scholarly journals Quantification of Retinal Vessel Myogenic Constriction in Response to Blood Pressure Peaks: Implications for Flicker Light-Induced Dilatation

2021 ◽  
Vol 12 ◽  
Author(s):  
Lukas Streese ◽  
Anja Vaes ◽  
Denis Infanger ◽  
Ralf Roth ◽  
Henner Hanssen
Keyword(s):  
Blood Pressure ◽  
Retinal Vessel ◽  
Clinical Trial Registration ◽  
Physically Active ◽  
Complete Dataset ◽  
Risk Patients ◽  
Vessel Dilatation ◽  
Microvascular Endothelial Function ◽  
Flicker Light ◽  
Retinal Arteriolar

Background/AimsFlicker-light induced retinal vessel dilatation (FID), a marker of microvascular endothelial function, has been shown to be blunted in sedentary cardiovascular risk patients (SR) as well as healthy physically active individuals (HA). This study aimed to quantify the retinal myogenic response to blood pressure (BP) peaks and its effects on consecutive FID for differentiation of microvascular health.MethodsTen HA and eleven SR with a previously established restriction of arteriolar FID (aFID) (<2.2%) were invited in order to assess BP-induced myogenic constriction following a standardized handgrip task and a consecutive FID. BP was measured beat-to-beat.ResultsThe complete dataset of nine HA (3 female, mean age 65 years) and nine SR (5 female, mean age 61 years) individuals was analyzed. The central retinal arteriolar diameter equivalent (CRAE) was 183 ± 11 μm for HA and 176 ± 20 μm for SR. Initial baseline aFID was 1.6 ± 0.4% in HA and 1.6 ± 0.7% in SR. Systolic (p = 0.334) and diastolic (p = 0.245) BP increase following the handgrip task was in the range of 20–30% and comparable in both groups. BP increase was followed by a significantly higher arteriolar (−2.9 ± 1.3% vs. −1.3 ± 0.6%, p < 0.01) myogenic constriction in HA compared to SR. Moreover, in the consecutive assessment of FID directly after the BP-induced vessel constriction, aFID (4.1 ± 2.0% vs. 1.6 ± 0.9%, p < 0.01) was higher in HA compared to SR.ConclusionInitial baseline aFID was blunted in HA and SR. Retinal myogenic constriction was impaired in SR compared to HA. The consecutive aFID after BP-induced myogenic constriction recovered in HA but remained blunted in SR. Additional assessment of retinal myogenic constriction needs to be considered to improve CV risk stratification and reduce false-positive findings of endothelial dysfunction in otherwise healthy active individuals.Clinical Trial RegistrationClinicalTrials.gov: NCT03986892 (https://clinicaltrials.gov/ct2/show/NCT03986892).

Impaired retinal microvascular function predicts long-term adverse events in patients with cardiovascular disease

2020 ◽  
Author(s):  
James D Theuerle ◽  
Ali H Al-Fiadh ◽  
Fakir M Amirul Islam ◽  
Sheila K Patel ◽  
Louise M Burrell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Endothelial Dysfunction ◽  
Cardiovascular Events ◽  
Retinal Vessel ◽  
Light Stimulation ◽  
Traditional Risk Factors ◽  
Flicker Light ◽  
Retinal Arteriolar

Abstract Aims Endothelial dysfunction is a precursor to the development of symptomatic atherosclerosis. Retinal microvascular reactivity to flicker light stimulation is a marker of endothelial function and can be quantified in vivo. We sought to determine whether retinal microvascular endothelial dysfunction predicts long-term major adverse cardiovascular events (MACE). Methods and results In a single-centre prospective observational study, patients with coronary artery disease (CAD) or cardiovascular risk factors underwent dynamic retinal vessel assessment in response to flicker light stimulation and were followed up for MACE. Retinal microvascular endothelial dysfunction was quantified by measuring maximum flicker light-induced retinal arteriolar dilatation (FI-RAD) and flicker light-induced retinal venular dilatation (FI-RVD). In total, 252 patients underwent dynamic retinal vessel assessment and 242 (96%) had long-term follow-up. Of the 242 patients, 88 (36%) developed MACE over a median period of 8.6 years (interquartile range 6.0–9.1). After adjustment for traditional risk factors, patients within the lowest quintile of FI-RAD had the highest risk of MACE [odds ratio (OR) 5.21; 95% confidence interval (CI) 1.78–15.28]. Patients with lower FI-RAD were also more likely to die (OR 2.09; 95% CI 1.00–4.40, per standard deviation decrease in FI-RAD). In Kaplan–Meier analysis, patients with FI-RAD responses below the cohort median of 1.4% exhibited reduced MACE-free survival (55.5 vs. 71.5%; log-rank P = 0.004). FI-RVD was not predictive of MACE. Conclusion Retinal arteriolar endothelial dysfunction is an independent predictor of MACE in patients with CAD or cardiovascular risk factors. Dynamic retinal vessel analysis may provide added benefit to traditional risk factors in stratifying patients at risk for cardiovascular events.

scholarly journals Retinal Vessel Diameters and Blood Pressure Progression in Children

Hypertension ◽  
2020 ◽  
Vol 76 (2) ◽  
pp. 450-457 ◽  
Author(s):  
Giulia Lona ◽  
Katharina Endes ◽  
Sabrina Köchli ◽  
Denis Infanger ◽  
Lukas Zahner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Subsequent Development ◽  
Retinal Vessel ◽  
Good Evidence ◽  
Retinal Arterioles ◽  
Microvascular Alterations ◽  
Retinal Arteriolar ◽  
Central Retinal Venular Equivalent ◽  
Retinal Vessel Diameters

The prevalence of high childhood blood pressure (BP) is rising globally and has been associated with subclinical vascular impairments in children. Longitudinal data on the association of microvascular alterations with the development of high BP in children are lacking. We aimed to analyze the association of central retinal arteriolar (CRAE) and venular (CRVE) diameters with development of higher BP over 4 years in young school children. In 2014, 391 children aged 6 to 8 years were screened for BP and retinal vessel diameters using standardized protocols. Retinal vessel analysis was performed using a retinal vessel analyzer to determine CRAE and central retinal venular equivalent. In the follow-up of 2018, all parameters were assessed in 262 children using the same standardized protocols. During follow-up, systolic and diastolic BP increased significantly (Δ 3.965±8.25 and 1.733±7.63 mm Hg, respectively), while CRAE decreased by Δ −6.325±8.55 µm without significant changes in central retinal venular equivalent (Δ −0.163±7.94 µm). Children with narrower CRAE at baseline developed higher systolic BP after four years (β [95% CI] 0.78 [0.170–1.398] mm Hg per 10 µm decrease, P =0.012). Children with increased systolic or diastolic BP at baseline developed narrower CRAE (β [95% CI] −0.154 [−0.294 to −0.014] µm per 1mmHg, P =0.031 and β [95% CI] −0.02 [−0.344 to −0.057] µm per 1 mmHg, P =0.006, respectively) at follow-up. Narrowing of retinal arterioles predicted evolution of systolic BP. In turn, higher initial systolic and diastolic BP was associated with subsequent development of microvascular impairments. Our results give good evidence for a bivariate temporal relationship between BP and microvascular health in children.

scholarly journals Bilateral Serous Retinal Detachments Associated with Accelerated Hypertensive Choroidopathy

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Yoshio Hirano ◽  
Tsutomu Yasukawa ◽  
Yuichiro Ogura
Keyword(s):  
Blood Pressure ◽  
Visual Acuity ◽  
Antihypertensive Treatment ◽  
Vascular Tortuosity ◽  
Arteriolar Narrowing ◽  
Hypertensive Choroidopathy ◽  
Retinal Arteriolar

Purpose. We report a case of hypertensive choroidopathy with bilateral serous retinal detachments.Patient. A 50-year-old man underwent bilateral serous retinal detachments. Retinal arteriolar narrowing, vascular tortuosity, and arteriovenous nicking were identified in both eyes. The blood pressure was 206/125 mmHg. The patient was diagnosed with bilateral hypertensive choroidopathy and treated with oral antihypertensive treatment.Results and discussion. One month after antihypertensive treatment, the serous retinal detachments resolved and the visual acuity improved. A patient with those findings should be considered as having hypertensive choroidopathy and treated as soon as possible.

scholarly journals Post-exercise hypotension of normotensive young men through track running sessions

2015 ◽  
Vol 21 (3) ◽  
pp. 192-195 ◽  
Author(s):  
Emerson Pardono ◽  
Manuella de Oliveira Fernandes ◽  
Luan Morais Azevêdo ◽  
Jeeser Alves de Almeida ◽  
Marcio Rabelo Mota ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Men ◽  
Daily Basis ◽  
Physically Active ◽  
Post Exercise ◽  
Laboratory Exercise ◽  
Practical Applications ◽  
Pharmacological Mechanism ◽  
Minute Post ◽  
Post Exercise Hypotension

INTRODUCTION: After a single session of physical exercise the blood pressure is reduced (post-exercise hypotension, PHE) and it has been considered as a non-pharmacological mechanism to control the blood pressure. When the exercise is performed since youth it can prevent or avoid hypertension. However, it is important to consider studies with clear practical applications to optimize its reproducibility on a daily basis. OBJECTIVE: Analyze the PEH of normotensive and physically active young men after two track running sessions (maximum and submaximal). METHODS: Participated in this study 62 physically active young men (23.3 ± 4.2 years old; 75.5 ± 9.8 kg; 177.7 ± 5.5 cm; 12.0 ± 4.6% body fatF; 52.4 ± 4.0 mL.kg-1.min-1oxygen uptake), which performed a maximum laboratory exercise test for determination of maximal oxygen uptake (VO2max - aerobic power) and subsequently three randomly running sessions (maximum - T1600; submaximal - T20; control - CON), with 48h interval between themselves. Blood pressure (BP) was measured each 15min during a 60 min period after sessions. RESULTS: Both the maximum and the submaximal exercise lead to PEH. The post-exercise values of systolic blood pressure and diastolic blood pressure differed from resting value in session T20 (p<0.05). The same pattern occurred after T1600 (p<0.05), evidenced from 30th minute post-exercise. The CON did not result in PEH. The magnitude of decay for the mean BP at the 45th after maximum exercise was higher than the other sessions (p<0.05). CONCLUSION: We concluded that both maximum and submaximal exercises, performed on a track running condition, caused PEH in young normotensive and physically active men.

scholarly journals Does socioeconomic status make a difference? A register-based study on the extent to which cardiovascular screening in patients with inflammatory arthritis leads to recommended follow-up in general practice

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e000940
Author(s):  
Anette Hvenegaard Kjeldgaard ◽  
Kim Hørslev-Petersen ◽  
Sonja Wehberg ◽  
Jens Soendergaard ◽  
Jette Primdahl
Keyword(s):  
Blood Pressure ◽  
Socioeconomic Status ◽  
High Risk ◽  
Secondary Care ◽  
Inflammatory Arthritis ◽  
Low Risk ◽  
Risk Screening ◽  
High Risk Patients ◽  
Eular Recommendations ◽  
Risk Patients

ObjectiveTo investigate to what extent patients with inflammatory arthritis (IA) follow recommendations given in a secondary care nurse-led cardiovascular (CV) risk screening consultation to consult their general practitioner (GP) to reduce their CV risk and whether their socioeconomic status (SES) affects adherence.MethodsAdults with IA who had participated in a secondary care screening consultation from July 2012 to July 2015, based on the EULAR recommendations, were identified. Patients were considered to have high CV risk if they had risk Systematic COronary Risk Evaluation (SCORE) ≥5%, according to the European SCORE model or systolic blood pressure ≥145 mmHg, total cholesterol ≥8 mmol/L, LDL cholesterol ≥5 mmol/L, HbA1c ≥42 mmol/mol or fasting glucose ≥6 mmol/L. The primary outcome was a consultation with their GP and at least one action focusing on CV risk factors within 6 weeks after the screening consultation.ResultsThe study comprised 1265 patients, aged 18–85 years. Of these, 336/447 (75%) of the high-risk patients and 580/819 (71%) of the low-risk patients had a GP consultation. 127/336 (38%) of high-risk patients and 160/580 (28%) of low-risk patients received relevant actions related to their CV risk, for example, blood pressure home measurement or prescription for statins, antihypertensives or antidiabetics. Education ≥10 years increased the odds for non-adherence (OR 0.58, 95% CI 0.0.37 to 0.92, p=0.02).Conclusions75% of the high-risk patients consulted their GP after the secondary care CV risk screening, and 38% of these received an action relevant for their CV risk. Higher education decreased adherence.

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