Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit, San Filippo Neri Hospital-Salus Infirmorum Clinic, Rome, Italy.
Physical Medicine and Neurorehabilitation Operative Unit, Salus Infirmorum Clinic, Rome, Italy.
Hypertens Res. 2017 Dec;40(12):947-963. doi: 10.1038/hr.2017.75. Epub 2017 Oct 5.
Obesity is a growing global health concern, with a rapid increase being observed in morbid obesity. Obesity is associated with an increased cardiovascular risk and earlier onset of cardiovascular morbidity. The growing obesity epidemic is a major source of unsustainable health costs and morbidity and mortality because of hypertension, type 2 diabetes mellitus, dyslipidemia, certain cancers and major cardiovascular diseases. Similar to obesity, hypertension is a key unfavorable health metric that has disastrous health implications: currently, hypertension is the leading contributor to global disease burden, and the direct and indirect costs of treating hypertension are exponentially higher. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult-to-treat phenotypes: excess body mass is such an example, facilitating a cascade of pathophysiological sequelae that create such as a direct obesity-hypertension link, which consequently increases cardiovascular risk. Although some significant issues regarding assessment/management of obesity remain to be addressed and the underlying mechanisms governing these disparate effects of obesity on cardiovascular disease are complex and not completely understood, a variety of factors could have a critical role. Consequently, a comprehensive and exhaustive investigation of this relationship should analyze the pathogenetic factors and pathophysiological mechanisms linking obesity to hypertension as they provide the basis for a rational therapeutic strategy in the aim to fully describe and understand the obesity-hypertension link and discuss strategies to address the potential negative consequences from the perspective of both primordial prevention and treatment for those already impacted by this condition.
肥胖是一个日益严重的全球健康问题,病态肥胖的发病率迅速上升。肥胖与心血管风险增加和心血管发病率提前有关。不断增长的肥胖流行是不可持续的健康成本和发病率及死亡率的主要来源,因为肥胖与高血压、2 型糖尿病、血脂异常、某些癌症和主要心血管疾病有关。与肥胖类似,高血压是一个关键的不利健康指标,会对健康产生灾难性的影响:目前,高血压是全球疾病负担的主要原因,治疗高血压的直接和间接成本呈指数级增长。不良的生活方式特征和健康指标往往聚集在一起,形成复杂且难以治疗的表型:超重就是一个例子,它会引发一系列病理生理后果,例如直接的肥胖-高血压关联,从而增加心血管风险。尽管在评估/管理肥胖方面仍存在一些重大问题,并且肥胖对心血管疾病的这些不同影响的潜在机制复杂且尚未完全理解,但许多因素可能起着关键作用。因此,全面详尽地研究这种关系应该分析肥胖与高血压相关的发病因素和病理生理机制,因为它们为针对肥胖-高血压关联的合理治疗策略提供了基础,并讨论从原发性预防和治疗的角度来看,针对这一状况的潜在负面影响的策略。