梁春高血压伴肥胖患者的降压策略-更新版.ppt

大多数(73.5%)之前采用接近最大剂量的ACE-I或ARB单药治疗未达到目标舒张压者，换药采用氯沙坦/HCTZ，并逐渐采用海捷亚治疗8周后，非糖尿病患者舒张压 90 mmHg，糖尿病患者舒张压 80mmHg，自基线平均血压降低: 16.68/12.14mmHg。平均依从率较高，这可能归功于观察到的血压降低。联合治疗也与 Framingham卒中危险, 微白蛋白尿降低相关，且对于糖尿病，LVH以及肥胖患者有效，耐受性良好。 References 1. Data on file, MSD. * * 67 obese women (mean body mass index, 33.6 +/- 3.1; average age, 50 +/- 11 years) the ratio of the intra-abdominal visceral fat area to subcutaneous fat area was determined using a computed tomographic section at the level of the umbilicus. * * * * * * * Figure 2.?Cardiac structural and hemodynamic changes with increasing weight. Representative CMRI cines from each cohort are shown. P values were derived from 1-way analysis of variance. Pairwise comparisons were performed by using the Bonferroni method. A: Horizontal long axis. B: Short axis. CMRI data are presented as mean±SD, and hemodynamic data are presented as median and interquartile range. CMR = cardiac magnetic resonance; LA = left atrium; LAP = left atrial pressure; LVEDV = left ventricular end-diastolic volume; MAP = mean arterial pressure; RA = right atrium; RVEDV = right ventricular end-diastolic volume Method：Thirty sheep were studied at baseline, 4 months, and 8 months, following a high-calorie diet. Ten sheep were sampled at each time point for cardiac magnetic resonance imaging and hemodynamic studies. High-density multisite biatrial epicardial mapping was used to quantify effective refractory period, conduction velocity, and conduction heterogeneity index at 4 pacing cycle lengths and AF inducibility. Histology was performed for atrial fibrosis, inflammation, and intramyocardial lipidosis, and molecular analysis was performed for endothelin-A and -B receptors, endothelin-1 peptide, platelet-derived growth factor, transforming growth factor β1, and connective tissue growth factor. * Obesity-induced changes in skeletal muscle, adipose tissue and the liver result in localized inflammation and insulin resistance (IR) through autocrine and paracrine signa