Manažment obezitou indukovanej hypertenzie

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Autoři: Michał Holecki ^1,2; Magdalena Zawadzka ²
Působiště autorů: Department of Internal Medicine and Metabolic Diseases, School of Health Science, Medical University of Silesia, Katowice, Poland ¹; Department of Internal Medicine, District Railway Hospital, Katowice, Poland ²
Vyšlo v časopise: Forum Diab 2018; 7(2): 98-101
Kategorie: Prehľadové práce

Souhrn

Obezita je epidémiou 21. storočia. V roku 2014 malo viac ako 1,9 miliardy dospelých nadváhu, z toho 600 miliónov osôb bolo obéznych. Obezitou trpí viac ako 42 miliónov detí vo veku nad 5 rokov. V roku 2015 pribudlo celosvetovo ďalších 100 miliónov obéznych dospelých osôb. Riziko rozvoja hypertenzie u obéznych dospelých je 2- až 3-krát vyššie a u obéznych detí dokonca 7-krát vyššie, v porovnaní s jedincami s normálnou hmotnosťou. Obezita a hypertenzia sa súčasne vyskytuje u 78 % (65 %) hypertenzných mužov (žien). Vývoj hypertenzie je u obéznych pacientov spojený s mnohými centrálnymi a periférnymi abnormalitami, ako je aktivácia sympatického nervového systému a systému renín-angiotenzín-aldosterón; poškodenie funkcie endotelu; zvýšená retencia vody spôsobená nadmerným príjmom sodíka, zvýšená resorpcia sodíka v renálnych tubuloch a znížená hladina atriálneho natriuretického peptidu (ANP). Prehľadný článok sumarizuje vplyv obezity na kardiovaskulárny systém, niektoré charakteristické znaky hypertenzie vyvolanej obezitou, najvhodnejšiu liečbu a taktiež najčastejšie chyby v terapii.

Kľúčové slová:

ABPM antihypertenzíva hemodynamika hypertenzia hypertenzia asociovaná s obezitou kardiovaskulárny systém krvný tlak obezita sympatický nervový systém systém renín-angiotenzín-aldosterón

Zdroje

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