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At least 19 recordsLinked to original sources
PubMed1989

[Malignant hypertensive retinopathy in spontaneously hypertensive stroke-prone rats. Effect of treatment with cicletanine].

Stroke-Prone spontaneously hypertensive rat strain (SHR-SP) always develops hypertensive retinopathy. The aim of the present work was to study the activity of a new antihypertensive drug, a synthetic furopyridine: cicletanine, in retinal hypertensive morphological lesions. The experiment was performed in 39 rats SHR-SP/A3N Iffa Credo, 11 weeks old, divided into 3 groups: group 1 was the control group, groups 2 and 3 were orally treated with cicletanine (respectively 100 and 150 mg/kg). All the rats had free access to tap water containing 1 p. 100 NaCl. During 6 weeks, blood pressure, body weight and survival were recorded, then all the rats were sacrificed. The eyes were removed, the posterior pole collected and fixed with Trump liquid for transmission election microscopy. In the SHR-SP control group, each layer showed neural body and/or process lesions: in the ganglion cell layer, some ganglion cells realized cytoid bodies corresponding to a lysed cell with nucleus degeneration, most of the axons were destroyed. In the inner and outer plexiform layers, most of the contacts between processes were lost because of fibrinous deposits. Numerous synapses were destroyed in the outer plexiform layer. These findings might explain the numerous dense bodies in the inner rod segment and the vesiculation of the rod outer segment. The capillaries showed markedly hypertensive lesions. Whereas, in both treated groups, rare and animal lesions were observed. The fact that these lesions were so few and so unimportant after 6 weeks of treatment, as well as for the photoreceptors which remained unimpaired, is closely related to cicletanine therapy, since it was so even though the treatment had been started with an already high blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Severe hypertensive retinopathy. Increased incidence in renoparenchymal hypertension.

In 205 patients with histologically evaluated glomerulonephritis, 69 patients with essential hypertension and 12 patients with renovascular hypertension, the retina was examined and evaluated by fundus photography. Changes of the retina were classified according to the recommendations of WHO: mild to severe changes of retinal arteries were termed as mild hypertensive retinopathy, and exaggerated changes, including exudates, hemorrhages and optic disc changes, as severe hypertensive retinopathy. In spite of the short duration of renal disease and the young age of the patients in many cases, retinal changes in patients with renal hypertension were significantly more severe: especially in focal segmental sclerosis and membranoproliferative glomerulonephritis was severe hypertensive retinopathy observed. Mild hypertensive retinopathy was more prevalent in essential hypertension. When renal disease progresses the retinal findings tended to deteriorate as well. Since the 24-hour blood pressure profile was comparable in most of the groups studied, it was supposed that the vulnerability of the retina and probably other vascular beds (e.g. kidneys) was increased. We conclude that the retina of these patients should be examined even in the case of relatively mild hypertension (greater than 180/100 mm Hg) and early antihypertensive treatment is an important requirement.

Adult↗
PubMedDate not supplied

'Minimal-change hypertensive retinopathy' and 'arterial pre-hypertension', illustrated via ambulatory blood-pressure monitoring in putatively normotensive subjects.

PURPOSE: To investigate the 24 h blood-pressure (BP) pattern in subjects who were found to show some incipient signs of hypertensive retinopathy but had been diagnosed as normotensives by means of casual sphygmomanometry. METHODS: Non-invasive ambulatory BP monitoring was performed in 25 caucasian subjects (16 M, 9 F; mean age 46 +/- 16 years) showing this type of retinal problem. A comparable number of controlled normotensive Caucasian subjects (15 M, 10 F; mean age: 48 +/- 15 years) without funduscopic signs of hypertensive retinopathy were investigated as a reference group. A series of BP tests over time was analysed by means of conventional biometry and chronobiological methods. RESULTS: The biometric estimates suggest that the investigated subjects with incipient hypertensive retinopathy, although characterized by BP values below 140/90 mmHg, show a significantly higher daily systolic BP. The increase, however, is within WHO reference limits and is not associated with the abolition of the circadian BP rhythm. CONCLUSIONS: The results suggest that the initial signs of hypertensive retinopathy may appear before BP elevation above WHO reference limits occurs. Because of this, it can be assumed that there is such a condition as 'minimal-change hypertensive retinopathy' associated with a haemodynamic picture of 'arterial pre-hypertension'.

Blood Pressure↗
PubMed1997

[Minimal lesion hypertensive retinopathy and arterial pre-hypertension: evidence of arterial pressure monitoring in presumed normotensive subjects at zero risk].

The present study investigates the blood pressure (BP) 24 h pattern in 25 subjects who were found to show some incipient signs of hypertensive retinopathy, although they were diagnosed as normotensive by means of casual sphygmomanometry. BP was controlled by means of non invasive ambulatory monitoring. A comparable number of normotensive subjects without fundoscopic signs of hypertensive retinopathy was investigated as a control group. BP times series were analyzed by means of conventional and rhythmometric biometry. The biometric estimates suggest that the subjects with incipient hypertensive retinopathy show a significantly higher level of daily systolic BP even though their BP values remain below the reference limits. This finding suggests that the hypertensive retinopathy may exist in a non-zero stage characterizable as minimal change tensive retinopathy. This retinal picture occurs in subjects who show a pre-hypertensive stage in their BP 24 h pattern.

Adolescent↗
PubMed1993

Resolution of hypertensive retinopathy despite persistent high diastolic pressure.

Four patients with exudative retinopathy due to hypertension were observed for periods ranging from 12 to 35 months. Despite multiple drug therapy in high dosage and some clinic attendance, blood pressure was not controlled and remained severely elevated. Even though severe hypertension persisted, however, exudative phenomena disappeared and renal function remained stable during the follow-up period. Neither the pathogenesis nor the natural course of hypertensive retinopathy is yet fully understood. It is accepted that antihypertensive therapy causes gradual regression of the retinal changes of hypertensive retinopathy. There are no data concerning the natural course and progress of hypertensive retinopathy in patients with severe untreated hypertension. It is unclear why the patients in our study had complete regression of hypertensive retinopathy.

Adult↗
PubMed1994

High prevalence of hypertensive retinopathy and coronary heart disease in hypertensive patients with persistent microalbuminuria under short intensive antihypertensive therapy.

In 84 patients with insufficiently treated essential hypertension (systolic blood pressure > or = 160 mmHg and/or diastolic blood pressure > or = 100 mmHg) and normal renal function (creatinine clearance Mean +/- SD = 114 +/- 22 ml/min/1.73 m2) the mean urinary albumin excretion was 39 +/- 19 mg/24h in comparison to 14 +/- 13 mg/24h (p < 0.001) in 10 healthy controls. In 39 of the hypertensive patients albumin excretion was increased (> 30 mg/24h urine) in a subclinical range (microalbuminuria). After 3 days of effective antihypertensive treatment (systolic blood pressure < 150 mmHg and diastolic blood pressure < 90 mmHg) the mean albumin excretion of the microalbuminuric patients decreased from 66 +/- 33 mg/24h to 44 +/- 28 mg/24h (p < 0.01). 27 of these hypertensive patients showed persistent microalbuminuria; in the other 12 patients with primary microalbuminuria the albumin excretion rate was normal now. In the patients with persistent microalbuminuria the prevalence of hypertensive retinopathy was 85% in comparison to only 33% in the patients with reversible microalbuminuria under intensified antihypertensive treatment (p < 0.01) and 31% in the patients with primary normoalbuminuria. The prevalence of coronary heart disease was 11% in the patients with normoalbuminuria and 29% in those with irreversible microalbuminuria (ns). Thus hypertensive patients with persistent but not with reversible microalbuminuria under short intensive antihypertensive therapy show a statistically significant higher prevalence of hypertensive retinopathy and therefore can be considered as an indicator of general microvascular damage in essential hypertension.

Adult↗
PubMed1982

Pathophysiology of hypertensive retinopathy.

The effects of systemic hypertension on the posterior segment of the eye are discussed under the headings of hypertensive choroidopathy, hypertensive retinopathy, and hypertensive optic disc edema. The sympathetic nervous control and autoregulatory mechanisms of the retinal and choroidal vasculatures are briefly reviewed. In hypertensive choroidopathy focal occlusion of choriocapillaris leads to necrosis of retinal pigment epithelium (Elschnig spots). Hypertensive retinopathy is described in vasoconstrictive, exudative, and sclerotic phases, followed by complications of the sclerotic phase. Hypertensive optic disc edema is influenced by the blood supply and extracellular tissue fluid pressure of the optic nervehead. In baboons with hypertensive disc edema, accumulation of axoplasmic components is observed in the optic nervehead.

Animals↗
PubMed1998

Absence of hypertensive retinopathy in a Turkish kindred with autosomal dominant hypertension and brachydactyly.

BACKGROUND: A 60 member Turkish kindred with autosomal dominant hypertension, which cosegregates completely with brachydactyly and short stature, was studied. Affected people have severe hypertension and generally die of stroke by the age of 50. The hypertension closely resembles essential hypertension and, accordingly, the mechanisms of blood pressure elevation are unknown. The gene responsible was mapped to chromosome 12p. METHODS: All 29 affected family members underwent a basic physical examination and funduscopy. Other than markedly elevated blood pressures and the residua of stroke in a few subjects, the apparent lack of end organ damage was striking, including the normal appearing fundi. Five affected individuals were studied in a clinical research unit study. All underwent a complete ophthalmological examination. Fluorescein angiograms were obtained in three subjects. RESULTS: Systolic blood pressures ranged from 170 to 250 mm Hg, while diastolic blood pressures ranged from 100 to 150 mm Hg in affected individuals. In all affected subjects, the fundi were only minimally altered or clinically normal. All three fluorescein angiograms were normal. Despite severe hypertension since childhood the patients showed no signs of hypertensive retinopathy. CONCLUSIONS: The absence of hypertensive retinopathy in this novel form of inherited hypertension is due to an altered structure of retinal arteriolar walls or some other protective mechanism. Since evidence of end organ damage is scarce in other organs as well, the protective mechanism appears to be generalised.

Adolescent↗
PubMed2006

The relationship between hypertensive retinopathy and Angiotensin converting enzyme gene polymorphism.

OBJECTIVE: Hypertensive retinopathy is an important complication and a major site of target organ damage from hypertension. Angiotensin converting enzyme (ACE) has a main role in cardiovascular physiology. It was shown that ACE gene polymorphism is related to plasma concentrations of ACE. We aimed to investigate the relationship between ACE gene polymorphism and hypertensive retinopathy. METHODS: One-hundred and eight patients (62 female, mean age; 52.8 +/- 7.0 years) with essential hypertension and 30 healthy volunteers were enrolled in this study. Hypertensive retinopathy was diagnosed in a dark room with direct ophthalmoscopy by a single ophthalmologist who was blinded to clinical data. Polymerase chain reaction analysis was used to detect the insertion/deletion (l/D) polymorphism of the ACE gene. Patients were assigned to Group DD, Group ID and Group II. Three genotypic subgroups were compared for hypertensive retinopathy. RESULTS: There were 42 patients (27 female, mean age: 52.4 +/- 7.8) in DD group; 51 patients (28 female, mean age: 53.6 +/- 6.9) in ID group and 15 patients (7 female, mean age: 51.2 +/- 5.6) in II group. Basal characteristics of the patients were similar in the three groups. The genotypic distributions of patients and healthy controls were comparable. Hypertensive retinopathy was determined in 15 (35.7%) patients in DD group, 8 (15.6%) patients in ID group and 2 (13.3%) patients in II group (p<0.05). CONCLUSION: We found a significant relationship between ACE gene I/D polymorphism and hypertensive retinopathy. Identification of ACE genotype in hypertensive patients might be useful to discriminate the patients who are more susceptible to hypertensive retinopathy.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2006

Fred Hollows lecture: hypertensive retinopathy - a journey from fundoscopy to digital imaging.

Hypertensive retinopathy refers to a spectrum of retinal microvascular signs that develop in response to elevated blood pressure. These signs are broadly divided into localized signs (focal retinal arteriolar narrowing, arteriovenous nicking, retinal haemorrhages, cotton wool spots, hard exudates and microaneurysms) and diffuse signs (generalized retinal arteriolar narrowing, arterial wall opacification and optic disc oedema). Although their association with systemic morbidity was recognized more than a century ago, the prognostic significance of hypertensive retinopathy has not received much attention. In large part, this is because clinical assessment of hypertensive retinopathy signs with the direct fundoscopy has proven imprecise. Data from large population-based studies in the past decade, using retinal photographic methods to define hypertensive retinopathy signs, have provided new insights into the epidemiology, systemic associations and clinical significance of hypertensive retinopathy. These studies show that hypertensive retinopathy signs are common (up to 14% of adults aged 40 years and older, even in those without clinical diabetes or hypertension) and are strongly associated with blood pressure. Various retinopathy signs predict the risk of stroke, congestive heart failure and cardiovascular mortality, independent of blood pressure and other risk factors. These data suggest that patients with hypertensive retinopathy signs may benefit from a careful cardiovascular evaluation, and appropriate risk reduction therapy if indicated. Future advances in digital retinal imaging technology will allow researchers and clinicians to better chart and monitor the vascular effects of hypertension.

Humans↗
PubMed2004

Blood pressure assessment in healthy cats and cats with hypertensive retinopathy.

OBJECTIVE: To determine whether there was an association between hypertensive retinopathy and high systolic, diastolic, and mean arterial blood pressures in cats. ANIMALS: 181 cats. PROCEDURE: Systolic, diastolic, and mean arterial blood pressures were measured by use of a noninvasive oscillometric technique. The range of blood pressure measurements in healthy cats from various age groups was determined. Associations among systolic, diastolic, and mean arterial blood pressure; hypertensive retinopathy; hyperthyroidism; left ventricular cardiac hypertrophy; chronic renal failure; and serum biochemical abnormalities were determined. RESULTS: All blood pressure measurements increased with age in healthy cats. The frequency of hypertensive retinopathy also increased with age and with blood pressure, and hypertensive retinopathy was particularly found in cats with systolic blood pressures > 168 mm Hg. There was an increased risk for hypertensive retinopathy in cats that were female, > 10 years old, and neutered. The risk of chronic renal failure also increased as blood pressure, particularly systolic blood pressure, increased. CONCLUSIONS AND CLINICAL RELEVANCE: Hypertensive retinopathy was common in cats > or = 10 years of age and was associated with systolic blood pressures > 168 mm Hg when measured by the noninvasive oscillometric technique.

Age Factors↗
PubMed2005

The association of plasma adiponectin levels with hypertensive retinopathy.

OBJECTIVE: Previous studies have demonstrated that low plasma adiponectin concentrations are associated with essential hypertension. It has also recently been shown that adiponectin plays an essential role in the modulation of angiogenesis. These data led us to hypothesize that adiponectin might contribute to end-organ damage in hypertension. METHODS: In the present study we have evaluated the relationship between plasma adiponectin concentrations and hypertensive retinopathy. One hundred and ten patients newly diagnosed with essential hypertension (EHT) (mean age, 46.79+/-5.0 years; body mass index (BMI), 26.47+/-2.23 kg/m(2); male/female ratio, 58/52) and 57 healthy normotensive control subjects (NT) (mean age, 46.84+/-5.4 years; BMI, 26.66+/-2.65 kg/m(2); male/female ratio, 33/24) were enrolled. RESULTS: Plasma adiponectin levels were significantly lower in EHT than in NT (P < 0.001). In addition, adiponectin concentrations were strongly correlated with systolic and diastolic blood pressures in EHT (r = -0.757, P < 0.001; r = -0.761, P < 0.001) while there was no correlation in the NT group. Plasma adiponectin in patients with grade 0 hypertensive retinopathy (n = 52) was significantly higher than that of the patients with grade 1 (n = 30) and 2 (n = 28) hypertensive retinopathy (P < 0.001 for each). Plasma adiponectin in patients with grade 0 hypertensive retinopathy was also significantly lower than that in the NT group (P < 0.001). The estimated threshold of plasma adiponectin concentration for hypertensive retinopathy was 17 microg/ml. This critical adiponectin level served largely to separate patients with retinopathy from those without. CONCLUSION: Our results have shown that plasma adiponectin concentrations decrease progressively with higher grades of hypertensive retinopathy even after correction for other atherogenic risk factors, suggesting that a critical adiponectin level is needed for the development of retinopathy.

Adiponectin↗
PubMed1995

Hypertensive retinopathy in Afro-Caribbeans and Europeans. Prevalence and risk factor relationships.

The prevalence of hypertension is particularly high in people of black African descent throughout the world, and the consequences of hypertension, such as hypertensive heart and renal disease and stroke, are also more common. But there is little consensus on whether hypertensive retinopathy follows a similar pattern. We determined the prevalence of hypertensive retinopathy and its relationships with resting and ambulatory blood pressure in a population study of Afro-Caribbeans and Europeans aged 40 to 64 years in London, UK. Retinal photographs of 651 participants were graded for hypertensive retinopathy. Age- and sex-standardized prevalence of retinopathy was 11% (95% confidence interval, 8% to 14%) in Europeans and 21% (95% confidence interval, 16% to 26%) in Afro-Caribbeans (P < .001), respectively. This ethnic difference in prevalence was greatest in normotensive women (8% in Europeans versus 20% in Afro-Caribbeans, P < .001). Resting systolic pressure was 8 mm Hg higher in normotensive Afro-Carribean compared with European women, but this could not fully account for the ethnic difference in the prevalence of retinopathy. Examination of the different relationships of age and resting and ambulatory blood pressures with hypertensive retinopathy showed that these relationships were strongest in European women and weakest in Afro-Caribbean women. We conclude that hypertensive retinopathy is more common in Afro-Caribbeans, particularly women, and that ethnic differences in resting blood pressure cannot fully account for this. The relatively weak relationship between resting and ambulatory blood pressures and retinopathy in Afro-Caribbeans suggests that factors other than blood pressure determine the high rates of hypertensive retinopathy in this group.

Adult↗
PubMed1983

Hypertensive retinopathy in the newborn infant.

Hypertension (blood pressure greater than 70 mm Hg on three days) was noted in 1.2% of all neonatal admissions to the intensive and intermediate care nurseries. During this investigation of neonatal hypertension, a retinopathy identical to that seen in hypertensive adults was noted. Indirect ophthalmoscopy was performed in 21 neonates with elevated blood pressure. Eleven of these patients demonstrated some or all of the following abnormalities: increased ratio of venous to arterial caliber, vascular tortuosity (including arteriovenous crossing changes), superficial and deep hemorrhages, and exudates. These findings appeared to resolve after control of the hypertension. The specificity of this constellation of lesions for hypertensive retinopathy and their possible clinical significance are explained in light of what is known about hypertensive retinopathy in adults.

Exudates and Transudates↗
PubMed2005

Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality.

Hypertensive retinopathy has long been regarded as a risk indicator for systemic morbidity and mortality. New population-based studies show that hypertensive retinopathy signs are strongly associated with blood pressure, but inconsistently associated with cholesterol and other risk factors of atherosclerosis. Mild hypertensive retinopathy signs, such as generalized and focal retinal arteriolar narrowing and arteriovenous nicking, are weakly associated with systemic vascular diseases. Moderate hypertensive retinopathy signs, such as isolated microaneurysms, haemorrhages and cotton-wool spots, are strongly associated with subclinical cerebrovascular disease and predict incident clinical stroke, congestive heart failure and cardiovascular mortality, independent of blood pressure and other traditional risk factors. These data support the concept that an assessment of retinal vascular changes may provide further information for vascular risk stratification in persons with hypertension.

Atherosclerosis↗