Freshly soldpublic : 2013ASH / ISH Hypertension Management Guide


Patient type Initial medication When the target blood pressure is not reached<140 / 90mmHg,The second drug that should be added When the target blood pressure is not reached<140 / 90mmHg,The second and third drugs should be added
A: The patient has other diseases or high blood pressure is the main disease
Black patients (African Bev?elimination) CCB (a) or thiazide diuretics ARB (b) or ACEI drugs (if there are no such drugs,You k?Can add another drug from the original drug. Combination of CCB + ACEI / ARB drugs + thiazide diuretics
Whitee or other non-black patients: patients under 60 years of age ARB (b) or ACEI drugs CCB (a) or thiazide diuretics Combination of CCB + ACEI / ARB drugs + thiazide diuretics
Whitee or other non-black patients: patients under 60 years of age CCB (a) or thiazide diuretics (although ACEI drugs or ARB drugs h?are often effectiveThe guidelines recommend the use of these two types of medicines. ARB (b) or ACEI drugs (if ACEI or ARB drugs are the parent drugs,Can use CCB or thiazide diuretics) Combination of CCB + ACEI / ARB drugs + thiazide diuretics
B: Hypertensive patients with other diseases
Hypertension with diabetes ARB or ACEI drugs (note: in the black bev?solution,It is recommended that the original drug is CCB drugs or thiazide diuretics. CCB or thiazide diuretics (note: in the black bev?solution,If the original drug is CCB or thiazide diuretics,At this point, ARB or ACEI drugs should be added. Add a second drug (thiazide diuretics or CCB drugs)
Hypertension with chronic kidney disease ARB or ACEI drugs (note: in the black bev?solution,ACEI drugs have a better kidney protection effect) CCB or thiazide diuretics (c) Add a second drug (thiazide diuretics or CCB drugs)
Hypertension combined with coronary heart disease (d) Beta blockers + ARB drugs or ACEI drugs CCB or thiazide diuretics Add a second drug (thiazide diuretics or CCB drugs)
History of high blood pressure combined with stroke ACEI drugs or ARB drugs Thiazide diuretics or CCB drugs Add a second drug (thiazide diuretics or CCB drugs)
Hypertension with heart failure IncludingLich patients with symptomatic heart failure,Independentnig from blood pressure,Should regul?re ARB drugs or ACEI drugs + β blockers + diuretics + spironolactone.If blood pressure is not well controlled,Dihydropyridine CCB drugs k?can be added.
a: CCB (a) drugs are often recommendedBut thiazide diuretics cost less
b: ARB type (b) can be considered for useBecause ACEI drugs cough and neur?cause deme k?can,Although ACEI drugs can cost lessnnen
c: if eGFR<40 ml / min,A diuretic (such as furosemide or toracimide) can be used
d: If a myocardial infarction has occurred in the past,Independentnig from blood pressure,Both recommend the use of β-blockers and ARB or ACEI drugs.
e: If diuretics are used,The best effect is the use of indapamide.

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