Rascher W, Kiess W, Körner A
Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Loschgestr. 15, 91054, Erlangen, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Apr;56(4):492-9. doi: 10.1007/s00103-012-1638-5.
Obesity is also an important risk factor in children and adolescents for "essential" arterial hypertension, and contrary to what was assumed earlier, high blood pressure does cause damage to the cardiovascular system. As known from adults, elevated blood pressure induces cardiac hypertrophy, calcifications and atherosclerosis at the coronary vessels and thickens the small blood vessels. These early vascular alterations are particularly pronounced, when increased blood pressure is accompanied by other risk factors, such as dyslipidemia, hyperinsulinemia or smoking. As in any child with elevated blood pressure, the diagnostic evaluation should focus on confirmation of hypertension, determine if an underlying cause can be identified and whether hypertensive target organ damage is present. New reference office blood pressure values were recently published by a large representative community-based study in Germany. Therapy should begin with lifestyle modifications; however, antihypertensive medications will often be needed. Hypertension in obese adolescents occurs frequently and must be diagnosed and treated adequately.
肥胖也是儿童和青少年患“原发性”动脉高血压的重要危险因素，与之前的假设相反，高血压确实会对心血管系统造成损害。正如在成年人中所知，血压升高会导致心脏肥大、冠状动脉钙化和动脉粥样硬化，并使小血管增厚。当血压升高伴有其他危险因素，如血脂异常、高胰岛素血症或吸烟时，这些早期血管改变会更加明显。对于任何血压升高的儿童，诊断评估应侧重于确认高血压，确定是否能找出潜在病因以及是否存在高血压靶器官损害。德国一项大型代表性社区研究最近公布了新的诊室血压参考值。治疗应从生活方式改变开始；然而，通常还需要使用抗高血压药物。肥胖青少年中高血压很常见，必须进行充分的诊断和治疗。
