October 4, 2022

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Careful with these antihypertensive drugs if hypertension is complicated by hyperuricemia

Careful with these antihypertensive drugs if hypertension is complicated by hyperuricemia

 

Careful with these antihypertensive drugs if hypertension is complicated by hyperuricemia.   Patients with gout should avoid long-term use of diuretics such as hydrochlorothiazide and indapamide.

Careful with these antihypertensive drugs if hypertension is complicated by hyperuricemia

For gout patients with high blood pressure, while actively treating gout, the antihypertensive drugs used are different from those used by general hypertensive patients.


Potassium drugs can inhibit the excretion of uric acid and increase the level of uric acid, thereby triggering or aggravating gout.


Therefore, how should gout patients with hypertension choose antihypertensive drugs? What kind of drugs can be taken to control blood pressure without causing an increase in uric acid levels?


Attention should be paid to these antihypertensive drugs when hypertension is combined with hyperuricemia.

 

1. Calcium ion antagonist

The name of the drug mostly ends with “dipine”. Calcium ion antagonist, “dipine”, is the most commonly used antihypertensive drug.

After the calcium ions that inhibit vasoconstriction enter the cells, they can achieve the purpose of lowering blood pressure by expanding blood vessels, relaxing vascular smooth muscle, and reducing peripheral vascular resistance. The main target is blood vessels.

Amlodipine and levalamlodipine are the first choices for patients with gout, and have almost no effect on blood uric acid. They are also optional for patients with angina. Nitrendipine and Nisoldipine come in second place and have little effect on uric acid;


But it is best not to choose nifedipine, nicardipine and diltiazem, long-term use will increase blood uric acid levels.

 


2. Angiotensin receptor Ⅱ antagonist


The name of the drug mostly ends with “sartan”, and its representative drugs are Losartan, Valsartan, Telmisartan, Irbesartan, etc.

In addition to lowering blood pressure, angiotensin II receptor blockers can also increase renal blood flow and accelerate the excretion of urine, uric acid and urine sodium. For hypertensive patients with gout or heart failure.

Among these drugs, losartan is a drug that has been proven to have antihypertensive and uric acid effects; valsartan has no obvious effect on uric acid levels, while telmisartan has adverse effects of elevated uric acid, so Patients with gout and hyperuricemia are best not to use it.

 


3. Types of beta receptor blockers


The name of the drug mostly ends with “Lol”. This type of antihypertensive drug has a hypotensive effect.

Among these factors, metoprolol and betarolol have little effect on uric acid, and generally do not increase blood uric acid. Propranolol, nadolol, etc. can be selected to inhibit the secretion of uric acid and increase blood The effect of uric acid is obvious, so it is not suitable to choose.

 

4. Angiotensin converting enzyme inhibitor category

The name of the drug usually ends with “Puli”. The effect of these drugs on uric acid is still controversial: some scholars believe that Prili is a good medicine for the treatment of hypertension with hyperuricemia, but there is no sufficient evidence that such drugs reduce uric acid excretion;

Some scholars have also questioned this, thinking that ACE inhibitors will only expand a part of the renal artery. After the drug is used, the blood flow in the kidney will be reduced, reducing the excretion of uric acid, which will induce or aggravate gout.

Therefore, for the selection of pristine drugs, we must closely cooperate with the attending physician and choose carefully; if we choose, we must monitor blood pressure and blood uric acid at the same time, just in case.

 


5.  Diuretics


It is important to know that for hypertensive patients, diuretics are the basic drugs for lowering blood pressure, mainly by increasing urination and reducing blood volume.

Patients with gout should avoid long-term use of diuretics such as hydrochlorothiazide and indapamide.

These drugs will cause increased blood uric acid, increased kidney urate deposition, and promote the development of gout nephropathy and other adverse reactions.

 

 

 

 

 

(source:internet, reference only)


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