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高血压青年个体的肥胖与交感神经过度活跃:印度医疗服务提供者的临床视角

Obesity and Sympathetic Overactivity in Young Individuals With Hypertension: Clinical Perspective of Indian Healthcare Providers.

作者信息

Jadhav Uday, Solanki Dharmesh, Kumar Srinivas, Hazra Prakash, Alexander Thomas, Gupta Amit, Ghatge Shweta, Revankar Santosh

机构信息

Cardiology, Mahatma Gandhi Mission (MGM) New Bombay Hospital, Navi Mumbai, IND.

Interventional Cardiology, Wockhardt Hospital, Rajkot, IND.

出版信息

Cureus. 2024 Nov 20;16(11):e74115. doi: 10.7759/cureus.74115. eCollection 2024 Nov.

Abstract

INTRODUCTION

To understand the current clinical practices followed by healthcare professionals (HCPs) among populations with hypertension and obesity with sympathetic overactivity and develop strategies to improve the management of hypertension.

METHODS

A standard questionnaire was formulated based on high sympathetic overactivity and/or obesity in young patients with hypertension to gather information on the perception and practices of HCPs toward the management of young patients with hypertension who have high sympathetic overactivity and/or obesity. HCPs throughout India were selected. The key insights and recommendations from the panel discussion were summarized in a report that helped to develop strategies to improve the management of young hypertension patients with high sympathetic overactivity/obesity.

RESULTS

A total of 1170 HCPs participated in the survey and in panel discussion meetings. According to 53% of HCPs, patients with hypertension with increased sympathetic overactivity or stress are most commonly aged 41-60 years. These patients have a higher likelihood of developing stroke (60%), alcoholism (46%), and sleep apnea (41%). Moreover, these HCPs also opined that patients with hypertension and obesity are at greater risk of developing coronary artery disease and chronic kidney disease (69%) and often require multiple antihypertensive drugs (60%). For the management of hypertension in obese patients with sympathetic overactivity, a combination of telmisartan and cardio-selective beta-blockers is the preferred treatment (66%). Additionally, a combination of telmisartan and metoprolol is recommended to control sympathetic overactivity in obese patients with hypertension.

CONCLUSION

Sympathetic overactivity is becoming more common in young adults with hypertension, and the combination of telmisartan and cardio-selective beta-blockers is the best treatment option for these patients. This approach may help to effectively manage hypertension and reduce the risk of complications associated with sympathetic overactivity. The limitation of the study is its reliance on self-reported data from HCPs, which may introduce bias.

摘要

引言

了解医疗保健专业人员(HCPs)在患有交感神经过度活跃的高血压和肥胖人群中目前遵循的临床实践,并制定改善高血压管理的策略。

方法

基于年轻高血压患者的高交感神经过度活跃和/或肥胖制定了一份标准问卷,以收集HCPs对患有高交感神经过度活跃和/或肥胖的年轻高血压患者管理的看法和实践信息。选取了印度各地的HCPs。小组讨论的关键见解和建议总结在一份报告中,该报告有助于制定改善患有高交感神经过度活跃/肥胖的年轻高血压患者管理的策略。

结果

共有1170名HCPs参与了调查和小组讨论会议。据53%的HCPs称,交感神经过度活跃或压力增加的高血压患者最常见的年龄为41 - 60岁。这些患者发生中风(60%)、酗酒(46%)和睡眠呼吸暂停(41%)的可能性更高。此外,这些HCPs还认为,高血压和肥胖患者发生冠状动脉疾病和慢性肾病的风险更高(69%),并且通常需要多种抗高血压药物(60%)。对于交感神经过度活跃的肥胖患者的高血压管理,替米沙坦和心脏选择性β受体阻滞剂联合使用是首选治疗方法(66%)。此外,建议使用替米沙坦和美托洛尔联合使用来控制肥胖高血压患者的交感神经过度活跃。

结论

交感神经过度活跃在患有高血压的年轻人中越来越普遍,替米沙坦和心脏选择性β受体阻滞剂联合使用是这些患者的最佳治疗选择。这种方法可能有助于有效管理高血压并降低与交感神经过度活跃相关的并发症风险。该研究的局限性在于其依赖于HCPs的自我报告数据,这可能会引入偏差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa8f/11662092/a5109f05ac54/cureus-0016-00000074115-i01.jpg

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