Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Obes Rev. 2012 Jan;13(1):17-26. doi: 10.1111/j.1467-789X.2011.00914.x. Epub 2011 Aug 10.
Obesity-related hypertension is increasingly recognized as a distinct hypertensive phenotype requiring a modified approach to diagnosis and management. In this review rapidly evolving insights into the complex and interdependent mechanisms linking obesity to hypertension are discussed. Overweight and obesity are associated with adipose tissue dysfunction, characterized by enlarged hypertrophied adipocytes, increased infiltration by macrophages and marked changes in secretion of adipokines and free fatty acids. This results in chronic vascular inflammation, oxidative stress, activation of the renin-angiotensin-aldosterone system and sympathetic overdrive, eventually leading to hypertension. These mechanisms may provide novel targets for anti-hypertensive drug treatment. Recognition of obesity-related hypertension as a distinct diagnosis enables tailored therapy in clinical practice. This includes lifestyle modification and accommodated choice of blood pressure-lowering drugs.
肥胖相关性高血压越来越被认为是一种特殊的高血压表型，需要采用改良的诊断和治疗方法。本文讨论了肥胖与高血压之间复杂且相互依存的机制的最新研究进展。超重和肥胖与脂肪组织功能障碍有关，其特征为脂肪细胞增大、肥大、巨噬细胞浸润增加以及脂肪因子和游离脂肪酸的分泌明显改变。这导致慢性血管炎症、氧化应激、肾素-血管紧张素-醛固酮系统和交感神经兴奋过度，最终导致高血压。这些机制可能为抗高血压药物治疗提供新的靶点。将肥胖相关性高血压视为一种特殊的诊断，可以在临床实践中进行针对性的治疗。这包括生活方式的改变和降压药物的选择。
