D'Elia Lanfranco, Strazzullo Pasquale
Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, "Federico II" University of Naples Medical School, Via S. Pansini, 5, 80131, Naples, Italy.
High Blood Press Cardiovasc Prev. 2018 Mar;25(1):17-23. doi: 10.1007/s40292-017-0240-1. Epub 2017 Nov 2.
Isolated systolic hypertension, the most common form of hypertension in the elderly, but also detectable among young and middle-aged subjects, is independently associated with higher risk of cardiovascular events and all-cause mortality. Among various pathophysiological changes associated with aging, excess body weight and insulin resistance may predispose to this type of hypertension. Overweight or frank obesity and their frequent companion insulin resistance could mediate the development of isolated systolic hypertension through increase in the renin-angiotensin-aldosterone system activity, in the sympathetic tone and in salt-sensitivity, all in turn leading to endothelial dysfunction, arterial stiffness and increase in blood pressure. This review will focus on this cluster of pathophysiological factors and on the mechanistic pathways whereby they may favor the development of isolated systolic hypertension.
单纯收缩期高血压是老年人中最常见的高血压形式，但在年轻人和中年人中也可检测到，它与心血管事件风险增加和全因死亡率独立相关。在与衰老相关的各种病理生理变化中，体重超标和胰岛素抵抗可能易引发此类高血压。超重或明显肥胖及其常见的伴随情况胰岛素抵抗，可能通过增加肾素 - 血管紧张素 - 醛固酮系统活性、交感神经张力和盐敏感性来介导单纯收缩期高血压的发生，所有这些反过来又会导致内皮功能障碍、动脉僵硬和血压升高。本综述将聚焦于这一系列病理生理因素以及它们可能促进单纯收缩期高血压发生的机制途径。
