Obesity-Related Hypertension in Children.
Obesity-Related Hypertension in Children.
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DOI：
10.3389/fped.2017.00197
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发表时间：
2017
影响因子：
2.6
通讯作者：
Brady TM
中科院分区：
文献类型：
--
作者：
Brady TM
肥胖症和高血压在儿童中都呈上升趋势。每一种都与心血管疾病的风险增加有关，并且两者都会进入成年期，增加心脏病的患病率以及相关的发病率和死亡率。所有儿童都应接受高血压筛查，但合并肥胖的儿童不仅可能特别受益于筛查，而且可能是最具挑战性的筛查。当试图获得准确的血压（BP）测量时，增加的臂围和圆锥形臂形状尤其成问题。本文综述了合并肥胖儿童高血压评估和管理的独特方面。强调了可能导致肥胖儿童血压升高的特定传统和非传统危险因素。本文综述了目前提出的肥胖可能导致血压升高和高血压的病理生理机制，重点讨论了交感神经系统和肾素-血管紧张素-醛固酮系统的作用。本综述还提出了一种针对肥胖相关高血压儿童的靶向治疗方法，为推荐的治疗性生活方式改变提供了证据，这应该成为这类高危儿童抗高血压治疗计划的基础。本文还综述了特定药物治疗肥胖相关性高血压的优势。
Obesity and hypertension have both been on the rise in children. Each is associated with increased cardiovascular disease risk and both track into adulthood, increasing the prevalence of heart disease and related morbidity and mortality. All children should be screened for hypertension, but children with comorbid obesity may not only particularly benefit from the screening but may also prove the most challenging to screen. Increased arm circumference and conical arm shape are particularly problematic when attempting to obtain an accurate blood pressure (BP) measurement. This review focuses on the unique aspects of hypertension evaluation and management in the child with comorbid obesity. Specific traditional and non-traditional risk factors that may contribute to elevated BP in children with obesity are highlighted. Current proposed pathophysiologic mechanisms by which obesity may contribute to elevated BP and hypertension is reviewed, with focus on the role of the sympathetic nervous system and the renin–angiotensin–aldosterone system. This review also presents a targeted treatment approach to children with obesity-related hypertension, providing evidence for the recommended therapeutic lifestyle change that should form the basis of any antihypertensive treatment plan in this population of at-risk children. Advantages of specific pharmacologic agents in the treatment of obesity-related hypertension are also reviewed.
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影响因子：
8.9
作者：
Dorresteijn, J. A. N.;Visseren, F. L. J.;Spiering, W.
通讯作者：
Spiering, W.
DOI：
10.1136/bmj.e4759
发表时间：
2012-09-25
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Friedemann C;Heneghan C;Mahtani K;Thompson M;Perera R;Ward AM
通讯作者：
Ward AM
影响因子：
8.3
作者：
Engeli, S;Bohnke, J;Sharma, AM
通讯作者：
Sharma, AM
影响因子：
5.1
作者：
Sorof, JM;Poffenbarger, T;Portman, RJ
通讯作者：
Portman, RJ
影响因子：
3.2
作者：
Lambert, Elisabeth A.;Chatzivlastou, Kanella;Head, Geoffrey A.
通讯作者：
Head, Geoffrey A.