Falkner Bonita
Departments of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Am Soc Hypertens. 2008 Jul-Aug;2(4):267-74. doi: 10.1016/j.jash.2008.01.003. Epub 2008 Jun 2.
Hypertension and obesity are both common health problems in children and adolescents. More than 17% of children are obese and even more children are overweight. Hypertension, although defined differently in children than in adults, can be detected in 3% to 4% of children, and approximately 30% of obese adolescents have high blood pressure (BP) associated with obesity. Children with high BP and obesity frequently have other risk factors that are components of the metabolic syndrome. Evidence of target organ damage, including left ventricular hypertrophy, is detectable in many children with hypertension and is more commonly found in children with high BP and obesity. Both obesity and hypertension are considered inflammatory conditions. There are some emerging data in the young that show an association of insulin resistance, obesity, and high BP with inflammatory markers. Children and adolescents with hypertension and especially obesity-associated hypertension can be identified and should be evaluated for additional metabolic risk factors. Considering the heightened risk for premature cardiovascular (CV) disease, therapeutic interventions, including lifestyle changes and medications, when indicated, are important for all children and adolescents with obesity-associated hypertension.
高血压和肥胖都是儿童及青少年常见的健康问题。超过17%的儿童肥胖，甚至更多儿童超重。高血压在儿童中的定义与成人不同，3%至4%的儿童可检测出高血压，约30%的肥胖青少年患有与肥胖相关的高血压。患有高血压和肥胖的儿童经常有其他作为代谢综合征组成部分的危险因素。在许多高血压儿童中可检测到包括左心室肥厚在内的靶器官损害证据，在患有高血压和肥胖的儿童中更常见。肥胖和高血压都被视为炎症性疾病。在年轻人中有一些新数据显示胰岛素抵抗、肥胖和高血压与炎症标志物有关联。患有高血压尤其是肥胖相关性高血压的儿童和青少年可以被识别出来，并且应该评估是否存在其他代谢危险因素。鉴于过早发生心血管疾病的风险增加，对于所有患有肥胖相关性高血压的儿童和青少年而言，包括生活方式改变和必要时药物治疗在内的治疗性干预措施很重要。
