Renal Haemodynamic Studies in Obesity Hypertension
Renal Haemodynamic Studies in Obesity Hypertension
复制标题
肥胖症高血压的肾血流动力学研究
作者：
E. Reisin;F. Messerli;H. Ventura;E. Frohlich
先前的研究报道了肥胖高血压患者的全身血流动力学特征；然而，他们的肾脏血流动力学尚未被探索。本报告比较了肥胖和瘦弱的正常血压和高血压患者的肾脏和全身血流动力学结果。我们的研究结果表明，与瘦弱的正常血压和高血压患者相比，正常血压和高血压肥胖患者的肾血流量、总血容量和心输出量增加，总外周血管和肾血管阻力降低。体重与总血容量、心输出量和肾血流量直接显著相关，但与总外周阻力间接相关。因此，肥胖患者的心输出量升高和体积扩张与肾脏灌注增加有关；这种增加的肾血流量是肥胖高血压患者肾血管阻力降低的原因。因此，我们认为肥胖的这种体积扩张效应可以抵消高血压疾病产生的主动血管收缩的相反作用，并可能解释肥胖和瘦弱高血压患者预后的差异。
Previous investigations have reported the systemic haemodynamic characteristics of obese hypertensive patients; however, their renal haemodynamics have not been explored. This report compares the renal and systemic haemodynamic findings in obese and lean normotensive and hypertensive patients. Our results demonstrate that both normotensive and hypertensive obese subjects had an increased renal blood flow, total blood volume and cardiac output, with decreased total peripheral and renal vascular resistances in comparison with lean normotensive and hypertensive patients. Body weight correlated directly and significantly with total blood volume, cardiac output and renal blood flow but indirectly with total peripheral resistance. Therefore, the elevated cardiac output and volume expansion found in obese patients were associated with increased renal perfusion; this increased renal blood flow accounts for the reduced renal vascular resistance in patients with obesity hypertension. Thus, we suggest that this effect of volume expansion in obesity could counteract the opposing effect of active vasoconstriction produced by the hypertensive disease and may account for the difference in prognosis of obese and lean hypertensive patients.