Hu Yilan, Bao Jiaqi, Gao Zhicheng, Ye Lifang, Wang Lihong
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.
Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Jan 26;17:407-415. doi: 10.2147/DMSO.S446904. eCollection 2024.
Obesity is becoming increasingly prevalent in China and worldwide and is closely related to the development of hypertension. The pathophysiology of obesity-associated hypertension is complex, including an overactive sympathetic nervous system (SNS), activation of the renin-angiotensin-aldosterone system (RAAS), insulin resistance, hyperleptinemia, renal dysfunction, inflammatory responses, and endothelial function, which complicates treatment. Sodium-glucose cotransporter protein 2 (SGLT-2) inhibitors, novel hypoglycemic agents, have been shown to reduce body weight and blood pressure and may serve as potential novel agents for the treatment of obesity-associated hypertension. This review discusses the beneficial mechanisms of SGLT-2 inhibitors for the treatment of obesity-associated hypertension. SGLT-2 inhibitors can inhibit SNS activity, reduce RAAS activation, ameliorate insulin resistance, reduce leptin secretion, improve renal function, and inhibit inflammatory responses. SGLT-2 inhibitors can, therefore, simultaneously target multiple mechanisms of obesity-associated hypertension and may serve as an effective treatment for obesity-associated hypertension.
肥胖在中国乃至全球正变得越来越普遍，并且与高血压的发展密切相关。肥胖相关性高血压的病理生理学很复杂，包括交感神经系统（SNS）过度活跃、肾素-血管紧张素-醛固酮系统（RAAS）激活、胰岛素抵抗、高瘦素血症、肾功能障碍、炎症反应以及内皮功能，这些使得治疗变得复杂。钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂作为新型降糖药物，已被证明可减轻体重和降低血压，可能成为治疗肥胖相关性高血压的潜在新型药物。本综述讨论了SGLT-2抑制剂治疗肥胖相关性高血压的有益机制。SGLT-2抑制剂可抑制SNS活性，降低RAAS激活，改善胰岛素抵抗，减少瘦素分泌，改善肾功能，并抑制炎症反应。因此，SGLT-2抑制剂可同时针对肥胖相关性高血压的多种机制，可能成为治疗肥胖相关性高血压的有效药物。
