When treating high blood pressure, pay attention to a few small details to increase the effectiveness of the drug

According to official data, the number of people with high blood pressure in China has reached 330 million, which is the main cause of dangerous diseases such as myocardial infarction, cerebral infarction, and cerebral hemorrhage. Among the consultations Huazi encounters, the most common one is about high blood pressure.

Huazi found that many friends with high blood pressure can take medication regularly, but during the treatment process, because some small details are not controlled well, the expected control effect cannot be achieved, resulting in poor effect after taking the medication or increasing adverse reactions of the drug.

1. Low sodium and high blood pressure

Science has confirmed that sodium ions are one of the causes of high blood pressure , while potassium ions can counteract the blood pressure-raising effect of sodium ions. There is a theory that the imbalance of sodium and potassium intake in Chinese dietary habits is the main cause of high blood pressure. Therefore , for patients with high blood pressure, controlling the intake of sodium ions and increasing the intake of potassium ions are beneficial to controlling blood pressure .

For patients with hypertension, the recommended daily salt intake is between 3 and 5 grams . Low-sodium salt, which uses potassium chloride to replace part of the sodium chloride, is more suitable for patients with hypertension. In addition, the use of thiazide diuretics (hydrochlorothiazide, indapamide, etc.) has the side effect of excreting potassium and retaining sodium. Eating low-sodium salt can reduce the impact of side effects on blood pressure.

However, it should be noted that antihypertensive drugs such as prils, sartans, and potassium-sparing diuretics (spironolactone, triamterene, etc.) can increase blood potassium . Low sodium salt contains more potassium ions, and when used with the above drugs, it may cause hyperkalemia and the risk of cardiac arrest.

People with renal insufficiency have a weakened ability to regulate electrolytes and are also prone to hyperkalemia. Therefore, when using the above-mentioned drugs and people with renal insufficiency for antihypertensive treatment, they should be careful not to consume low-sodium salt, and should regularly test blood potassium levels and intervene promptly if abnormalities are found.

2. Try not to eat grapefruit (grapefruit)

For people with high blood pressure, eating more vegetables and fruits can help control blood pressure, but grapefruit is best not to be eaten because it contains more furanocoumarins, which can interfere with the metabolic function of the liver enzyme CYP3A4 .

Most drugs, such as dihydropyridines among antihypertensive drugs, some statins among lipid-lowering drugs, and repaglinide among hypoglycemic drugs, need to be metabolized by the CYP3A4 enzyme.

For people who need to take medication for a long time, eating a large amount of grapefruit may inhibit the activity of the liver drug enzyme CYP3A4, causing drug metabolism to slow down and leading to cumulative poisoning. Therefore , for patients with hypertension, trying not to eat grapefruit can reduce the risk of medication .

3. Take medicine according to blood pressure fluctuation time

Most patients with hypertension take medication after getting up in the morning. For people with normal blood pressure fluctuations, taking medication in the morning is the most suitable . The daily fluctuation pattern of human blood pressure is normally two peaks in the morning and afternoon, and a trough at night. Therefore, taking medication in the early morning can better control the peak blood pressure during the day.

However, some hypertensive patients, especially elderly hypertensive patients, have irregular blood pressure fluctuations and may experience high blood pressure at night or in the early morning. They need to take medication before bed to better control their blood pressure.

For people with high blood pressure, it is best to do 24-hour dynamic blood pressure monitoring , which can judge blood pressure fluctuations and determine the most appropriate time to take medication.

4. Choice of antihypertensive drugs

When choosing antihypertensive drugs, it is recommended to give priority to long-acting antihypertensive drugs that are taken once a day , rather than short-acting antihypertensive drugs that are taken more than three times a day. This is because long-acting antihypertensive drugs have a long-lasting effect and are slowly metabolized, and they have the best effect on controlling blood pressure. Short-acting antihypertensive drugs are prone to fluctuations in blood drug concentrations, and blood pressure will also fluctuate accordingly, with the risk of inducing acute cardiac and cerebral events.

If the initial blood pressure exceeds 160/100 mmHg, it is recommended to choose two antihypertensive drugs for combined treatment . About 70% of hypertensive patients need two or more drugs in combination to control their blood pressure.

When taking drugs labeled as sustained-release or controlled-release, do not break or grind the tablets unless the instructions state that they can be broken into pieces. After taking sustained-release or controlled-release drugs, do not be nervous if you see the entire tablet being excreted from the body, because some drugs are insoluble skeleton tablets, and the tablets will not break after the drug is released.

To sum up, in the treatment of hypertension, it is necessary to understand the impact between drugs and low sodium salt, grapefruit, the relationship between medication time and blood pressure fluctuations, the optimization of antihypertensive drugs and other small details, so that you can increase the effect of drugs without spending more money and reduce the risk of medication. Drugs must be used under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.