How do high blood pressure diabetes drug

Angiotensin-converting enzyme inhibitors and angiotensin receptor antagonist Ⅱ is recognized diabetic patients with hypertension drug of choice, the advantage is mainly reflected in four aspects: First, on glucose and lipid metabolism does not have an adverse impact, even To improve with sugar and fat metabolism in the role; in the second, play the role of step-down at the same time, organizations can improve peripheral insulin sensitivity; with three kidneys function can reduce urinary albumin, to postpone the occurrence of diabetic kidney disease, Development; Fourth inhibit arterial smooth muscle cell proliferation, to prevent atherosclerosis, reduce or reverse left ventricular hypertrophy and improve cardiac function, heart failure and reduce the incidence of myocardial infarction. Taking angiotensin-converting enzyme inhibitors or angiotensin receptor antagonist Ⅱ treatment, care should be taken to monitor serum creatinine and serum potassium changes in serum creatinine, serum potassium were significantly higher should not be used.
Early benefits of multi-drug
Clinical research has shown that single-drug treatment step-down effect is limited, the need to strengthen control of blood pressure is often combined with blood pressure medicine. Combination therapy can increase blood pressure effects, as well as lower the high-dose single-drug treatment for adverse reactions. There are a variety of clinical combination program, such as angiotensin-converting enzyme inhibitors (or angiotensin receptor antagonist Ⅱ) and the calcium channel blocker; angiotensin-converting enzyme inhibitors and diuretics; calcium antagonist And β-blocker; β-blockers and diuretics; α and β-blocker-blocker, and so on. In particular, angiotensin-converting enzyme inhibitors and calcium antagonists in conjunction with, in addition to increased blood pressure effects, but also have to strengthen the protection of kidney function, while no adverse effects on glucose metabolism, it is especially suitable for high blood pressure in patients with diabetes mellitus. Has been introduced several angiotensin-converting enzyme inhibitors and calcium antagonists fixed joint preparation, so that not only increase the efficacy, but also enhance the patient's treatment compliance.
Disease-specific, individualized medicine
Whether it is high blood sugar or high blood pressure will lead to kidney damage, high blood pressure in patients with diabetes mellitus in the choice of drug treatment, renal function should be to protect, prevent or delay the deterioration of renal function on an extremely important position. Angiotensin-converting enzyme inhibitors, angiotensin receptor antagonist Ⅱ, calcium antagonist on diabetic patients with high blood pressure in patients with renal protective effect of both.

Diabetic patients with isolated systolic hypertension, can use low-dose diuretics, or joint use of diuretics and angiotensin-converting enzyme inhibitors and calcium antagonists. If the continued existence of high blood pressure, the selection of α-blockers can increase the effect.

Autonomic nervous system dysfunction and hypertension treatment is more difficult to choose angiotensin-converting enzyme inhibitors, angiotensin receptor antagonist Ⅱ, calcium antagonists, patients with severe β-blockers or diuretics; Shen Α-blocker use.

Blood glucose, blood lipids in patients with poorly controlled may make use of the angiotensin-converting enzyme inhibitors, angiotensin receptor antagonist Ⅱ, calcium antagonists, α-blocker; be used with caution β-blocker and diuretic Agent.

Diabetic patients with high blood pressure with fast heart rate, in patients with angina pectoris, β-blockers should be preferred; frequent angina attack may choose calcium antagonists, will help reduce coronary heart disease, cardiovascular events. Can also be selected angiotensin-converting enzyme inhibitors, angiotensin receptor antagonist Ⅱ, α receptor antagonist.

Patients with peripheral vascular disease may make use of the angiotensin-converting enzyme inhibitors, angiotensin receptor antagonist Ⅱ, calcium antagonists, α receptor antagonist; β-blocker used with caution.

Fluctuations in blood pressure greater patients, as far as possible should be selected once-daily long-acting agents, can reduce blood pressure fluctuations, and easy to raise long-term treatment compliance.

Patients with diabetes often due to the merger of autonomic nervous system dysfunction, prone to orthostatic hypotension, the use of antihypertensive drugs after the sit or stand by the position, we must move slowly to prevent the occurrence of syncope. In addition, blood pressure, diabetes night drop lower than non-diabetics, therefore, in the early and late step-down dose of the drug on the arrangements necessary to take this into account. In addition, the blood pressure in elderly patients should be decreased gradually to avoid complications arising from rapid decline.