Poucas novidades para o obeso hipertenso nas novas guidelines

Os papéis-chave da prevenção continuam em destaque. As estratégias para aumentar o exercício físico, reduzir o peso corporal e prevenir ou tratar a hipertensão, os distúrbios lipídicos e a diabetes prévia são eficientemente para prevenir complicações cardiovasculares. Foram estas as recentes recomendações principais , publicadas no Eur Heart J. 2018 Aug 14.

Obesity and cardiovascular risk: a call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity: part A: mechanisms of obesity induced hypertension, diabetes and dyslipidemia and practice guidelines for treatment.

Kotsis V(1), Jordan J(2), Micic D(3), Finer N(4), Leitner DR(5), Toplak H(5),Tokgozoglu L(6), Athyros V(7), Elisaf M(8), Filippatos TD(9), Redon J(10)(11),Redon P(10), Antza C(1), Tsioufis K(12), Grassi G(13)(14), Seravalle G(15), Coca A(16), Sierra C(16), Lurbe E(17)(18), Stabouli S(19), Jelakovic B(20), Nilsson PM(21).

Obesity is a key factor for cardiovascular diseases and complications. Obesity is associated with hypertension, dyslipidemia and type II diabetes, which are the major predictors of cardiovascular disease in the future. It predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke that are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to  prevent obesity very early before the disease manifestation emerge. Key roles in  the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications. Epidemiology and mechanisms of obesity-induced hypertension, diabetes and dyslipidemia will be reviewed and the role of lifestyle modification and treatment strategies in obesity will be updated and analyzed. The best treatment options for people with obesity, hypertension, diabetes and dyslipidemia will discussed.

J Hypertens. 2018 Jul;36(7):1427-1440