Fudaiwen (valsartan hydrochlorothiazide tablets) has unique advantages in elderly hypertension and salt sensitive hypertension. Its synergistic mechanism of ARB and diuretics can improve the pathological and physiological characteristics of these two types of patients in a targeted manner. At the same time, attention should be paid to dose adjustment and monitoring points for special populations.

1. Application of elderly hypertension

(1) Advantages of blood pressure reduction: Elderly patients often have reduced RAAS activity and increased volume load. Compound therapy is more likely to achieve blood pressure control through a dual mechanism and can reduce adverse reactions of high-dose monotherapy.

(2) Dose adjustment: It is recommended to start with a low dose (such as 80/12.5mg) and gradually increase according to tolerance. Due to the sensitivity of elderly people to changes in blood volume, caution should be taken against first dose hypotension.

(3) Monitoring focus: Regular assessment of renal function (every 3-6 months) and electrolytes (especially blood potassium), and attention should be paid to orthostatic hypotension in patients with concomitant arteriosclerosis.

2. Application of salt sensitive hypertension

(1) Mechanism adaptation: Sodium excretion disorders in salt sensitive individuals lead to capacity expansion, hydrochlorothiazide promotes sodium excretion, valsartan blocks excessive vasoconstriction caused by high salt diets, and synergistically improves blood pressure salt sensitivity.

(2) Clinical evidence: Studies have shown that for patients with high salt intake, combination therapy can reduce systolic blood pressure by an additional 5-10mmHg compared to using ARB alone, especially suitable for the high salt diet population in China.

(3) Individualized strategy: The dosage of diuretics should be adjusted in conjunction with 24-hour urine sodium testing, and it is recommended to limit daily salt intake to<6g to enhance efficacy.

3. Precautions for combination therapy

(1) Elderly patients: Avoid using strong diuretics in combination to prevent insufficient capacity, and monitor the degree of ankle edema when used in combination with CCB.

(2) Salt sensitive individuals: Long term use should pay attention to metabolic effects, such as hydrochlorothiazide may exacerbate insulin resistance, and may be combined with thiazolidinedione drugs if necessary.

(3) Seasonal adjustment: When sweating increases in summer, elderly and salt sensitive patients can reduce the dosage of hydrochlorothiazide as appropriate to prevent dehydration induced hypotension.