Mechanisms linking obesity to hypertension
Mechanisms linking obesity to hypertension
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DOI：
10.1111/j.1467-789x.2011.00914.x
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发表时间：
2012-01-01
期刊：
影响因子：
8.9
通讯作者：
Spiering, W.
中科院分区：
文献类型：
--
作者：
Dorresteijn, J. A. N.;Visseren, F. L. J.;Spiering, W.
肥胖相关性高血压越来越被认为是一种独特的高血压表型，需要改进诊断和管理方法。在这篇评论中，迅速发展的洞察力的复杂性和相互依赖的机制联系肥胖高血压进行了讨论。超重和肥胖与脂肪组织功能障碍有关，其特征在于肥大的脂肪细胞增大、巨噬细胞浸润增加以及脂肪因子和游离脂肪酸分泌的显著变化。这导致慢性血管炎症、氧化应激、激活肾素-血管紧张素-醛固酮系统和交感神经系统，最终导致高血压。这些机制可能为抗高血压药物治疗提供新的靶点。认识到肥胖相关的高血压作为一个独特的诊断，使定制的治疗在临床实践中。这包括改变生活方式和适当选择降血压药物。
Obesity-related hypertension is increasingly recognized as a distinct hypertensive phenotype requiring a modified approach to diagnosis and management. In this review rapidly evolving insights into the complex and interdependent mechanisms linking obesity to hypertension are discussed. Overweight and obesity are associated with adipose tissue dysfunction, characterized by enlarged hypertrophied adipocytes, increased infiltration by macrophages and marked changes in secretion of adipokines and free fatty acids. This results in chronic vascular inflammation, oxidative stress, activation of the renin-angiotensin-aldosterone system and sympathetic overdrive, eventually leading to hypertension. These mechanisms may provide novel targets for anti-hypertensive drug treatment. Recognition of obesity-related hypertension as a distinct diagnosis enables tailored therapy in clinical practice. This includes lifestyle modification and accommodated choice of blood pressure-lowering drugs.