七、有合并症的高血压用药问题 1.高血压合并高血脂症已知TC、LDC—C及VLDL—C上升,HDL—C与TC比值降低,是冠心病最敏感的指标;T_g升高是冠心病的独立危险因素,而β阻滞剂、噻嗪类利尿剂、利血平、甲基多巴等多种降压药可对血脂和脂蛋白造成不良影响,故在高血压伴高脂血症者不宜长期使用。 2.高血压合并冠心病高血压合并急性心肌梗塞、心功能不全者首选硝苯吡啶。但也有报道心绞痛伴重度高血压时对硝苯吡啶很敏感,可发生显著血压下降,而加重心绞痛,故使用硝 Seven, with complications of hypertension medication problems 1. Hypertension with hyperlipidemia TC, LDC-C and VLDL-C increased, HDL-C and TC ratio decreased, is the most sensitive indicators of coronary heart disease; T_g increased Is an independent risk factor for coronary heart disease, and β blockers, thiazide diuretics, reserpine, methyl dopa and other antihypertensive drugs can cause adverse effects on lipids and lipoproteins, it is associated with high blood pressure LIP is not suitable for long-term use. Hypertension with coronary heart disease complicated by acute myocardial infarction, heart failure, preferred nifedipine. However, there are also reports of angina pectoris with severe hypertension is very sensitive to nifedipine, can occur significant drop in blood pressure, and aggravating angina pectoris, so the use of nitrate