Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
Curr Hypertens Rep. 2013 Oct;15(5):470-4. doi: 10.1007/s11906-013-0374-z.
Hypertension and obesity often coexist, exposing patients to cardiovascular and metabolic risks, particularly type 2 diabetes mellitus. Moreover, obesity may render hypertensive patients treatment resistant. We review how drugs recently approved for obesity or type 2 diabetes mellitus treatment affect blood pressure. The weight-reducing drug lorcaserin induces modest reductions in body weight while slightly improving blood pressure. The fixed low-dose topiramate/phentermine combinations elicit larger reductions in body weight and blood pressure. Concomitant improvements in glucose metabolism, adiposity, and blood pressure differentiate the first clinically available SGLT2 inhibitor dapagliflozin from other oral antidiabetic drugs. Yet, the mechanisms through which metabolic drugs affect blood pressure and their interaction with antihypertensive drugs are poorly understood. Blood pressure-lowering effects of metabolic drugs could be exploited in the clinical management of obese hypertensive patients with and without type 2 diabetes mellitus, particularly in patients with difficult to control arterial hypertension.
高血压和肥胖症常并存，使患者面临心血管和代谢风险，尤其是 2 型糖尿病。此外，肥胖可能使高血压患者对治疗产生抵抗。我们回顾了最近批准用于肥胖或 2 型糖尿病治疗的药物如何影响血压。减重药物lorcaserin 可适度降低体重，同时略微改善血压。固定低剂量托吡酯/安非他酮联合用药可更大幅度地降低体重和血压。葡萄糖代谢、肥胖和血压的同时改善将首个临床可用的 SGLT2 抑制剂达格列净与其他口服抗糖尿病药物区分开来。然而，代谢药物影响血压的机制及其与降压药物的相互作用仍知之甚少。代谢药物的降压作用可在肥胖高血压患者（伴或不伴 2 型糖尿病）的临床管理中得到利用，特别是在难以控制的动脉高血压患者中。
