Mechanisms of hypertension in the overweight.
Mechanisms of hypertension in the overweight.
复制标题
超重高血压的机制。
作者：
E. Sims
我们正处于一个对轻度和中度高血压的管理进行重新评估的时期。美国退伍军人管理局在近20年前开始的研究表明，高血压的药物治疗明显降低了发病率和死亡率。自那时以来，大规模的对照研究要么将一种药物与另一种药物的效果进行比较，要么将一种或多种药物与社区常规护理的效果进行比较。然而，人们越来越感到不安的是，在数百万服用长期副作用已知和未知的药物的患者中，许多人可能这样做是不适当的。几年前，在一项停用高血压药物或替代安慰剂的延长试验中，杜斯坦等人说。研究发现，相对较少的高血压患者可以在不用药的情况下持续降压。然而，最近Finnerty在一大系列患者中表明，在不损害降压效果的情况下，可以减少降压药的总剂量或数量，并显著减少药物的不良症状。然而，在这两项研究中，都没有尝试用非药理学方法来替代药理学措施。值得注意的是，高血压患者往往是一组超重的患者，在大多数大型系列中，患者的平均体重比理想体重高30%，而且代谢紊乱，如非胰岛素依赖型糖尿病和高脂血症，往往与此相关。1979年美国国立卫生研究院高血压工作组的报告敦促关注超重的特殊问题
WE are in a period in which the management of mild and moderate hypertension is being reevaluated. The U.S. Veterans Administration studies initiated nearly 20 years ago indicated that drug treatment of hypertension clearly reduced morbidity and mortality. Large scale controlled studies since that time have either compared the effect of one drug with another or of one or more drugs with that of usual care in the community. There is, however, an increasing uneasiness that many of the million of patients taking drugs with known and unknown longterm side effects may be doing so inappropriately. Some years ago in an extended trial of withdrawal of hypertension drugs or substitution of a placebo, Dustan et al. found that relatively few hypertension patients could sustain their reduction of blood pressure without medication. However, more recently Finnerty has shown in a large series of patients that the total dosage or the number of antihypertensive drugs can be reduced without impairing the antihypertensive effect and with considerable reduction in adverse symptoms of medication. In neither of these studies, however, was an attempt made to substitute nonpharmacologic for pharmacologic measures. It is noteworthy that hypertensives tend to be an overweight group of patients, with a mean of 30% above ideal weight in most large series, and that metabolic derangements such as noninsulin-dependent diabetes and hyperlipidemia are often associated. The 1979 Report of the Hypertension Task Force of the National Institutes of Health urged that attention be given to the special problems of the overweight
饮食和交感神经系统：与高血压的关系。
影响因子：
4.9
作者：
Landsberg,L;Young,JB
通讯作者：
Young,JB
运动在治疗肥胖症高血压中的作用。
影响因子：
4.9
作者：
Horton,ES
通讯作者：
Horton,ES