Abstract
Hipertansiyon, çağımızın önemli mortalite ve morbidite yaratan sorunlarının başında gelmektedir. Obezite, genetik faktörler zemininde çevresel etki ile artmaktadır. Çocukluk çağında esansiyel hipertansiyon, obezitedeki global artış nedeniyle belirgin artış göstermektedir. Obezite ve hipertansiyonun birlikteliği ise çalışmalarda kanıtlanmıştır. Obez hastalardaki hipertansiyon nedenleri ise birden fazla faktöre bağlı olarak bulunmuştur. Obez hastalarda eşlik eden hiperinsülinemi ve insülin direncinin; hiperleptinineminin; böbrekte eşlik eden yapısal ve fonksiyonel değişikliklerin; inflamasyon ve oksidatif stresin; endotel disfonksiyonunun; santral sinir sistemi aktivasyonunun; eşlik edebilen obstrüktif uyku apnesinin; fruktoz içeren gıda tüketimindeki artışının; ürik asit yüksekliğinin ve nitrik oksit mekanizmasındaki değişikliklerin, hipertansiyon patofizyolojisinde önemli rol aldığı bilinmektedir. Patofizyolojide yer alan mekanizmalar hastaların tedavi ve izleminde önemli ipuçlarını oluşturmaktadır. Obez çocuklar, önlem alınmaz ise erişkin hayatlarında hipertansiyon, kardiyovasküler sistem hastalıkları ve serebrovasküler sistem hastalıkları ve bu durumların birlikte getirdiği morbidite ve mortalite riski ile karşı karşıya olacaklardır.
Keywords
References
- Hanevold C, Waller J, Daniels S, Portman R, Sorof J. International Pediatric Hypertension Association. The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: A collaborative study of the International Pediatric Hypertension Association. Pediatrics 2004;113:328-33.
- Schachter M. Uric acid and hypertension. Curr Pharm Des 2005;11:4139-43.
- Gersch C, Palii SP, Kim KM, Angerhofer A, Johnson RJ, Henderson GN. Inactivation of nitric oxide by uric acid. Nucleosides Nucleotides Nucleic Acids 2008;27:967-78.
- Feig DI, Johnson RJ. The role of uric acid in pediatric hypertension. J Ren Nutr 2007;17:79-83.
- Levine AB, Punihaole D, Levine TB. Characterization of the role of nitric oxide and its clinical applications. Cardiology 2012;122:55- 68.
- Huang PL. eNOS, metabolic syndrome and cardiovascular disease. Trends Endocrinol Metab 2009;20:295-302.
- Jin RC, Loscalzo J. Vascular nitric oxide: Formation and function. J Blood Med 2010;2010:147-62.
- Gruber HJ, Mayer C, Mangge H, Fauler G, Grandits N, Wilders- Truschnig M. Obesity reduces the bioavailability of nitric oxide in juveniles. Int J Obes (Lond) 2008;32:826-31.
- Akcaboy M, Kula S, Göktas T, Nazlıel B, Terlemez S, Celik N, et al. Effect of plasma NO(x) values on cardiac function in obese hypertensive and normotensive pediatric patients. Pediatr Nephrol 2016;31: 473-83.
- Ludwig DS. Childhood obesity-the shape of things to come. N Eng J Med 2007; 357: 2325-27.
- kidney disease? Curr Opin Nephrol Hypertens 2009;18: 526-30.
Abstract
Hypertension is one of the major and predisposing causes of morbidity and mortality of our age. Obesity is increasing due to the effect of environmental factors on a genetic basis. Essential hypertension is increasing day by day in childhood, a result of the prominent increase in childhood obesity. It is well known that obesity and hypertension are strongly related. The mechanism of hypertension in obesity has been found to be multifactorial. The major mechanisms involved in hypertension are hyperinsulinemia and insulin resistance; hyperleptinemia; functional and structural changes of the kidneys; inflammation and oxidative stress; endothelial dysfunction; overactivation of the central nervous system; obstructive sleep apnea; an increase in fructose-related food; the elevation of uric acid levels; and alterations in nitric oxide metabolism. The mechanisms that are involved in the pathophysiology provide important clues for the treatment and follow-up of obese and hypertensive children. If the necessary preventive measures are not taken, childhood obesity might lead to a high-risk of cardiovascular and cerebrovascular morbidity and mortality for adult individuals in the future
Keywords
References
- Hanevold C, Waller J, Daniels S, Portman R, Sorof J. International Pediatric Hypertension Association. The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: A collaborative study of the International Pediatric Hypertension Association. Pediatrics 2004;113:328-33.
- Schachter M. Uric acid and hypertension. Curr Pharm Des 2005;11:4139-43.
- Gersch C, Palii SP, Kim KM, Angerhofer A, Johnson RJ, Henderson GN. Inactivation of nitric oxide by uric acid. Nucleosides Nucleotides Nucleic Acids 2008;27:967-78.
- Feig DI, Johnson RJ. The role of uric acid in pediatric hypertension. J Ren Nutr 2007;17:79-83.
- Levine AB, Punihaole D, Levine TB. Characterization of the role of nitric oxide and its clinical applications. Cardiology 2012;122:55- 68.
- Huang PL. eNOS, metabolic syndrome and cardiovascular disease. Trends Endocrinol Metab 2009;20:295-302.
- Jin RC, Loscalzo J. Vascular nitric oxide: Formation and function. J Blood Med 2010;2010:147-62.
- Gruber HJ, Mayer C, Mangge H, Fauler G, Grandits N, Wilders- Truschnig M. Obesity reduces the bioavailability of nitric oxide in juveniles. Int J Obes (Lond) 2008;32:826-31.
- Akcaboy M, Kula S, Göktas T, Nazlıel B, Terlemez S, Celik N, et al. Effect of plasma NO(x) values on cardiac function in obese hypertensive and normotensive pediatric patients. Pediatr Nephrol 2016;31: 473-83.
- Ludwig DS. Childhood obesity-the shape of things to come. N Eng J Med 2007; 357: 2325-27.
- kidney disease? Curr Opin Nephrol Hypertens 2009;18: 526-30.
Details
| Other ID | JA22AZ25NE |
|---|---|
| Journal Section | Collection |
| Authors | |
| Publication Date | June 1, 2017 |
| Submission Date | June 1, 2017 |
| Published in Issue | Year 2017 Volume: 11 Issue: 2 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.