Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Curr Hypertens Rep. 2019 Feb 12;21(2):16. doi: 10.1007/s11906-019-0915-1.
Weight loss is strongly associated with improvement in blood pressure; however, the mechanism of weight loss can impact the magnitude and sustainability of blood pressure reduction.
Five drugs-orlistat, lorcaserin, liraglutide, phentermine/topiramate, and naltrexone/bupropion-are currently approved for weight loss therapy in the USA. Naltrexone/bupropion results in an increase in in-office and ambulatory blood pressure compared to placebo. Other therapies are associated with modest lowering of blood pressure, and are generally well-tolerated; nonetheless, evidence is limited regarding their effect on blood pressure, particularly longitudinally, in individuals with hypertension. Although weight loss medications can be an effective adjunct to lifestyle modifications in individuals with obesity, there is limited evidence regarding their benefit with regard to blood pressure. Future studies evaluating the effectiveness of weight loss medications should include careful assessment of their short- and long-term impact on blood pressure in individuals with hypertension.
体重减轻与血压改善密切相关；然而，体重减轻的机制会影响血压降低的幅度和可持续性。
目前在美国，有五种药物——奥利司他、lorcaserin、利拉鲁肽、 phentermine/托吡酯和纳曲酮/安非他酮——被批准用于减肥治疗。与安慰剂相比，纳曲酮/安非他酮会导致诊室和动态血压升高。其他疗法与血压适度降低有关，且一般耐受性良好；然而，关于它们对高血压患者血压的影响的证据有限，特别是在纵向研究中。虽然减肥药物可以作为肥胖患者生活方式改变的有效辅助手段，但关于它们在血压方面的益处的证据有限。未来评估减肥药物有效性的研究应包括仔细评估它们对高血压患者血压的短期和长期影响。
