护士健康研究的数据显示,18 岁时体重增加超过 5 kg 的人群,到中年时患高血压的风险会升高 60%。[35]Huang Z, Willet WC, Manson JE, et al. Bodyweight, weight change and risk of hypertension in women. Ann Intern Med. 1998 Jan 15;128(2):81-8.
http://www.ncbi.nlm.nih.gov/pubmed/9441586?tool=bestpractice.com
体重每增加4.5kg(10 磅) ,血压相应升高 4.5 mmHg。[36]Kannel WB, Garrison RJ, Dannenberg AL. Secular blood pressure trends in normotensive patients. Am Heart J. 1993 Apr;125(4):1154-8.
http://www.ncbi.nlm.nih.gov/pubmed/8465743?tool=bestpractice.com
一项系统评价发现,随着体重指数、腰围、体重、腰臀比和腰围身高比的增加,高血压的风险也在不断增加。[37]Jayedi A, Rashidy-Pour A, Khorshidi M, et al. Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: a systematic review and dose-response meta-analysis of more than 2.3 million participants. Obes Rev. 2018 Jan 15;19(5):654-667.
http://www.ncbi.nlm.nih.gov/pubmed/29334692?tool=bestpractice.com
据推测,肥胖和高血压之间的联系是由于循环血容量增加,继而导致心输出量的增加和外周血管阻力的持续升高。[32]Sharma AM, Engeli S, Pischon T. New developments in mechanisms of obesity-induced hypertension: role of adipose tissue. Curr Hypertens Rep. 2001 Apr;3(2):152-6.
http://www.ncbi.nlm.nih.gov/pubmed/11276398?tool=bestpractice.com
肥胖与代谢综合征、胰岛素抵抗和 2 型糖尿病有关。
III 级肥胖(体重指数≥40)的减重治疗可减少或消除心血管疾病的危险因素,对高血压、糖尿病和血脂异常同样具有一定疗效。[38]Heneghan HM, Meron-Eldar S, Brethauer SA, et al. Effect of bariatric surgery on cardiovascular risk profile. Am J Cardiol. 2011 Nov 15;108(10):1499-507.
http://www.ncbi.nlm.nih.gov/pubmed/21880286?tool=bestpractice.com
[39]Sarkhosh K, Birch DW, Shi X, et al. The impact of sleeve gastrectomy on hypertension: a systematic review. Obes Surg. 2012 May;22(5):832-7.
http://www.ncbi.nlm.nih.gov/pubmed/22350987?tool=bestpractice.com