Section of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
Department of Cardiology, AP-HP Hôpitaux Universitaires Henri Mondor, Créteil, France.
Curr Hypertens Rep. 2022 Nov;24(11):535-546. doi: 10.1007/s11906-022-01213-5. Epub 2022 Jul 5.
Anti-hypertensive and lipid lowering therapy addresses only half of the cardiovascular disease risk in patients with body mass index > 30 kg/m, i.e., obesity. We examine newer aspects of obesity pathobiology that underlie the partial effectiveness of anti-hypertensive lipid lowering therapy for the reduction of cardiovascular disease risk in obesity.
Obesity-related insulin resistance, vascular endothelium dysfunction, increased sympathetic nervous system/renin-angiotensin-aldosterone system activity, and glomerulopathy lead to type 2 diabetes, coronary atherosclerosis, and chronic disease kidney disease that besides hypertension and dyslipidemia increase cardiovascular disease risk. Obesity increases cardiovascular disease risk through multiple pathways. Optimal reduction of cardiovascular disease risk in patients with obesity is likely to require therapy targeted at both obesity and obesity-associated conditions.
抗高血压和降脂治疗仅能解决体重指数（BMI）>30kg/m2 的患者一半的心血管疾病风险，即肥胖。我们研究肥胖发病机制的新方面，这些方面是抗高血压和降脂治疗降低肥胖患者心血管疾病风险的部分疗效的基础。
肥胖相关的胰岛素抵抗、血管内皮功能障碍、交感神经系统/肾素-血管紧张素-醛固酮系统活性增加以及肾小球病导致 2 型糖尿病、冠状动脉粥样硬化和慢性肾脏病，除了高血压和血脂异常外，还会增加心血管疾病的风险。肥胖通过多种途径增加心血管疾病的风险。肥胖患者心血管疾病风险的最佳降低可能需要针对肥胖和肥胖相关疾病的治疗。
