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Refractory hypertension is not a golden rule for no cure: avoid reducing and stopping medication by yourself

2023-02-19T00:18:35.079Z


Hypertension is a well-known urban disease, and taking medicine to control blood pressure is a common treatment. However, when hypertensive patients take at least three different pharmacological antihypertensive drugs (including


Hypertension is a well-known urban disease, and taking medicine to control blood pressure is a common treatment.

However, when hypertensive patients take at least three different pharmacological antihypertensive drugs (including a water-removing drug) on ​​the premise of improving their lifestyle, they still fail to achieve the ideal blood pressure level; or take at least four different pharmacological antihypertensive drugs In order to control the blood pressure at the ideal level, there is a high chance that it belongs to resistant hypertension.

Refractory hypertension patients face more health risks due to "difficult to control" blood pressure. The key to effective blood pressure control is whether to follow the doctor's instructions to take the medicine. Do not reduce or stop the medicine on your own. This will cause blood pressure to go out of control, and it may even cause death in severe cases threaten.


Written by: Dr. Cui Junming, Medical Consultant and President of Hong Kong Society of Hospital Pharmacists


Hypertension is an urban disease, and taking medication to control blood pressure is a common treatment. However, when hypertensive patients take at least three different pharmacological antihypertensive drugs (including a water-removing drug) on ​​the premise of improving their lifestyle, they still cannot reach the ideal blood pressure level .

(File photo/Photo by Chen Shuxia)

The normal blood pressure of adults is 120/80mmHg up and down, and high blood pressure is when the up and down pressure is 130/80mmHg or above.

Hypertension is difficult to detect because of its symptoms, and it can lead to a series of cardiovascular diseases such as heart failure. It has always been called the "silent killer".

Obesity, diabetes, alcoholism, lack of exercise, and excessive salt intake (more than 5 grams per day) are high-risk groups.

According to the American Heart Association, about 22% of hypertensive patients will develop resistant hypertension.

The etiology of resistant hypertension can be divided into diseases and drugs.

Suffering from chronic kidney disease, adrenal cancer, and sleep apnea may lead to persistent high blood pressure; inappropriate consumption of non-steroidal anti-inflammatory painkillers, cold medicine, and contraceptives may also lead to persistently elevated blood pressure.

Cui Junming, Medical Consultant of Medical Kindness and President of Hong Kong Society of Hospital Pharmacists.

Compared with general hypertension, patients with resistant hypertension often need to take different drugs "a multi-pronged approach".

According to international guidelines, there are currently three first-line antihypertensive drugs, the first being angiotensin-converting enzyme inhibitors or angiotensin II receptor inhibitors.

The second refers to calcium ion channel inhibitors, and the third is diuretics.

The effects of the first and second are to dilate blood vessels, and the third is to absorb water.

The same use of three drugs can help lower blood pressure.

If blood pressure is still not under control, a dehydrating drug called Spironolactone can be added.

At present, there is another new drug class that can be used for treatment, which is the sodium glucose co-transporter-2 inhibitor (SGLT-2 inhibitor). blood pressure.

The normal blood pressure of adults is 120/80mmHg up and down, and high blood pressure is when the up and down pressure is 130/80mmHg or above.

(Getty Images)

Although the blood pressure of patients with resistant hypertension is difficult to control, it does not mean that there is no cure for it. On the contrary, clinically, most patients with this disease face the challenge of failing to follow the doctor's instructions to take medicine.

During the period of long-term blood pressure control, they tend to forget to take the medicine, or they can't bear the side effects of the medicine, so they reduce or stop the medicine on their own, which leads to the deterioration of the condition and the difficulty in controlling the blood pressure. In the end, they have to increase the dosage or the type of medicine, forming a vicious circle.

There was a case who stopped taking blood pressure medicine when he felt dizzy at the beginning, and there were also patients who stopped taking blood pressure medicine because they were worried that the effects of blood pressure medicine would "collide" with other medicines, which would affect their condition.

In fact, if patients have doubts about the prescribed drugs and their side effects, they are advised to consult with the pharmacist to understand the functions and combinations of different drugs, so as to enhance medication compliance.

If it is found that the functions of the drugs taken by the patient for different diseases overlap, the pharmacist can also advise the doctor to cut down the drugs with duplicate effects, so as to reduce the "stress" for the patient.

"01 Clinic" cooperates with the charitable organization [Medical Kindness] to publish medical and health articles written by medical staff every Sunday.

Founded in 2019, Medical Kindness Co., Ltd. hopes to gather the love and strength of the society, and encourage those who are willing to actively participate in the volunteer projects organized by Medical Kindness Coalition, to show their strengths and help the disadvantaged.



With the operation of a professional team, the Medical and Charitable Association is committed to improving the confidence of sponsors and sponsoring organizations, so as to achieve the goal of taking from the society and using it in the society.



The website will also provide the public with accurate medical information; hold irregular medical and health lectures and free clinics, and actively cooperate with other community organizations and medical institutions to provide citizens with various discounts on medical services.


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Source: hk1

All news articles on 2023-02-19

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