血管紧张素受体脑啡肽酶抑制剂:肥胖性高血压治疗“不二之选”  

Angiotensin receptor-neprilysin inhibitor:“Best choice”for obese hypertension

作　　者：王丽霞[1] 韩拓 王怡雯 张春艳[1] 李永勤[1] 王聪霞[1] WANG Li-xia;HAN Tuo;WANG Yi-wen;ZHANG Chun-yan;LI Yong-qin;WANG Cong-xia(Department of Cardiology,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shaanxi,China)

机构地区：[1]西安交通大学第二附属医院心血管内科,陕西西安710004

出　　处：《心脏杂志》2023年第2期229-232,共4页Chinese Heart Journal

基　　金：国家自然科学基金项目(81273878);陕西省自然科学基金公关项目(2020SF-244)。

摘　　要：随着高血压和肥胖在全球的大流行,肥胖性高血压的患病人数持续激增。目前关于肥胖性高血压的发病机制尚未完全清楚,临床亦缺乏针对性的治疗药物。血管紧张素受体脑啡肽酶抑制剂(angiotensin receptor-neprilysin inhibitor,ARNI)是一种同时作用于肾素-血管紧张素系统(renin-angiotensin system,RAS)和利钠肽(natriuretic peptides,NPs)系统的新型心血管药物。作为全球首个上市的ARNI类药物,沙库巴曲缬沙坦已被广泛用于射血分数减低心力衰竭(heart failure with reduced ejection fraction,HFrEF)患者的一线治疗。随着其原发性高血压适应证的获批,越来越多证据显示,沙库巴曲缬沙坦在控制血压达标方面优于传统RAS阻滞剂,并能够带来降压以外改善糖脂代谢、延缓肾功能恶化的额外获益,有望成为治疗肥胖性高血压的“不二之选”。本文通过文献回顾,探讨沙库巴曲缬沙坦对于肥胖性高血压的全面调治作用与其可能机制,为其在高血压及其合并症治疗中提供更多理论依据。With the global epidemic of high hypertension and obesity,the number of patients with obese hypertension will continue to soar.However,the pathogenesis of obesity-induced hypertension is not completely clear,and there is a lack of targeted drug in clinical treatment.Angiotensin receptorneprilysin inhibitor(ARNI)is a new cardiovascular drug that acts on both renin-angiotensin system(RAS)and natriuretic peptide system(NPs).As the first agent of ARNI to be marketed in the world,sacubitril/valsartan has been widely used in patients with heart failure with reduced ejection fraction(HFrEF).With the approval of essential hypertension indications,more and more evidence has shown that sacubitril/valsartan is superior to traditional RAS blockers in blood pressure control.Sacubitril/valsartan also has additional benefits such as improving glucose and lipid metabolism and delaying renal deterioration,which may make sacubitril/valsartan the“best choice”for obese hypertension.Through systematic literature review,we discuss the comprehensive therapeutic effect and possible mechanism of sacubitril/valsartan in the control of obese hypertension and provide more theoretical basis for the treatment of hypertension and its complications.

关 键 词：沙库巴曲缬沙坦 肥胖 高血压 

分 类 号：R544[医药卫生—心血管疾病]