As an angiotensin-converting enzyme inhibitor, the antihypertensive effect and dosage adjustment of Longes should follow the principle of individualization. The following is a detailed explanation of the antihypertensive mechanism, standard dosage, and clinical application of the drug.

1. Mechanism of blood pressure lowering effect

(1) By inhibiting angiotensin-converting enzyme and reducing the production of angiotensin II, peripheral blood vessels can be directly dilated.

(2) Reduce aldosterone secretion, reduce sodium and water retention, and achieve blood pressure control.

(3) It takes effect 1 hour after a single administration, reaches peak effect 6 hours, and lasts for more than 24 hours.

2. Standard Dose Guidelines

(1) Primary hypertension: initial dose 10mg once daily, maintenance dose 20-40mg once daily.

(2) Renal hypertension: The initial dose is 2.5-5mg once daily, adjusted according to renal function.

(3) Heart failure patients: The initial dose is 2.5mg once daily, gradually titrated to the tolerated dose.

3. Principle of dose adjustment

(1) Renal insufficiency: The dose is halved when creatinine clearance rate is 10-30ml/min, and 1/4 dose is used when creatinine clearance rate is<10ml/min.

(2) Elderly people: It is recommended to start from 5mg and gradually adjust to the target blood pressure.

(3) Dialysis patients: Administer medication after dialysis, with an initial dose of 2.5mg, adjusted according to blood pressure response.

4. Efficacy evaluation criteria

(1) Evaluate the antihypertensive effect 2-4 weeks after treatment, with a compliance rate of approximately 60-70%.

(2) 24-hour dynamic blood pressure monitoring shows stable blood pressure reduction, with a trough to peak ratio greater than 50%.

(3) When using combination therapy, dose complementarity should be considered to avoid excessive blood pressure reduction.