Hypertension in Obesity and the Impact of Weight Loss

被引:95
|
作者
Cohen, Jordana B. [1 ]
机构
[1] Hosp Univ Penn, Renal Electrolyte & Hypertens Div, 3400 Spruce St,1 Founders, Philadelphia, PA 19104 USA
关键词
Obesity; Morbid obesity; Hypertension; Antihypertensive; Bariatric surgery; Weight loss; BODY-MASS INDEX; MINERALOCORTICOID RECEPTOR ANTAGONISM; HYDROCHLOROTHIAZIDE-BASED THERAPY; DISEASE RISK-FACTORS; BARIATRIC SURGERY; CARDIOVASCULAR-DISEASE; BLOOD-PRESSURE; UNITED-STATES; ENDOTHELIAL FUNCTION; INSULIN-RESISTANCE;
D O I
10.1007/s11886-017-0912-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review Several interrelated mechanisms promote the development of hypertension in obesity, often contributing to end organ damage including cardiovascular disease and chronic kidney disease. Recent Findings The treatment of hypertension in obesity is complicated by a high prevalence of resistant hypertension, as well as unpredictable hemodynamic effects of many medications. Weight loss stabilizes neurohormonal activity and causes clinically significant reductions in blood pressure. While lifestyle interventions can improve blood pressure, they fail to consistently yield sustained weight loss and have not demonstrated long-term benefits. Bariatric surgery provides more permanent weight reduction, corresponding with dramatic declines in blood pressure and attenuation of longterm cardiovascular risk. Summary Hypertension is closely linked to the prevalence, pathophysiology, and morbidity of obesity. There are multiple barriers to managing hypertension in obesity. Surgical weight loss offers the most promise in reducing blood pressure and decreasing end organ damage in this patient population.
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页数:8
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