Treatment
General:weight loss in obese patients,salt-restriction,regular physical exercise,no smoking,no coffee.
Strategy:Blood pressure maintain stable,close to normal gradually.
It is not necessary to use more than two kinds of drugs in the beginning of the treatment.unless the blood press is significantly higher than 160/100mm Hg.
Maximize drug dose before adding another drug:
Step 1(monotherapy):Diuretics.
Step 2(two kinds of drugs):ACE-inhibitor and Ca-blocker.
Step3(three kinds of drugs):Ca-blocker,ACE-inhibitor,diuretics.
Step 4(four kinds of drugs):Beta-blocker,Ca-blocker.ACE-inhibitor,diuretics.
Patients with heart failure:loop diuretic+ACE-inhibitor.
Patients with angina pectoris/MI:Beta-blocker/ACE-inhibitor.(https://www.daowen.com)
Patients with diabetes:ACE-inhibitor.
Patients with renal dysfunction:loop diuretic and Ca-blocker.Pregnancy:methyldopa.
Patients with stroke:If BP>220/110mm Hg,the BP should be lowered slowly,e.g.hydralazine 5mg was used until the BP<200/110 mm Hg.
Treatment goal:BP<140/90mm Hg in general.<130/80mm Hg in high risk patients(diabetes,CHD,renal dysfunction).<120/70mm Hg in aortic aneurysm/dissection.
Abbreviations
HTN(hypertension):高血压
MI(myocardial infarction):心肌梗死
CHD(coronary heart disease):冠心病
ESP:稳定
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