1 calcium antagonist (personal suggestion: recommendation)

Non-dihydropyridine calcium antagonists: benzothiazole: diltiazem, etc. Phenylalkylamine: verapamil, etc.

Dihydropyridines: the first generation nifedipine; Second-generation sustained-release nifedipine and felodipine; Third generation lacidipine, amlodipine, etc.

(1) Common calcium channel blockers:

Nifedipine (Xintongding): It takes effect quickly and has short effect.

Nimodipine (Nimodipine): The cerebral vasodilation effect is stronger than nifedipine, and it can be used for subarachnoid hemorrhage, cerebral vasospasm and ischemic stroke.

Nitrendipine: It has diuretic effect, and its antihypertensive effect is persistent and mild.

Nicardipine (Perdipine): It has selective cardiovascular effect and can increase the cardiac index. It is used for patients with hypertension complicated with cardiac encephalopathy.

Amlodipine (Loxoxib): This drug takes effect slowly, and it takes 7-8 days to show its antihypertensive effect.

Diltiazem (soothing, soothing)

Commonly used slow-release calcium blockers are: Li Huan, Yixinping and Baixintong.

Nifedipine sustained-release tablets

Felodipine sustained-release tablets (Boydine)

Ankle edema occurred in 2 1% of lacidipine sustained-release tablets.

Nimodipine sustained-release tablets

Lacidipine sustained-release tablets

Nicardipine sustained-release tablets (perdipine sustained-release tablets)

Diltiazem sustained-release tablets in the treatment of rapid heart rate atrial fibrillation.

Verapamil verapamil sustained-release tablets

(2) Commonly used controlled-release calcium ion blockers are:

Nifedipine Gastrointestinal Controlled Release Tablets (Baixintong)

Nifedipine controlled-release tablets (Nifedipine, Long-acting Xintongzhi) have good effects on preventing stroke, vascular dementia and anti-atherosclerosis, and have no effect on glycolipid and electrolyte metabolism.

Advantages: 1, the antihypertensive efficacy and range are relatively strong, but the individual differences in efficacy are small, only relative contraindications have no absolute contraindications. 2. It has a good antihypertensive effect on elderly patients, and the systolic blood pressure is obviously reduced. 3. It can be used in combination with almost every antihypertensive drug to enhance the antihypertensive effect. Can increase the excretion of uric acid. About 80% is excreted by the kidney, and 20% is excreted with feces.

Adverse reaction: 1. Postural hypotension II. Tachycardia 3. Myocardial contractility inhibition: it is more common in non-dihydropyridine calcium antagonists. Constipation 5. Edema in the front of tibia and ankle. Bradycardia or conduction block: more common in non-dihydropyridine calcium antagonists 7. Headache, facial flushing and polyuria. Rash and allergic reaction. Taboo: bones become brittle and easy to fracture.

2 thiazide diuretics: (personal advice: follow the doctor's advice)

It is often combined with other antihypertensive drugs to treat moderate and severe hypertension, especially for patients with high blood volume. Thiazine diuretics are the most commonly used, and their adverse reactions mainly include: hyperuricemia, so gout patients are prohibited; Renal insufficiency should not be used. Long-term and large-scale application can increase blood sugar, decrease glucose tolerance and increase insulin resistance; Elevated blood lipids. Other diuretics can also cause electrolyte disorders. Diuretics such as hydrochlorothiazide and its compound preparations (compound hypotensive tablets, compound hypotensive tablets). It is suitable for primary and secondary hypertension, especially for elderly patients with hypertension or complicated heart failure.

Taboo: hyperuricemia (thiazide diuretics can increase blood uric acid) or gout patients are prohibited, and patients with diabetes and hyperlipidemia should use it with caution.

3 beta blockers: (Personal advice: follow the doctor's advice)

Representative drugs are metoprolol and propranolol. It is suitable for hypertensive patients with angina pectoris, myocardial infarction, heart failure, tachyarrhythmia, glaucoma and pregnancy. It can not only prevent and treat hypertension, but also treat angina pectoris, especially patients with myocardial infarction, and prevent reinfarction; Young people have high blood pressure, fast heart rate and large cardiac output, which can obviously slow down the heart rate and lower blood pressure after taking medicine; The reduction of diastolic blood pressure is more obvious than that of systolic blood pressure, and it is suitable for treating hypertensive patients with high diastolic blood pressure alone or combined with other antihypertensive drugs to treat hypertensive patients with high systolic blood pressure and diastolic blood pressure. It has little effect on uric acid metabolism. Excretion through the kidneys.

Adverse reactions: bradycardia, atrioventricular block, heart failure induced by excessive dose, asthma; It may also have an effect on blood lipids. Because these drugs can slow down the heart rate, they should be closely monitored to ensure that the heart rate is greater than 60 beats/minute after use. Contraindications: patients with heart block, asthma, chronic obstructive pulmonary disease and peripheral vascular disease, and type 2 diabetes: Beta blockers can cover up the symptoms of hypoglycemia caused by excessive insulin treatment, and should not be used.

4 angiotensin converting enzyme inhibitor (ACEI) (personal suggestion: if there is no adverse reaction, it is recommended)

The representative drugs are captopril, enalapril, cilazapril, quinapril, ramipril, benazepril, perindopril, spironolactone and fosinopril.

Can significantly reduce mild to moderate hypertension; Combined with other drugs, it also has a good antihypertensive effect on severe hypertension, especially for patients with vascular stenosis. It is more suitable for patients with insulin resistance, diabetes, left ventricular dysfunction, heart failure and myocardial infarction, and can increase the excretion of uric acid.

Common adverse reactions: irritating dry cough, the incidence rate is 5%-20%, which may be related to the increase of some substances in pulmonary blood vessels and the stimulation of cough reflex.

5 angiotensin Ⅱ receptor antagonist (ARB) (personal suggestion: recommendation)

Representative drugs include Losartan (Cozuya), Valsartan (Devon), Irbesartan (Ambovi), Telmisartan, Losartan, etc., which are suitable for all kinds of mild to moderate hypertension, especially for patients who are intolerant of ACEI.

Adverse reactions: Patients who take this medicine occasionally have elevated liver function indicators.