Chhabria Shradha M, LeBron Jared, Ronis Sarah D, Batt Courtney E
Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH USA.
Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH USA.
Curr Cardiovasc Risk Rep. 2024;18(8-9):115-124. doi: 10.1007/s12170-024-00740-x. Epub 2024 Jul 30.
Hypertension (HTN) and obesity are increasing in prevalence and severity in adolescents and have significant implications for long term morbidity and mortality. This review focuses on the diagnosis and management of HTN in adolescents with obesity with an emphasis on co-management of the two conditions.
Recent studies affirm the increasing prevalence of abnormal blood pressures and diagnoses of HTN associated with increased adiposity. Current guidelines recommend routine screening with proper technique for HTN in patients with obesity. Additionally, obesity and HTN related co-occurring medical conditions should be evaluated as there is frequently a bidirectional impact on risk and outcomes. Importantly, advances in adolescent obesity management have subsequently led to positive implications for the management of obesity-related comorbidities such as HTN. The co-management of obesity and HTN is an emerging strategy for treatment and prevention of additional morbidity and mortality as patients progress to adulthood.
In adolescent patients with obesity, prompt recognition and appropriate diagnosis of HTN as well as related co-occurring conditions are necessary first steps in management. Co-management of obesity and HTN is likely to lead to improved outcomes. While lifestyle interventions serve as the foundation to this management, adjunctive and emerging therapies should be considered to adequately treat both conditions.
高血压（HTN）和肥胖症在青少年中的患病率和严重程度正在上升，对长期发病率和死亡率有重大影响。本综述重点关注肥胖青少年高血压的诊断和管理，强调对这两种情况的联合管理。
最近的研究证实，与肥胖增加相关的血压异常和高血压诊断的患病率正在上升。当前指南建议对肥胖患者进行高血压常规筛查，并采用适当技术。此外，应评估肥胖和高血压相关的并发疾病，因为它们对风险和结局往往有双向影响。重要的是，青少年肥胖管理的进展随后对肥胖相关合并症（如高血压）的管理产生了积极影响。肥胖和高血压的联合管理是一种新兴策略，可在患者步入成年期时预防更多的发病率和死亡率。
在肥胖的青少年患者中，及时识别和正确诊断高血压以及相关的并发疾病是管理的首要必要步骤。肥胖和高血压的联合管理可能会改善结局。虽然生活方式干预是这种管理的基础，但应考虑辅助和新兴疗法以充分治疗这两种情况。
