therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-8156РостГМУ10.21886/2712-8156-2024-5-3-14-20therapeutic-519Research ArticleОБЗОРЫREVIEWSОсобенности артериальной гипертензии у молодых людей с ожирениемAspects of arterial hypertension in young adults with obesityhttps://orcid.org/0009-0004-7969-3459НовакВ. Д.NovakV. D.

Новак Вероника Дмитриевна, ординатор кафедры терапии с курсом поликлинической терапии

Ростов-на-Дону 

Veronika D. Novak, resident 

Rostov-on-Don 

novak.ved@gmail.comhttps://orcid.org/0000-0002-2419-4319ХаишеваЛ. А.HaishevaL. A.

Хаишева Лариса Анатольевна, д.м.н., заведующий кафедрой терапии, декан факультета повышения квалификации и профессиональной переподготовки специалистов

Ростов-на-Дону 

Larisa A. Khaisheva, Dr. Sci. (Med.), professor 

Rostov-on-Don 

katelnitskay@mail.ruФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава РоссииРоссияRostov State Medical UniversityRussian Federation202427092024531420Copyright © Новак В.Д., Хаишева Л.А., 20242024Новак В.Д., Хаишева Л.А.Novak V.D., Haisheva L.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/519

Распространённость артериальной гипертензии и ожирения в мире продолжают нарастать, затрагивая всё более молодые популяции. Ожирение способствует развитию артериальной гипертензии через множество механизмов, включая активацию симпатической нервной системы, ренин-ангиотензин-альдостероновой системы, нарушение регуляции водно-электролитного баланса, воспаление и дисбаланс адипокинов. В свою очередь артериальная гипертензия может усиливать ожирение путём нарушения метаболических процессов и увеличения аппетита. Патофизиологические особенности гипертензии различаются у молодых женщин и мужчин с повышенной массой тела. Нами был проведён несистематический обзор литературы с целью детального изучения механизмов патогенетического взаимодействия и взаимного усугубления повышенного артериального давления и индекса массы тела. Рассматривалась литература с 2004 г. по настоящее время на русском и английском языках с использованием платформ «PubMed Central», «ScienceDirect», «Google Scholar», а также поиск в архиве журнала «Circulation» и «Кардиоваскулярная терапия и профилактика» по ключевым словам, представленным ниже.

The global prevalence of hypertension and obesity continues to rise, affecting increasingly young people. Obesity causes hypertension through a variety of mechanisms, including sympathetic nervous system activation, renin angiotensin aldosterone system, fluid and electrolyte dysregulation, inflammation, and adipokine imbalance. In turn, arterial hypertension can exacerbate obesity by altering metabolic pathways and increasing appetite. The pathophysiological features of hypertension are different between young overweight women and men. We performed a non-systematic literature review to thoroughly investigate mechanisms of pathogenetic interaction and mutual aggravation of high blood pressure and body mass index. The literature was reviewed from 2004 to the present in Russian and English using the PubMed Central, ScienceDirect, Google Scholar platforms, as well as a search in the archives of the journals Circulation and Cardiovascular Therapy and Prevention using the keywords listed below.

артериальная гипертензиягипертоническая болезньожирениеповышенный индекс массы телаизбыточная масса теламолодыевоспалениеадипокиныметаболический синдромhypertensionhigh blood pressureyoung adultsobesityelevated body mass indexinflammationadipokinesmetabolic syndromeHypertensionhigh blood pressureyoung adultsyoungobesityelevated body mass indexelevated BMIinflammationadipokinesbiomarkersmetabolic syndromeReferencesNCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304):957-980. Erratum in: Lancet. 2022;399(10324):520. DOI: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 24.NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304):957-980. Erratum in: Lancet. 2022;399(10324):520. DOI: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 24.GBD 2013 Risk Factors Collaborators; Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries,1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(10010):2287-2323. DOI: 10.1016/S0140-6736(15)00128-2GBD 2013 Risk Factors Collaborators; Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries,1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(10010):2287-2323. DOI: 10.1016/S0140-6736(15)00128-2GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223-1249. DOI: 10.1016/S0140-6736(20)30752-2GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223-1249. DOI: 10.1016/S0140-6736(20)30752-2Jelaković B, Marinović Glavić M, Batinić Sermek M, Bilajac L, Bubaš M, Buzjak Služek V, et al. Croatian Action on Salt and Health (CRASH): On the Road to Success-Less Salt, More Health. Nutrients. 2024;16(10):1518. DOI: 10.3390/nu16101518Jelaković B, Marinović Glavić M, Batinić Sermek M, Bilajac L, Bubaš M, Buzjak Služek V, et al. Croatian Action on Salt and Health (CRASH): On the Road to Success-Less Salt, More Health. Nutrients. 2024;16(10):1518. DOI: 10.3390/nu16101518Costa EC, Hay JL, Kehler DS, Boreskie KF, Arora RC, Umpierre D,et al. Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training On Blood Pressure in Adults with Pre- to Established Hypertension: A Systematic Review and Meta-Analysis of Randomized Trials. Sports Med. 2018;48(9):2127-2142. DOI: 10.1007/s40279-018-0944-yCosta EC, Hay JL, Kehler DS, Boreskie KF, Arora RC, Umpierre D,et al. Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training On Blood Pressure in Adults with Pre- to Established Hypertension: A Systematic Review and Meta-Analysis of Randomized Trials. Sports Med. 2018;48(9):2127-2142. DOI: 10.1007/s40279-018-0944-yCao L, Li X, Yan P, Wang X, Li M, Li R, et al. The effectiveness of aerobic exercise for hypertensive population: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2019;21(7):868-876. DOI: 10.1111/jch.13583Cao L, Li X, Yan P, Wang X, Li M, Li R, et al. The effectiveness of aerobic exercise for hypertensive population: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2019;21(7):868-876. DOI: 10.1111/jch.13583World Health Organization. Guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.World Health Organization. Guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.Ерина А.М., Ротарь О.П., Солнцев В.Н., Шальнова С.А., Деев А.Д., Баранова Е.И., и др. Эпидемиология артериальной гипертензии в Российской Федерации – важность выбора критериев диагностики. Кардиология. 2019;59(6):5-11. DOI: 10.18087/cardio.2019.6.2595Erina A.M., Rotar O.P., Solntsev V.N., Shalnova S.A., Deev A.D., Baranova E.I., et al. Epidemiology of Arterial Hypertension in Russian Federation – Importance of Choice of Criteria of Diagnosis. Kardiologiia. 2019;59(6):5-11. (In Russ.) DOI: 10.18087/cardio.2019.6.2595Spyridaki EC, Avgoustinaki PD, Margioris AN. Obesity, inflammation and cognition. Current Opinion in Behavioral Sciences. 2016;9:169-175. DOI: 10.1016/j.cobeha.2016.05.004Spyridaki EC, Avgoustinaki PD, Margioris AN. Obesity, inflammation and cognition. Current Opinion in Behavioral Sciences. 2016;9:169-175. DOI: 10.1016/j.cobeha.2016.05.004Booth A, Magnuson A, Fouts J, Foster M. Adipose tissue, obesity and adipokines: role in cancer promotion. Horm Mol Biol Clin Investig. 2015;21(1):57-74. DOI: 10.1515/hmbci-2014-0037Booth A, Magnuson A, Fouts J, Foster M. Adipose tissue, obesity and adipokines: role in cancer promotion. Horm Mol Biol Clin Investig. 2015;21(1):57-74. DOI: 10.1515/hmbci-2014-0037Драпкина О.М., Ким О.Т. Бурая жировая ткань — новая мишень борьбы с ожирением? Кардиоваскулярная терапия и профилактика. 2021;20(5):2860. DOI: 10.15829/1728-8800-2021-2860Drapkina O.M., Kim O.T. Is brown adipose tissue a new target for obesity therapy? Cardiovascular Therapy and Prevention. 2021;20(5):2860. (In Russ.) DOI: 10.15829/1728-8800-2021-2860Leggio M, Lombardi M, Caldarone E, Severi P, D’Emidio S, Armeni M, et al. The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res. 2017;40(12):947-963. DOI: 10.1038/hr.2017.75Leggio M, Lombardi M, Caldarone E, Severi P, D’Emidio S, Armeni M, et al. The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res. 2017;40(12):947-963. DOI: 10.1038/hr.2017.75Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33(5):386-393. DOI: 10.1038/hr.2010.9Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33(5):386-393. DOI: 10.1038/hr.2010.9Di Marzo V, Côté M, Matias I, Lemieux I, Arsenault BJ, Cartier A, et al. Changes in plasma endocannabinoid levels in viscerally obese men following a 1 year lifestyle modification programme and waist circumference reduction: associations with changes in metabolic risk factors. Diabetologia. 2009;52(2):213-217. DOI: 10.1007/s00125-008-1178-6Di Marzo V, Côté M, Matias I, Lemieux I, Arsenault BJ, Cartier A, et al. Changes in plasma endocannabinoid levels in viscerally obese men following a 1 year lifestyle modification programme and waist circumference reduction: associations with changes in metabolic risk factors. Diabetologia. 2009;52(2):213-217. DOI: 10.1007/s00125-008-1178-6Canale MP, Manca di Villahermosa S, Martino G, Rovella V, Noce A, De Lorenzo A, et al. Obesity-related metabolic syndrome: mechanisms of sympathetic overactivity. Int J Endocrinol. 2013;2013:865965. DOI: 10.1155/2013/865965Canale MP, Manca di Villahermosa S, Martino G, Rovella V, Noce A, De Lorenzo A, et al. Obesity-related metabolic syndrome: mechanisms of sympathetic overactivity. Int J Endocrinol. 2013;2013:865965. DOI: 10.1155/2013/865965Muniyappa R, Sowers JR. Role of insulin resistance in endothelial dysfunction. Rev Endocr Metab Disord. 2013;14(1):5-12. DOI: 10.1007/s11154-012-9229-1Muniyappa R, Sowers JR. Role of insulin resistance in endothelial dysfunction. Rev Endocr Metab Disord. 2013;14(1):5-12. DOI: 10.1007/s11154-012-9229-1Aroor AR, McKarns S, Demarco VG, Jia G, Sowers JR. Maladaptive immune and inflammatory pathways lead to cardiovascular insulin resistance. Metabolism. 2013;62(11):1543-1552. DOI: 10.1016/j.metabol.2013.07.001Aroor AR, McKarns S, Demarco VG, Jia G, Sowers JR. Maladaptive immune and inflammatory pathways lead to cardiovascular insulin resistance. Metabolism. 2013;62(11):1543-1552. DOI: 10.1016/j.metabol.2013.07.001Grassi G., Seravalle G., Quarti-Trevano F., Mancia G. Obesity and the autonomic nervous system. In: Handbook of Obesity – Volume 2: Clinical Applications and Prevention. CRC Press; 2010.Grassi G., Seravalle G., Quarti-Trevano F., Mancia G. Obesity and the autonomic nervous system. In: Handbook of Obesity – Volume 2: Clinical Applications and Prevention. CRC Press; 2010.Lambert E, Straznicky N, Schlaich M, Esler M, Dawood T, Hotchkin E, et al. Differing pattern of sympathoexcitation in normal-weight and obesity-related hypertension. Hypertension. 2007;50(5):862-868. DOI: 10.1161/HYPERTENSIONAHA.107.094649Lambert E, Straznicky N, Schlaich M, Esler M, Dawood T, Hotchkin E, et al. Differing pattern of sympathoexcitation in normal-weight and obesity-related hypertension. Hypertension. 2007;50(5):862-868. DOI: 10.1161/HYPERTENSIONAHA.107.094649Sarzani R, Salvi F, Dessì-Fulgheri P, Rappelli A. Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. J Hypertens. 2008;26(5):831-843. DOI: 10.1097/HJH.0b013e3282f624a0Sarzani R, Salvi F, Dessì-Fulgheri P, Rappelli A. Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. J Hypertens. 2008;26(5):831-843. DOI: 10.1097/HJH.0b013e3282f624a0Bomback AS, Klemmer PJ. Interaction of aldosterone and extracellular volume in the pathogenesis of obesity-associated kidney disease: a narrative review. Am J Nephrol. 2009;30(2):140-146. DOI: 10.1159/000209744Bomback AS, Klemmer PJ. Interaction of aldosterone and extracellular volume in the pathogenesis of obesity-associated kidney disease: a narrative review. Am J Nephrol. 2009;30(2):140-146. DOI: 10.1159/000209744Симоненко В.Б., Горюцкий В.Н., Дулин П.А. Роль инсулинорезистентности в патогенезе артериальной гипертонии. Клиническая медицина. 2014;92(9):27-33. eLIBRARY ID: 21993345 EDN: SNHHIVSimonenko V.B., Goryutsky V.N., Dulin P.A. The role of insulin resistance in pathogenesis of arterial hypertension. Clinical medicine (Russian jornal). 2014;92(9):27-33. eLIBRARY ID: 21993345 EDN: SNHHIVHall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesityinduced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116(6):991-1006. DOI: 10.1161/CIRCRESAHA.116.305697Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesityinduced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116(6):991-1006. DOI: 10.1161/CIRCRESAHA.116.305697O’Keeffe LM, Simpkin AJ, Tilling K, Anderson EL, Hughes AD, Lawlor DA, et al. Sex-specific trajectories of measures of cardiovascular health during childhood and adolescence: A prospective cohort study. Atherosclerosis. 2018;278:190-196. DOI: 10.1016/j.atherosclerosis.2018.09.030O’Keeffe LM, Simpkin AJ, Tilling K, Anderson EL, Hughes AD, Lawlor DA, et al. Sex-specific trajectories of measures of cardiovascular health during childhood and adolescence: A prospective cohort study. Atherosclerosis. 2018;278:190-196. DOI: 10.1016/j.atherosclerosis.2018.09.030Nardin C, Maki-Petaja KM, Miles KL, Yasmin, McDonnell BJ, Cockcroft JR, et al. Cardiovascular Phenotype of Elevated Blood Pressure Differs Markedly Between Young Males and Females: The Enigma Study. Hypertension. 2018;72(6):1277-1284. DOI: 10.1161/HYPERTENSIONAHA.118.11975Nardin C, Maki-Petaja KM, Miles KL, Yasmin, McDonnell BJ, Cockcroft JR, et al. Cardiovascular Phenotype of Elevated Blood Pressure Differs Markedly Between Young Males and Females: The Enigma Study. Hypertension. 2018;72(6):1277-1284. DOI: 10.1161/HYPERTENSIONAHA.118.11975Gerdts E, Sudano I, Brouwers S, Borghi C, Bruno RM, Ceconi C, et al. Sex differences in arterial hypertension. Eur Heart J. 2022;43(46):4777-4788. DOI: 10.1093/eurheartj/ehac470Gerdts E, Sudano I, Brouwers S, Borghi C, Bruno RM, Ceconi C, et al. Sex differences in arterial hypertension. Eur Heart J. 2022;43(46):4777-4788. DOI: 10.1093/eurheartj/ehac470Colafella KMM, Denton KM. Sex-specific differences in hypertension and associated cardiovascular disease. Nat Rev Nephrol. 2018;14(3):185-201. DOI: 10.1038/nrneph.2017.189Colafella KMM, Denton KM. Sex-specific differences in hypertension and associated cardiovascular disease. Nat Rev Nephrol. 2018;14(3):185-201. DOI: 10.1038/nrneph.2017.189Palatini P, Mos L, Santonastaso M, Saladini F, Benetti E, Mormino P, et al. Premenopausal women have increased risk of hypertensive target organ damage compared with men of similar age. J Womens Health (Larchmt).2011;20(8):1175-1181. DOI: 10.1089/jwh.2011.2771Palatini P, Mos L, Santonastaso M, Saladini F, Benetti E, Mormino P, et al. Premenopausal women have increased risk of hypertensive target organ damage compared with men of similar age. J Womens Health (Larchmt).2011;20(8):1175-1181. DOI: 10.1089/jwh.2011.2771de Simone G, Devereux RB, Izzo R, Girfoglio D, Lee ET, Howard BV, et al. Lack of reduction of left ventricular mass in treated hypertension: the strong heart study. J Am Heart Assoc. 2013;2(3):e000144. DOI: 10.1161/JAHA.113.000144de Simone G, Devereux RB, Izzo R, Girfoglio D, Lee ET, Howard BV, et al. Lack of reduction of left ventricular mass in treated hypertension: the strong heart study. J Am Heart Assoc. 2013;2(3):e000144. DOI: 10.1161/JAHA.113.000144Thompson P, Logan I, Tomson C, Sheerin N, Ellam T. Obesity, Sex, Race, and Early Onset Hypertension: Implications for a Refined Investigation Strategy. Hypertension. 2020;76(3):859-865. DOI: 10.1161/HYPERTENSIONAHA.120.15557Thompson P, Logan I, Tomson C, Sheerin N, Ellam T. Obesity, Sex, Race, and Early Onset Hypertension: Implications for a Refined Investigation Strategy. Hypertension. 2020;76(3):859-865. DOI: 10.1161/HYPERTENSIONAHA.120.15557Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640-1645. DOI: 10.1161/CIRCULATIONAHA.109.192644Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640-1645. DOI: 10.1161/CIRCULATIONAHA.109.192644

The authors declare that there are no conflicts of interest present.