Dihydropyridine calcium channel blockers at arterial hypertension
Об этом видео: Dihydropyridine calcium channel blockers: increasing the effectiveness of treatment of arterial hypertension through combination therapy
Dihydropyridine calcium channel blockers play a fundamental role in the treatment of hypertension and chronic coronary heart disease. These drugs are effective in lowering blood pressure, but their use is sometimes hampered by the side effect of peripheral edema, often manifested by swelling of the legs. This discomfort may deter patients from continuing treatment, compromising blood pressure control.
The addition of renin-angiotensin system (RAAS) blockers, especially angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), markedly reduces the risk of peripheral edema. Studies show a synergistic effect when dihydropyridine calcium channel blockers are combined with these drugs, especially second generation or newer ones.
Dihydropyridine calcium channel blockers primarily work by dilating blood vessels, which lowers blood pressure. However, this expansion can also cause fluid to accumulate in the legs, leading to swelling. Renin-angiotensin system blockers, on the other hand, affect the renin-angiotensin system, reducing fluid retention and thereby effectively counterbalancing the edema they cause.
The benefits of this type of combination therapy include:
Minimized peripheral edema.
Improved blood pressure management.
Broader cardiovascular protection, including reducing the risk of heart failure and slowing the progression of kidney disease.
Effective combinations of drugs:
Amlodipine + Lisinopril
Nifedipine + Valsartan
Felodipine + Ramipril
Lercanidipine + Enalapril
Recommendations for combination therapy:
Start treatment at lower doses and increase as needed to achieve blood pressure goals.
Avoid potential side effects such as dizziness, especially when initiating combination therapy.
Ongoing monitoring is critical to assess effectiveness and adjust the treatment plan.
Consult your doctor to tailor your treatment plan to your specific conditions, assessing the potential risks and benefits.
Dihydropyridine calcium channel blockers are effective for the treatment of hypertension and chronic coronary artery disease, but their use may be limited by side effects such as peripheral edema. Combining them with RAAS blockers (ACEIs or ARBs) significantly reduces this side effect.
The combination of dihydropyridine calcium channel blockers and RAAS blockers acts synergistically. Although calcium channel blockers dilate blood vessels, lowering blood pressure, they can cause fluid to accumulate. RAAS blockers counteract this by reducing fluid retention through a different mechanism.
Benefits of this combination include reduction in peripheral edema, improved blood pressure control, and additional cardiovascular protection. Special combinations of drugs are recommended (for example, amlodipine + lisinopril, nifedipine + valsartan, felodipine + ramipril, lercanidipine + enalapril).
Advice: Start with lower doses, monitor for side effects, and see your doctor regularly for personalized treatment.
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