Pediatric Cardiology, Johns Hopkins University, Bloomberg Children's Center, 1800 Orleans Street, M2303, Baltimore, MD, 21287, USA.
Division of Pediatric Nephrology, Johns Hopkins University, David M. Rubenstein Child Health Building, 200 N. Wolfe Street, Baltimore, MD, 21287, USA.
Curr Hypertens Rep. 2019 Feb 12;21(2):18. doi: 10.1007/s11906-019-0922-2.
To review the most recent literature on current strategies for the treatment of hypertension associated with pediatric obesity.
Over the last three decades, childhood and adolescent overweight and obesity prevalence in the USA has continued to rise. Unsurprisingly but rather disturbingly, this rising prevalence has been paralleled by an increase in cardiovascular disease (CVD) risk factors in childhood such as hypertension, dyslipidemia, and diabetes that become manifest earlier than previously reported. These childhood CVD risk factors are not only associated with target organ damage in childhood but also track into adulthood, increasing the risk of long-term CVD morbidity and mortality. There have been several mechanisms proposed to explain the role of obesity on the development of hypertension in childhood. However, central to the management of obesity-related hypertension is a multifaceted approach targeting lifestyle modifications and weight loss. Effective treatment often also requires a pharmacologic approach and rarely bariatric surgery.
综述与小儿肥胖相关的高血压治疗的最新文献。
过去三十年来，美国儿童和青少年超重及肥胖的患病率持续上升。毫不奇怪，但令人不安的是，这种患病率的上升与儿童期心血管疾病（CVD）危险因素的增加相平行，如高血压、血脂异常和糖尿病，这些疾病比以前报道的更早出现。这些儿童 CVD 危险因素不仅与儿童期靶器官损害有关，而且还会持续到成年期，增加长期 CVD 发病率和死亡率的风险。有几种机制被提出来解释肥胖在儿童高血压发展中的作用。然而，肥胖相关高血压的管理的核心是一种针对生活方式改变和减肥的多方面方法。有效的治疗通常还需要药物治疗，很少需要进行减肥手术。
