Is it necessary to adjust antihypertensive drugs when blood pressure becomes low in summer?

Every summer, many hypertensive patients take the same dose of antihypertensive drugs, and their blood pressure will be lower than that in autumn and winter. The reason is that the temperature rises in summer and the peripheral blood vessels of human body dilate, which leads to the drop of blood pressure. Secondly, sweating increases in summer and sodium loss increases, which is equivalent to the role of diuretics. Sodium loss leads to a decrease in blood volume, which can also lower blood pressure.

So, when blood pressure becomes lower in summer, do antihypertensive drugs need to be reduced or stopped?

The first thing to look at is the extent of blood pressure drop. Generally speaking, if the range of blood pressure drop is not great and the patient has no related symptoms, there is no need to lower blood pressure. This is because the core strategy of antihypertensive therapy is to lower blood pressure steadily, which will inevitably bring about fluctuations in blood pressure levels. As the weather turns cold, blood pressure will rise again, especially in the elderly, because there are different degrees of atherosclerosis and poor blood vessel elasticity. In the process of drug adjustment, the tolerance to blood pressure fluctuation is low. After the weather turns cold, the blood pressure often rises to much higher than the baseline level before blood pressure reduction, which leads to a long adjustment period of antihypertensive drugs and large blood pressure fluctuation, which easily leads to an increase in the risk of cardiovascular and cerebrovascular diseases. Moreover, most of the self-test blood pressure at home is carried out during the day. It is hot in summer, with long days and short nights. Many people will suffer from the decline of sleep quality, lack of sleep and increase of sympathetic nerve excitability, which will lead to the increase of blood pressure at night and in the morning, so the blood pressure is low during the day, not necessarily at night, especially for the elderly, and it is often high at night and in the morning. Hypertension at night and in the morning is hidden and harmful, because hypertension at night or in the morning is one of the high-risk factors of cardiovascular disease.

For some patients with excessive blood pressure or intolerable clinical symptoms, the dosage and variety of antihypertensive drugs can be adjusted appropriately, and diuretics can be removed from the varieties. For example, patients who have been taking losartan potassium hydrochlorothiazide as a single-chip compound preparation can remove the diuretic hydrochlorothiazide and take irbesartan as a single-chip preparation.

Do not advocate stopping using antihypertensive drugs. This is because the mechanism of hypertension is various, such as the increase of renin-angiotensin-aldosterone level, the high excitability of sympathetic nerve activation, high salt diet, obesity, atherosclerosis and other factors all participate in the increase of blood pressure level, which is the result of the interaction of many factors. Therefore, the decrease of blood pressure in summer does not mean the elimination of these initial factors, but the leading role of some factors is weakened. For example, the increase of vasodilation and perspiration in summer plays a role in lowering blood pressure to a certain extent, but it gets colder with the climate. And most patients' blood pressure will rise again within a few days after stopping taking the drug. It is necessary to make a new medication plan, which will lead to an increase in blood pressure fluctuation frequency, which is not conducive to stable blood pressure reduction.

Finally, many antihypertensive drugs, such as Puli angiotensin converting enzyme inhibitor and angiotensin 2 receptor antagonist of sartan, not only have antihypertensive effect, but also have protective effect on heart and kidney. They are drugs to improve the prognosis of patients with coronary heart disease, and should be taken for a long time regardless of hypertension. Similarly, for patients with coronary heart disease and chronic heart failure, β -blockers such as metoprolol are also drugs to improve prognosis, prevent myocardial infarction, delay the progress of heart failure, improve survival rate and prolong life span, and cannot be stopped easily. # Health Heat Energy Plan # # Health Science Qualification Competition # # Ballad Zero Zero Plan #