the general senile hypertension

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other changes. Therefore, the general senile hypertension, the ideal blood pressure control is still a certain degree of difficulty, generally using conventional dose of 1/3 as the initial dose, slowly and carefully adjusted until the standard blood pressure.Typical casePatients, male, 65 years old. History of hypertension for 15 years, most hypertensive 180/80 mm Hg. The past five years appear elevated systolic blood pressure, diastolic blood pressure decreased, increased pulse pressure. Had taken nifedipine therapy, blood pressure was 140/55 mm Hg, and consciously dizziness discomfort. Examination revealed blood lipids and elevated plasma homocysteine, started taking nike air max 95 cheap lipid lowering drugs, antihypertensive drug regimens adjusted as follows: 20 mg simvastatin per night, enalapril maleate folic acid tablets a day (enalapril Lee 5 mg / folic acid 0.4 mg), indapamide tablets half tablets / day (2.5 mg / tablet). 15 days after the blood pressure was adjusted to 160/70 mm Hg, then increase the amount of indapamide tablets 1 tablet / day, 7 days decreased blood pressure was 155/70 mm Hg, plus amlodipine 2.5 mg / day. A month later, the review of blood lipids decreased; blood pressure stabilized at 140/70 mm Hg or so, not the readme discomfort.”Accompanied by high and low” in the treatment of hypertension drugsClinically for the treatment of high systolic blood pressure with low diastolic blood pressure drugs are the following categories.Nitrates nitrates can enhance the arterial wall diastolic function and improving arterial elasticity, reduced

systolic blood pressure lowering effect greater than diastolic blood pressure, play faster. Studies have shown that oral nitrate therapy can decrease systolic blood pressure, narrow pulse pressure, diastolic blood pressure is too low for elderly hypertensive patients is particularly applicable. But less than the intensity of oral antihypertensive drugs administered intravenously, and the long-term use may produce drug resistancenike air yeezy 2 cheap .Statins Statins not only can regulate blood lipids, but also improve arterial elasticity effect. But it improve arterial elasticity and reduce the role of pulse pressure is relatively slow, requiring long-term treatment would show efficacy. Also has a stimulating effect on the gastric mucosa, can cause elevated serum enzyme indicators, striated muscle injury, fatigue and other adverse reactions.ACEI and ARB angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) to improve arterial elasticity strongest effect, part of the role of blood pressure to get through. However, some patients may develop a dry cough after taking other adverse reactions.Calcium antagonists in vascular smooth muscle relaxation allows calcium antagonists, decreased blood pressure, arterial diameter expansion. Amlodipine are effective at lowering systolic blood pressure and pulse at the same time, can significantly improve endothelium-dependent

ShuZhang function, reversing carotid artery intima-media thickness, slow plaque formation. Nifedipine also significantly increased arterial compliance and distensibility, prevent or reverse arterial hypertrophy, increased arterial elasticity. SHEP large clinical trials have confirmed that long-term treatment with calcium antagonists can significantly reduce the risk of cardiovascular disease. Recommends taking the elderly GITS can achieve a stable plasma concentration. Such as nifedipine, 30 mg orally once daily or amlodipine 5 mg orally once daily. Not in favor of oral nifedipine, because the nike air max ltd running shoes buck fast, easy to induce cerebral insufficiency.Diuretics study found that excessive sodium intake can affect arterial distensibility and compliance, and to arterial wall thickness and interstitial collagen increased significantly. Small doses of diuretics can prevent collagen accumulation and relieve arterial stiffness. Diuretics have been proven in clinical trials to lower blood pressure at the same time, can significantly reduce the prevalence of cardiovascular disease. Currently has diuretic as elderly isolated systolic hypertension drug of choice, but a small dose combination therapy should be better.Aldosterone antagonists Aldosterone promotes arterial intima and interstitial fibrosis, middle collagen, blood vessels and heart muscle stiffness increases. Small doses of spironolactone and angiotensin-converting enzyme inhibitors, can reduce high aldosterone activity in vivo, control collagen. Spironolactone 20 mg / day, with a potassium-