АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ, ОЖИРЕНИЕ И ПОРАЖЕНИЕ ОРГАНОВ-МИШЕНЕЙ У ДЕТЕЙ
Abstract
Цель: изучить данные о связи между детским ожирением и артериальной гипертензией, их влиянии на поражение органов-мишеней и современные возможности терапии.
Материалы и методы. В ходе исследования были проанализированы публикации, размещенные в российских и зарубежных базах данных (eLibrary, PubMed, Google Scholar, UpToDate) преимущественно за последние 5 лет по следующим ключевым словам: «артериальная гипертензия», «детское ожирение», «поражение органов-мишеней», «hypertension», «childhood obesity», «target organ injury». При анализе данных учитывали все публикации, посвященные сочетанию детского ожирения и артериальной гипертензией, их влиянию на поражение органов-мишеней, методах диагностики и лечении.
Результаты. Распространённость артериальной гипертензии и ожирения в детской популяции растёт, несмотря на усилия общественного здравоохранения. Артериальная гипертензия и ожирение способствуют выработке провоспалительных цитокинов, которые активируют ренин-ангиотензин-альдостероновую систему и симпатическую нервную систему, что приводит к негативным последствиям в регуляции АД и функции почек. При повышенном АД могут наблюдаться неблагоприятные изменения в работе сердца, сосудов, почек, сетчатки глаза и нарушаться нейрокогнитивные функции. Результаты последних исследований свидетельствуют о достижениях в области терапии артериальной гипертензии и ожирения у детей, что способно снизить риск повреждения органов-мишеней в педиатрической популяции.
Выводы. Артериальная гипертензия и ожирение оказывают значительное влияние на ПОМ у детей. Мероприятия по нормализации АД и терапии детского ожирения способны уменьшить гипертрофию левого желудочка, улучшить показатели систолической и диастолической функции, а также функцию почек. Надлежащий скрининг и лечение этих заболеваний могут снизить потенциальное негативное влияние на сердечно-сосудистую систему в будущем.
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