Core tip: long term use of diuretics to reduce blood pressure, these 4 adverse reactions to know! Attention of patients with hypertension
A lot of people are not clear about diuretics. In fact, many patients with hypertension are taking them, such as hydrochlorothiazide and benfluthiazide, which are thiazide diuretics. The usage rate of diuretics is very high, ranking the first of five common antihypertensive drugs. However, diuretics also have adverse reactions, hypertension patients should pay attention to!
1、 Common adverse reactions of diuretics
Generally speaking, patients with hypertension use diuretics, more prone to the following several adverse reactions.
1. Electrolyte disorder
Long term use of large doses of diuretics, especially thiazide diuretics, patients are prone to hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, and other electrolyte disorders. If hypokalemia occurs, hypertension patients will appear fatigued, abdominal distension, myasthenia, arrhythmia, and other manifestations. Patients should pay attention in time and pay attention to distinguish.
It is mainly related to the hypotensive mechanism of thiazide diuretics: thiazide diuretics reduce the concentration of sodium ion in vascular smooth muscle by excreting sodium; at the same time, it reduces the concentration of calcium ion through Na + - Ca2 + exchange mechanism, so as to reduce the reactivity of vascular smooth muscle to vasoconstrictor and exert the antihypertensive effect.
2. Hyperglycemia
It was found that the increase of blood glucose in patients with hypertension during the use of thiazide diuretics may be due to the decrease of insulin secretion caused by hypokalemia and insulin resistance caused by the activation of secondary RAAS, which may lead to abnormal glucose tolerance and even diabetes.
3. Postural hypotension
In the process of long-term use of high blood pressure, or lie down for a long time, or the symptoms of dizziness will appear together. Postural hypotension often occurs in the elderly, patients with insufficient blood volume, or vasodilators.
4. Increased uric acid
Thiazide diuretics can interfere with the normal excretion of uric acid and lead to an increase in uric acid levels.
2、 How to deal with adverse reactions to diuretics?
Dealing with electrolyte disorders
Patients with hypokalemia can be treated with potassium-sparing diuretics in time, which can correct low magnesium and low potassium at the same time, kill two birds with one stone; when hyponatremia occurs, increase the intake of dietary sodium salt and drink less water, and stop diuretics when necessary.
Stabilize blood sugar
The increase in blood glucose caused by diuretics may be related to hypokalemia. Therefore, it is suggested that patients should pay attention to supplement potassium while using thiazide diuretics or combine with potassium-sparing diuretics. If diabetes occurs during the use of diuretics, ACEI, or ARB drugs are recommended.
Avoid orthostatic hypotension
For patients with low posture, it is recommended to take diuretics in the morning, and patients should avoid being too fast when standing up. If the symptoms are serious, consider reducing the dosage of diuretics or discontinuing it.
Don't worry too much about the increase of uric acid
Although thiazide diuretics may interfere with a uric acid exclusion, they generally do not lead to uric acid accumulation and therefore do not need treatment. But if gout has been diagnosed, thiazide diuretics should be banned in patients with such hypertension.
After talking about so many adverse reactions to diuretics, many people refuse to use them because they are worried about many adverse reactions. In fact, these adverse reactions are mainly caused by long-term and large-scale use, and the adverse reactions show a dose-dependent manner. And diuretics antihypertensive drugs still have a lot of antihypertensive advantages, we can not generalize.
Generally speaking, although the use of diuretics will have some adverse reactions, we can find out in time, the correct use of drugs can improve, and let it give full play to the antihypertensive effect.
