降壓藥如何選擇服用更有效,

降壓藥如何選擇服用更有效,

什么是藥物的谷峰比？

答：美國FDA提出了谷峰比的概念來衡量藥物的降壓效果，即一個(gè)藥物在谷值時(shí)的降壓作用（去除安慰劑作用）與峰值時(shí)的降壓效應(yīng)比值，一般認(rèn)為谷峰比大于50％的藥物能避免峰效應(yīng)過強(qiáng)而產(chǎn)生的低血壓不能有效控制的情況。ACE抑制劑藥物中，信誼生產(chǎn)的賴諾普利片是ACE抑制劑，谷峰比大于50％，因而它每天口服一次就能夠較好地穩(wěn)定控制一天24小時(shí)的血壓。

血壓降到多少才為正常？

答：美國國家高血壓預(yù)防、檢測、評(píng)價(jià)和治療委員會(huì)第7次報(bào)告中明確提出了降壓目標(biāo)：

——單純高血壓病人，SBP小于140mmHg，DBP小于90mmHg

——高血壓伴糖尿病或腎病病人，SBP小于130mmHg，DBP小于80mmHg

什么樣的降壓藥物最為理想？

答：中國高血壓病防治指南中明確指出了理想降壓藥物的標(biāo)準(zhǔn)：使用最小的有效劑量即可獲得可能有的療效而使不良反應(yīng)減至最??；即可以一天24小時(shí)內(nèi)穩(wěn)定降壓，又可以有效地防止靶器官損害，并能防止從夜間較低血壓到清晨血壓突然升高而導(dǎo)致猝死、腦卒中和心臟病發(fā)作；聯(lián)合用藥，既提高降壓效果，又不增加不良反應(yīng)。像信誼藥廠生產(chǎn)的賴諾普利片和恬爾新片都是符合以上理想降壓藥物標(biāo)準(zhǔn)的合格產(chǎn)品。

一種藥物降壓無效應(yīng)該怎么辦？

答：一種降壓藥物無效，可以調(diào)整用藥或者聯(lián)合用藥治療。

信誼藥廠生產(chǎn)的賴諾普利片（ACEI）和恬爾新片（CCB）是一組較理想的聯(lián)合用藥，即可以加強(qiáng)降壓效果，又可以改善心功能，提供心、腎等重要臟器的保護(hù)作用。是中國高血壓病防治指南推薦的常規(guī)用法，用量可根據(jù)病情的不同酌情調(diào)整。

降壓藥物做成緩釋片有什么益處？

答：緩釋制劑：口服藥物在規(guī)定溶劑中，按要求緩慢地非恒速釋放，且每日用藥次數(shù)與相應(yīng)的普通用藥比較至少減少一次或用藥間隔有所延長。降壓藥物做成緩釋片，使得血壓在一天24小時(shí)內(nèi)的波幅更小，從而達(dá)到平穩(wěn)降壓的目的。信誼生產(chǎn)的恬爾新緩釋片，服用后，還可以使藥物在體內(nèi)迅速崩解，從而使得藥物在體內(nèi)血藥的濃度迅速達(dá)到峰值，控制血壓，之后再緩慢釋放，達(dá)到平穩(wěn)控制血壓的目的。

茅聶聧貓隆聙氓聨聥貓聧爐盲祿聙盲鹿聢忙聴露氓聙聶氓聬聝 氓婁聜盲陸聲茅聙聣忙聥漏貓隆聙氓聨聥貓聧爐

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有高血壓如何選擇合適自己的降壓藥？

高血壓的藥物有六大類的藥物，但不是所有病人都適合每一類藥物。比如ACEI和ARB，它適合于腎臟功能不好的的病人。但它有個(gè)問題，就是很多病人用了之后會(huì)造成咳嗽干渴，容易引起干渴反應(yīng)。如果不能耐受就不適合用ARB或者ACEI病人。這一類藥物就不適合用。那么CCB適合于腦卒中風(fēng)險(xiǎn)的，但是它有一個(gè)不良反應(yīng)可以造成腳腫、雙側(cè)腳踝關(guān)節(jié)的水腫。那么利尿劑適合于發(fā)生高血壓合并心衰的病人，這種病人可能發(fā)生腳部的水腫，因?yàn)槟I功能不全，這種用利尿劑可能起到立竿見影的效果。長期服用利尿劑可能會(huì)造成電解質(zhì)流失，不同的病人要選擇不同的藥物來治療。
專家提示:高血壓患者如何選擇適合自己的降壓藥：ACEI和ARB適合于腎臟功能不好，有蛋白尿的病人，使用后咳嗽、干渴，不能耐受，就不適合用ARB或者ACEI，CCB適合腦卒中風(fēng)險(xiǎn)的病人，利尿劑適合高血壓合并心衰的病人，長期服用利尿劑可能會(huì)造成電解質(zhì)流失。
大部分患者我們很常見的，還是像剛才的說的鈣離子拮抗劑、硝苯地平控釋片或者非洛地平緩釋片等等這一類藥。大多數(shù)人比較常見，而且相對(duì)來說副作用也出現(xiàn)的相對(duì)少，這類藥一般適合于一些收縮壓，就是高壓比較高的或者是既往得過腦血管病的，他有一些擴(kuò)張腦動(dòng)脈這些作用，所以叫鈣離子拮抗劑。第二類就是比如說ACEI或ARB，叫血管緊張素轉(zhuǎn)換酶抑制劑，或者是血管緊張素抑制劑，它適合于一些比如說有些人患有糖尿病，或者以前得過心衰、心肌梗塞、冠心病，他們這類人更適合ARB或者ACEI這類藥。

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