de Faria Ana Paula, Modolo Rodrigo, Fontana Vanessa, Moreno Heitor
Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
J Clin Hypertens (Greenwich). 2014 Oct;16(10):754-9. doi: 10.1111/jch.12399. Epub 2014 Sep 4.
Resistant hypertension (RH) is a multifactorial disease, frequently associated with obesity and characterized by blood pressure above goal (140/90 mm Hg) despite the concurrent use of ≥3 antihypertensive drugs of different classes. The mechanisms of obesity-related hypertension include, among others, aldosterone excess and inflammatory adipokines, which have demonstrated a significant role in the pathogenesis of metabolic syndrome and RH. This review aims to summarize recent studies on the role of the adipokines leptin, resistin, and adiponectin in the pathophysiology of RH and target-organ damage associated with this condition. The deregulation of adipokine levels has been associated with clinical characteristics frequently recognized in RH such as diabetes, hyperactivity of sympathetic and renin-angiotensin-aldosterone systems, and vascular and renal damage. Strategies to regulate adipokines may be promising for the management of RH and some clinical implications must be considered when managing controlled and uncontrolled patients with RH.
顽固性高血压（RH）是一种多因素疾病，常与肥胖相关，其特征是尽管同时使用了≥3种不同类别的抗高血压药物，但血压仍高于目标值（140/90 mmHg）。肥胖相关高血压的机制包括醛固酮过多和炎性脂肪因子等，这些因素已在代谢综合征和RH的发病机制中显示出重要作用。本综述旨在总结近期关于脂肪因子瘦素、抵抗素和脂联素在RH病理生理学以及与此病症相关的靶器官损伤中作用的研究。脂肪因子水平失调与RH中常见的临床特征相关，如糖尿病、交感神经和肾素 - 血管紧张素 - 醛固酮系统的亢进以及血管和肾脏损伤。调节脂肪因子的策略可能对RH的管理具有前景，并且在管理RH控制和未控制的患者时必须考虑一些临床意义。
