Girerd Xavier, Hansel Boris
Service d'endocrinologie métabolisme, Hôpital de la Pitié, F-75013 Paris, France.
Presse Med. 2009 Apr;38(4):609-13. doi: 10.1016/j.lpm.2009.01.006. Epub 2009 Feb 23.
Obesity is a major risk factor for hypertension. Adipose tissue releases numerous substances that act on the pathophysiologic mechanisms of blood pressure. Management of obese patients with high blood pressure includes weight loss efforts, but antihypertensive treatment is most often necessary. Beta-blockers, alone or with thiazide diuretics, increase the risk of diabetes in hypertensive patients. Treatment against hypertension must include a renin-angiotensin system blocker, with a calcium channel blocker or a thiazide diuretic, if necessary.
肥胖是高血压的主要危险因素。脂肪组织会释放多种作用于血压病理生理机制的物质。对肥胖高血压患者的管理包括努力减重,但通常也需要进行抗高血压治疗。β受体阻滞剂单独使用或与噻嗪类利尿剂联合使用,会增加高血压患者患糖尿病的风险。抗高血压治疗必须包括一种肾素 - 血管紧张素系统阻滞剂,必要时可加用钙通道阻滞剂或噻嗪类利尿剂。