✅ What are the medications for high blood pressure for the treatment of gout
Отзывы What are the medications for high blood pressure for the treatment of gout
Ang arteryal na hypertension o hypertension ay isang kondisyon ng patuloy na systolic at diastolic na presyon ng dugo, kung saan ang mga sukatan ay lumalagpas sa 140/90 mmHg. Ang mataas na presyon ay nagpapakita ng mga hindi komportableng sintomas. Отзывы о What are the medications for high blood pressure for the treatment of gout
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Купить What are the medications for high blood pressure for the treatment of gout
What are the medications for high blood pressure for the treatment of gout?
High blood pressure (arterial hypertension) and gout (gouty arthritis) are two common diseases that often occur at the same time. In patients with both diseases, the question of an optimal drug selection arises: on the one Hand, the blood pressure to be reduced effectively, on the other hand, the therapy may aggravate the gout.
Pathophysiological Contexts
In gout it is due to a disturbed purine metabolism exchange to an increased concentration of uric acid (urine
a
ure>6.8 mg/dL) in the blood (hyperuricemia). This leads to the deposition of monosodium uratkristallen in the joints and other tissues, causing inflammatory attacks of Gout. Some antihypertensive drugs can the level of uric acid influence — partly positive, partly negative.
Medicines for high blood pressure: effects on gout
Thiazide diuretics (e.g. hydrochlorothiazide)
Effect on blood pressure: Effective reduction in blood pressure by reducing blood volume.
Effect on the gout: Increase the level of uric acid by inhibiting the renal uric acid excretion. Should be avoided in patients with gout as soon as possible.
Loop diuretics (e.g., furosemide)
Effect on blood pressure: a Strong diuresis and reduction in blood pressure.
Effect on the gout: Similar to Thiazides increase of uric acid concentration. Not recommended for use in existing gout.
ACE inhibitors (e.g., Ramipril, Enalapril)
Effect on blood pressure: the blood pressure reduction through inhibition of the Renin‑Angiotensin‑aldosterone system (RAAS).
Effect on the gout: Show a mild uricosuric effect (leading to an increased excretion of uric acid). Suitable for patients with hypertension and gout.
AT1‑receptor blockers (Sartans) (eg, Losartan)
Effect on blood pressure: Similar mechanisms of action, such as ACE inhibitors.
Effect on the gout: Losartan has a pronounced uricosuric property and lowers the level of uric acid. Especially suitable for the combination of hypertension and gout.
Calcium channel blockers (e.g., amlodipine, Felodipine)
Effect on blood pressure: a Vasodilator effect and reduction in blood pressure.
Effect on the gout: a Neutral effect on the level of uric acid. Well tolerated and is recommended for gout.
Beta-blockers (e.g., Metoprolol, Bisoprolol)
Effect on blood pressure reduction in the Cardiac output and thus blood pressure.
Effect on the gout: Mostly neutral, some can increase the uric acid level easily. Possible, but not the first choice.
Therapeutic Recommendations
For patients with concomitant arterial hypertension and gout, the following principles shall apply:
Preferred Drugs:
Losartan (Sartan with urikosurischer effect)
ACE inhibitors (mild uricosuric effect)
Calcium channel blockers (neutral with respect to uric acid)
Drugs with restrictions:
Beta-blockers (with caution)
To avoid:
Thiazide diuretics
Loop Diuretics
Summary
The choice of antihypertensive agents in patients with gout requires special attention. While diuretics can increase the level of uric acid and gout can predispose them to seizures, offer ACE inhibitors, Sartans (in particular, Losartan) and a calcium channel blocker, a cheap Alternative. An individual risk‑Benefit analysis, taking into account co-morbidities, side effects and life-style factors is crucial for a successful long-term therapy.
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