减肥药物, surgery could fight obesity-related high blood pressure

减肥对控制血压至关重要. 但是当饮食和运动不起作用的时候, 药物和手术是适当的治疗方法, 根据一项新的专家减肥策略分析.

High blood pressure, or hypertension, can lead to kidney problems, heart injury and stroke. But only a fraction of eligible patients are prescribed weight-loss medicine or referred for metabolic surgery, Dr. Michael E. 霍尔在线上电子游戏飞禽走兽发布会上说. He led the expert panel that wrote the report from the 美国心脏协会.

尽管治疗可能有助于预防严重的并发症, he said, they often aren't considered until after someone has suffered organ damage.

再加上生活方式的改变, anti-obesity medicines and surgical procedures can be effective long-term solutions for weight loss and blood pressure control in select individuals who are overweight or obese," said Hall, associate division director for cardiovascular diseases at the University of Mississippi Medical Center in Jackson.

The scientific statement was published Monday in the 美国心脏协会 journal Hypertension. 它是继之前关于 diet, 体育活动 and 控制体重.

Weight loss through a healthy diet and increased 体育活动 is the cornerstone of treatment for high blood pressure that's related to being overweight, Hall said.

National guidelines recommend a heart-healthy diet to help manage weight and control blood pressure. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) are well-established options, 报告说. 两者都强调多吃水果, vegetables, legumes, nuts and seeds; moderate amounts of fish, seafood, poultry and dairy; and low quantities of sweets and red and processed meats.

该声明还研究了间歇性禁食, an approach that alters the timing of eating and fasting during the day or week. It produced modest reductions in blood pressure in a few studies involving people with metabolic syndrome, 一组可导致心脏病的情况. However, analyses of several studies found intermittent fasting had a weak impact on blood pressure and was no more effective than other diets in reducing weight.

"There's no doubt that eating healthy foods has beneficial effects on both weight and blood pressure," Hall said. “很多减肥食谱都能在短期内取得成功."

但他说，长期保持减肥效果是具有挑战性的. 所以当饮食和运动不起作用的时候, health professionals should consider prescription medications for people who have a weight-related health issue such as high blood pressure.

A class of medications called GLP-1 receptor agonists have been shown to help with sustained weight loss and significantly reducing blood pressure, 根据声明. GLP-1受体激动剂, 比如利拉鲁肽和西马鲁肽, are synthetic hormones self-injected daily or weekly that reduce appetite and help people feel full.

Both medications were initially prescribed to treat Type 2 diabetes because they lower blood sugar by stimulating the release of insulin. The Food and Drug Administration recently approved both for weight management and weight loss in people classified as overweight or obese.

肥胖是通过体重指数(体重与身高的比值)来衡量的. BMI在25到29之间的人被归类为超重. 身体质量指数大于等于30的人被认为是肥胖.

该声明包括对代谢手术的研究综述, 也叫减肥手术或胃旁路手术. 它可以帮助严重肥胖的人减肥, BMI指数在40或更高的人, or if they have a BMI of 35 or higher along with an obesity-related health condition such as hypertension.

High blood pressure resolves in 63% of people who have metabolic surgery, 报告说, and several studies show less use of blood pressure-lowering medicines after surgery.

“代谢手术技术在不断发展, 而且它们的侵入性和风险都越来越小," Hall said. "对于特定的个体, medications or metabolic surgery or both may be considered in addition to healthy diet and increased 体育活动."

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