blood K+、Na+、Mg2+ - Blood total cholesterol, trigl
10、yceride, low density lipoprotein cholesterol (hdl-c) - Blood uric acid - Blood renin - Glucose tolerance (disabled) for diabetes patients Effective diuretic (furosemide) used in hypertensive crisis and poor associated with chronic renal hypertension patients.,Hypertensive crisis Patients with high b
11、lood pressure in the short term, the blood pressure increased significantly, and appear have a headache, be agitated, palpitation, sweating, nausea, vomiting, or pale flush, blurred vision and other signs. Mechanism: hyperthyroidism and circulating catecholamines increased sympathetic nervous activi
12、ty,Clinical application,A gleam of medication Application of the treatment for mild hypertension separately With other antihypertensive drug treatment, severe hypertension,Effect of diuresis medicine of compound preparations with other drugs,Compound antihypertension tablet: give up ping, hydralazin
13、e, hydrochlorothiazide Compound apocynum tablet: guanidine b organism, hydralazine, hydrochlorothiazide Jane chrysanthemum antihypertension tablet: clonidine, hydrochlorothiazide Compound captopril tablets, enalapril and hydrochlorothiazide Constant dropping pills: clonidine, hydralazine, hydrochlor
14、othiazide,Calcium antagonist medicine,Block L voltage dependent calcium channel - left intracellular Ca2 + diastolic small artery Nifedipine group, horizon, lacidipine flat, amlodipine,Nifedipine,【 Step-down characteristics 】 1 Buck degree was positively correlated with the original high blood press
15、ure, with normal blood pressure has no obvious antihypertensive effect ； 2 Oral absorption is good, work fast: sublingual administering 1-5 minutes work - in the treatment of variant angina pectoris, hypertensive crisis. Oral 30 to 60 minutes work - treatment of mild and moderate hypertension ； 3 Ca
16、n cause reflective heart rate share Receptor blockers.,Clinical application,Light, medium and severe hypertension treatment,Nitrendipine,Selectively ACTS on the peripheral vascular, blocking its internal flow of calcium ions, relaxing smooth muscle, the dilate blood vessels and step-down Warm and lasting antihypertensive effect, applicable to various types of high blood pressure,Lacidipine,Is a potent calcium antagonists, significantly and the effect of selective calcium ion
