1. Diuretics 2. Sympatholytic drugs 3. Vasodilators 4. Renin-angiotensin system inhibitors 5. Calcium channel blockers

cardiac output

peripheral resistance

1. The effect is weak, reducing blood pressure by an average of 10% 2. Most patients will see results within 2 to 3 weeks after taking the medicine. 3. Can be used for various types of hypertension (basic antihypertensive drugs) 4. Mild cases - single use, moderate and severe cases - combined use 5. Can cause the morbidity and mortality of stroke and left heart failure in elderly patients with hypertension

Early stage of medication

long term medication

Thiazide diuretics are the most commonly used class of diuretic and antihypertensive drugs. Hydrochlorothiazide is most commonly used When using thiazide diuretics alone for antihypertensive treatment, the dose should be as small as possible Long-term use of thiazide diuretics alone ⇨ combined use of potassium-sparing diuretics/ACEI ⇨ reduction of K⁺ excretion For patients with azotemia/uremia ⇨ the highly effective diuretic furosemide

first line medication Can be used alone to treat mild hypertension Combined with other antihypertensive drugs to treat moderate and severe hypertension. Diuretics combined with ACEI or ARB are the most common compound preparations.

Features

effect

Pharmacological effects

Clinical application

Adverse reactions

The antihypertensive mechanism is the same as propranolol, but it is more selective for cardiac β₁ receptors

Orally administered to treat various degrees of hypertension. Antihypertensive effect lasts longer

It antagonizes beta receptors and also antagonizes alpha receptors.

Suitable for various degrees of hypertension and hypertensive emergencies, gestational hypertension, pheochromocytoma, hypertension during anesthesia or surgery

a. β-blockers

Used to treat patients with mild and moderate hypertension accompanied by renal insufficiency and diabetes.

Does not affect blood lipid metabolism

First generation: nifedipine, verapamil, diltiazem First-line cardiovascular drugs for the treatment of mild to moderate hypertension Verapamil treats supraventricular tachycardia, nifedipine has strong coronary expansion effect, and treats coronary heart disease, etc. Features: The efficacy is certain, but the stability is poor

Second generation: Representative drugs: Nimodipine - strong dilation of cerebral blood vessels; Nitrendipine - strong dilation of renal blood vessels; Features: High selectivity for vascular smooth muscle, stable properties, and precise efficacy

Third generation: representative drug: amlodipine-long-acting Features: High selectivity for vascular smooth muscle and long half-life

Pharmacological effects

Clinical application

Adverse reactions

Moderately effective calcium channel blocker ⇨ Mild and long-lasting antihypertensive effect, suitable for all types of hypertension

The antihypertensive effect is gentler than that of nifedipine, and its duration is significantly longer than that of nifedipine. It is the only drug of its kind that can be used safely by patients with congestive heart failure Also has anti-atherosclerotic effects

It is a potent calcium antagonist that can significantly and selectively act on calcium ion channels in vascular smooth muscle. Its main function is to dilate peripheral arteries, reduce peripheral vascular resistance, thereby lowering blood pressure and making it less likely to cause reflex tachycardia and increased cardiac output. Anti-atherosclerotic effect For mild to moderate hypertension

Renal blood flow ↑, reverse remodeling, ↓ blood lipids, ↓ blood glucose, First-line drug for HF, acute myocardial infarction, hyperkalemia

ACEI reduces the production of Ang II and the degradation of bradykinin⇨ dilate blood vessels and lower blood pressure

Captopril

Good results for gout patients

AT₁ receptor: vascular smooth muscle, myocardium, brain, kidney and adrenal gland zona glomerulosa cells that secrete aldosterone - regulates the stability of cardiovascular function.

Losartan

The antihypertensive effect of clonidine is moderate to strong. Inhibit gastrointestinal secretion and movement; inhibit central nervous system Inhibition of sympathetic ⇨ peripheral blood vessel opening ⇨ antihypertensive effect

It is suitable for the treatment of moderate hypertension. It is often used for the long-term treatment of hypertension when other drugs are ineffective. It has a synergistic effect when combined with diuretics and is used for severe hypertension. It is taken orally to prevent migraines or as a detoxification drug to treat addiction to morphine-type analgesics. Solution eye drops⇨Treatment of open-angle glaucoma

dry mouth, constipation

Strengthen the effects of other central nervous system depressants

Directly relaxes arteriolar and venous smooth muscle Metabolism produces NO ⇨ powerful dilation of vascular smooth muscle

Suitable for the treatment of hypertensive emergencies and controlled hypotension during surgical anesthesia

Mainly produces antihypertensive effects by affecting the storage and release of catecholamines

Reserpine (reserpine), guanethidine