New strategies for the treatment of hypertension

 There are more than 100 million hypertension patients in China, but the blood pressure control rate is less than 5%. How to treat can make blood pressure fall down and keep stable is what many patients and even doctors want to know. It is important to adopt a new strategy for the treatment of hypertension, that is, low-dose combination of drugs + heart rate control, to improve the compliance of patients and stabilize the curative effect.

Now it is found that there are many disadvantages in the treatment of hypertension with single drug in the past. In order to achieve the effective effect, the dosage is very large. It is not only easy to have adverse reactions and patients can not bear to interrupt the treatment, but also has poor protection for large blood vessels, which can not reduce the occurrence of cardiovascular and cerebrovascular diseases. In recent years, who and the International League of hypertension have emphasized and advocated the treatment principle of low-dose combination therapy and heart rate control at the same time. The former is to fully reflect the individual needs of patients, starting from a small dose of medication, the patient tolerated the dosage, the effect is not good, then add the second or third. After clinical use, low-dose combination has many advantages, because hypertension is a multifactorial disease. Combination on demand can not only intervene risk factors from many aspects, strengthen the protection of large blood vessels, but also offset the adverse reactions of drugs. Moreover, different combinations have fixed ways, simple treatment, low cost and easy promotion.

A large number of studies have shown that the increase of heart rate plays a great role in the increase of blood pressure, and with the increase of age, the heart rate increases, and the probability of coronary heart disease and myocardial infarction increases accordingly. Because heart rate is a sensitive index of sympathetic nerve, which can significantly predict hypertension and coronary ischemia, many countries have taken fast heart rate as the main risk factor for male sudden death. Using evidence-based medicine to treat hypertension can improve the therapeutic effect. Since the relationship between heart rate and hypertension is very important, the heart rate should be reduced to a satisfactory level when choosing antihypertensive drugs. What is the ideal level of heart rate control? At present, there is no unified standard. The heart rate of patients with hypertension should be about 60 times per minute.