Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Piazzale Stefani 1, 37126 Verona, Italy.
Nutrients. 2019 Jul 21;11(7):1667. doi: 10.3390/nu11071667.
Arterial hypertension is strongly related to overweight and obesity. In obese subjects, several mechanisms may lead to hypertension such as insulin and leptin resistance, perivascular adipose tissue dysfunction, renal impairment, renin-angiotensin-aldosterone-system activation and sympathetic nervous system activity. Weight loss (WL) seems to have positive effects on blood pressure (BP). The aim of this review was to explain the mechanisms linking obesity and hypertension and to evaluate the main studies assessing the effect of WL on BP. We analysed studies published in the last 10 years (13 studies either interventional or observational) showing the effect of WL on BP. Different WL strategies were taken into account-diet and lifestyle modification, pharmacological intervention and bariatric surgery. Although a positive effect of WL could be identified in each study, the main difference seems to be the magnitude and the durability of BP reduction over time. Nevertheless, further follow-up data are needed: there is still a lack of evidence about long term effects of WL on hypertension. Hence, given the significant results obtained in several recent studies, weight management should always be pursued in obese patients with hypertension.
动脉高血压与超重和肥胖密切相关。在肥胖人群中，多种机制可能导致高血压，如胰岛素和瘦素抵抗、血管周围脂肪组织功能障碍、肾功能损害、肾素-血管紧张素-醛固酮系统激活和交感神经系统活性。体重减轻（WL）似乎对血压（BP）有积极影响。本综述旨在解释肥胖与高血压之间的联系，并评估评估 WL 对 BP 影响的主要研究。我们分析了过去 10 年发表的研究（13 项干预或观察性研究），这些研究显示了 WL 对 BP 的影响。考虑了不同的 WL 策略——饮食和生活方式的改变、药物干预和减重手术。尽管每项研究都能确定 WL 的积极作用，但主要的区别似乎在于随着时间的推移血压降低的幅度和持久性。然而，还需要进一步的随访数据：关于 WL 对高血压的长期影响仍缺乏证据。因此，鉴于最近几项研究取得的显著结果，超重和高血压患者应始终进行体重管理。
