The treatment of hypertensive patients with coronary heart disease

The treatment of hypertensive patients with coronary heart disease
Coronary heart disease is coronary atherosclerotic heart disease referred to. It is because of nutrient supply to the heart of the vessel - in a coronary artery caused by atherosclerosis. Clinical performance of the major angina, arrhythmias, heart failure, serious acute myocardial infarction or sudden death (sudden death). Angina attack is due to transient ischemic cardiomyopathy caused by hypoxia, usually have a coronary blood flow is reduced or sudden increase in myocardial oxygen consumption in both cases, you can break, but more because of the heart For various reasons burden, coronary blood flow can not meet the needs of heart occurred. When angina attack, often accompanied by high blood pressure, heart rate to accelerate, and the treatment of angina that is to reduce the myocardial oxygen consumption and reduce vascular resistance, slowed heart rate, improve myocardial ischemia, the termination of angina attack. Therefore, the mechanism of the treatment of hypertension and treatment of coronary heart disease in the same mechanism, the two are not contradictory.

1. Hypertensive patients with coronary heart disease, the buck is the optimal level of diastolic blood pressure in 11.4 ~ 12 kPa (85 ~ 80mmHg) about the excessive lowering diastolic blood pressure may lead to myocardial infarction. It was reported that when the diastolic blood pressure remained at 12.1 ~ 13.0 kPa (91 ~ 98mmHg), coronary heart disease mortality of the lowest, while diastolic blood pressure fell to 12.0 ~ 11.3 kPa (90 ~ 85mmHg) below, may occur because of a lack of myocardial perfusion Infarction.

2. Hypertensive patients with coronary heart disease, heart failure, calcium antagonists and the choice of converting enzyme inhibitors, these drugs can buck and can improve heart function. Application of sustainable long-term reversal of hypertension caused by left ventricular hypertrophy, which is leading to heart failure, myocardial ischemia, a serious arrhythmia and even sudden death risk factors. And diuretics for 30 percent of patients with hypertension can lower serum potassium and easy to cause ventricular arrhythmias, sudden death of increase in the number of coronary heart disease and can cause blood sugar, high blood lipid, accelerated atherosclerosis, is not under normal circumstances.

3. Hypertensive patients with arrhythmia, should choose not to affect the function of sinus drugs such as nitroglycerin, nifedipine, slow down the rhythm of the anti-drug, such as verapamil, methyl dopa, Clonidine; Selection of the merger tachycardia, verapamil, Effects of metoprolol, anti-hydrazine benzene pyridazine, guanethidine.

4. Hypertensive patients with coronary heart disease, myocardial infarction, acute myocardial infarction that early use of low-dose-converting enzyme inhibitors, prevent heart after myocardial infarction caused by the change of heart failure and improve patient quality of life. β blockers can prevent Sudden cardiac death and the incidence of re-infarction, which can reduce the mortality rate of patients after myocardial infarction.