scholarly journals Impact of Arterial Hypertension on the Eye: A Review of the Pathogenesis, Diagnostic Methods, and Treatment of Hypertensive Retinopathy

2022 ◽  
Vol 28 ◽  
Author(s):  
Jacek Dziedziak ◽  
Anna Zaleska-Żmijewska ◽  
Jacek Paweł Szaflik ◽  
Agnieszka Cudnoch-Jędrzejewska
Keyword(s):  
Arterial Hypertension ◽  
Diagnostic Methods ◽  
Hypertensive Retinopathy

scholarly journals Changes of morphofunctional state of cardiovascular system in adolescents with metabolic syndrome manifestations

2021 ◽  
Vol 12 (1) ◽  
pp. 21-30
Author(s):  
Natalya V. Gonchar ◽  
Аnzhela А. Аvakyan ◽  
Svetlana N. Chuprova ◽  
Nikolay V. Slizovskiy
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Cardiovascular System ◽  
Autonomic Dysfunction ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Holter Monitoring ◽  
Left Ventricular ◽  
Diagnostic Methods ◽  
Group 2

The results of investigation of features of morphofunctional state of cardiovascular system in adolescents with manifestations of metabolic syndrome depending on presence of hyperuricemia are presented. In the cardiorheumatology department of the hospital, 34 adolescent patients were observed. Criteria for inclusion in the study: the presence of increased blood pressure levels, increased body mass index values. Depending on serum uric acid levels, patients were divided into two groups: group 1 patients without hyperuricemia (n = 18) and group 2 patients with hyperuricemia (n = 16). Functional diagnostic methods were used: standard 12-channel electrocardiography, transtoral echocardiography, daily Holter monitoring. The main attention was paid to the study of the parameters of the left ventricle. Students t-test was used to determine the significance of the differences, the results at p 0.05 were considered reliable. It was established that adolescents with hyperuricemia were more often diagnosed with primary and secondary arterial hypertension, less often with labile arterial hypertension and autonomic dysfunction syndrome by hypertensive type, and adolescents without hyperuricemia were equally often diagnosed with primary arterial hypertension and labile arterial hypertension, autonomic dysfunction syndrome by hypertensive type. Signs of left ventricular remodeling according to echocardiography were more often noted in boys without hyperuricemia (62.5% of cases) than in girls without hyperuricemia (10%; p 0.01) and in boys with hyperuricemia (26.7%; p 0,05). The findings indicated more significant changes in the morphofunctional state of the cardiovascular system in adolescents with hypertensive conditions and manifestations of metabolic syndrome without hyperuricemia, which requires further study.

scholarly journals The history of research of the ophthalmic aspects of hypertension

2021 ◽  
Vol 9 (1) ◽  
pp. 14-18
Author(s):  
Aleksandra Krasińska ◽  
Agata Brązert ◽  
Jarosław Kocięcki
Keyword(s):  
Diagnostic Methods ◽  
Hypertensive Retinopathy ◽  
Cotton Wool Spots ◽  
Microvascular Changes ◽  
History Of Research ◽  
Organ Systems ◽  
History Of ◽  
Funduscopic Examination ◽  
Retinal Exudates

Abstract The awareness of the widespread influence of hypertension on various organ systems is ever increasing. Changes associated with this disease can be observed in the heart, brain, kidneys, but also the organ of vision. These usual microvascular changes are defined as hypertensive retinopathy. During a funduscopic examination, abnormalities such as narrowing of arterioles, symptoms of arteriole and vein intersection, cotton wool spots, intra-retinal exudates, retinal haemorrhages, and in severe cases even swelling of the optic disc and macula. This review presents an overview of the changes at the fundus of the eye that may occur in patients with hypertension, as well as problems with the classification of hypertensive retinopathy over the years, and the development of diagnostic methods in ophthalmology and fundoscopic imaging. Running title: The history of hypertensive retinopathy research

scholarly journals Hypertensive retinopathy: clinical aspects

HYPERTENSION ◽  
2021 ◽  
Vol 14 (3) ◽  
pp. 17-23
Author(s):  
N.Ya. Dotsenko ◽  
I.A. Shekhunova ◽  
S.S. Boev ◽  
L.V. Нerasуmenko ◽  
A.V. Molodan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Prognostic Value ◽  
Prognostic Significance ◽  
Young Patients ◽  
Small Diameter ◽  
Scientific Data ◽  
Clinical Aspects ◽  
Hypertensive Retinopathy ◽  
Routine Practice

Funduscopic examination has long been recognized as the most affordable way to assess the condition of small diameter vessels. However, accumulation of new research data, changes in the requirements for the management of patients with various diseases require a return to the clinical, prognostic significance of fundoscopy and the specification of indications for its conduction in certain situations. This article discusses the prevalence of retinopathy depending on the etiological factor, criteria and stages of its development. Until now, a number of issues regarding retinopathy have not been finally resolved, in particular the classification optimal for routine practice, method of its study, etc. It is believed that changes in the fundus blood vessels reflect parallel changes in the vessels of other regions, but this is not always so. A moderate prognostic value of “mild” retinopathy has been established in terms of the risk of cardiovascular diseases, with moderate retinopathy, this relationship reaches a strong level, and with a malignant one, there is a strong correlation with death. The article discusses indications for fundoscopy in routine clinical practice, taking into account the latest scientific data and international recommendations. For the treatment of hypertensive retinopathy, only adequate control of blood pressure is recommended, which can reduce the signs of retinopathy. The authors concluded that the prognostic value of stage 1–2 hypertensive retinopathy is minimal and does not affect patient management. The latter eliminates the need for fundoscopy in patients with mild, controlled arterial hypertension, not suffering from diabetes, with the exception of young patients. Fundoscopy is required in patients with difficult-to-control and resistant arterial hypertension, high variability of blood pressure.

scholarly journals HYPERTENSIVE ANGIORETINOPATHY IN A CHILD WITH PHEOCHROMOCYTOMA. CLINICAL CASE

2018 ◽  
Vol 13 (4) ◽  
pp. 189-192
Author(s):  
E. V Denisova ◽  
N. A Osipova ◽  
L. A Katargina
Keyword(s):  
Arterial Hypertension ◽  
Treatment Strategy ◽  
Clinical Case ◽  
Interdisciplinary Cooperation ◽  
Pathological Process ◽  
Hypertensive Retinopathy ◽  
Somatic Condition ◽  
Comprehensive Examination ◽  
The Right ◽  
Hypertension In Children

Purpose: to present a clinical case of a child with hypertensive retinopathy developed against the background of undiagnosed pheochromacytoma and primarily regarded as neuroretinitis. The description of the case shows that a comprehensive examination of the child together with a pediatrician and endocrinologist allowed to identify the etiology of the pathological process and choose the right treatment strategy. Discussion. It is important to note that the alertness of the pediatric ophthalmologist in terms of the development of hypertensive retinal angiopathy is reduced. Arterial hypertension in children is much less common than in adults, and cases of hypertensive retinal lesions in children are rare. This can lead to a number of errors in the diagnosis and treatment of eye pathology, as well as underestimation of the severity of the General somatic condition of the child, in this connection it is important to emphasize the importance of close interdisciplinary cooperation in the examination and treatment of children of ophthalmic profile.

COMPARATIVE ANALYSIS OF THE STRUCTURE OF SOMATIC PATHOLOGY IN PATIENTS WITH MYOMA AND UTERINE CANCER

2020 ◽  
Vol 21 (4) ◽  
pp. 11-15
Author(s):  
E. A. Mateykovich ◽  
◽  
E. А. Soldatova ◽  
V. P. Belov ◽  
Z. F. Khamitova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Arterial Hypertension ◽  
Charlson Comorbidity Index ◽  
Uterine Myoma ◽  
Diagnostic Methods ◽  
Hepatobiliary System ◽  
Comorbidity Index ◽  
Group 3 ◽  
Group 2 ◽  
Uterine Body

Objective: to conduct a comparative analysis of the structure of somatic pathology in patients with myoma and cancer of the uterine body. Materials and methods: 522 women were examined, including 40 gynecologically healthy (group 1), 314 patients suffering from uterine myoma (group 2), 168 patients with malignant neoplasms of the uterine body (group 3). All patients, in addition to General clinical, histological and instrumental diagnostic methods, were calculated the Charlson comorbidity index, which determines the presence of concomitant diseases and the prognosis of mortality. Results. A comprehensive assessment of concomitant pathology in patients with group 3 showed that the leading positions among all patients in frequency are occupied by arterial hypertension - 72%, coronary heart disease - 28,6%, obesity - 27,9%, endocrinopathy - 25,6%, gastropathy - 23,1%, pathology of the hepatobiliary system - 20,8%. When analyzing somatic pathology in patients with uterine myoma, it was found that arterial hypertension is most common - 23,6% (3,5 times less often than in group 3), anemia - 26,8% (3.8 times more often than in group 3), endocrinopathy - 10,8% (2,4 times less often than in group 3), gastrotopathy - 15% (0,8 times less often than in group 3), pathology of the hepatobiliary system - 15,2% (0,7 times less than with group 3). At the same time, comorbidity has its own characteristics depending on the main pathology and the age of the patients. Thus, the total number of extragenital pathology in women with group 3 was 73% compared to 27,4% in patients with uterine myoma. The Charlson comorbidity index for group 3 was 1,78 overall, and 0,35 for group 2, which is 5 times lower. Conclusion. The range of somatic conditions in patients with benign and malignant uterine tumors is very wide. The age Association is obvious. The leading positions in the two compared groups are occupied by cardiovascular diseases. The total number of extragenital pathology in women with group 3 is 2,7 times higher, and the comorbidity index is 5 times higher, compared to those in patients with uterine myoma.

scholarly journals POS1123 DISORDERS OF URODYNAMICS AND PARENCHYMA CONCENTRATION FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND GOUT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 840.1-840
Author(s):  
M. Gromova ◽  
V. Tsurko ◽  
O. Kisliak ◽  
A. Kashkadayeva ◽  
S. Averinova
Keyword(s):  
Arterial Hypertension ◽  
Gouty Arthritis ◽  
Concentration Function ◽  
Renal Parenchyma ◽  
Diagnostic Methods ◽  
Arterial Blood Flow ◽  
Arterial Blood ◽  
Group I ◽  
Increased Risk ◽  
Group Ii

Background:The combination of arterial hypertension and gout increases the risk of developing chronic kidney disease in patients.Objectives:To assess urodynamics and concentration function of the renal parenchyma in patients with arterial hypertension and gout.Methods:We examined 87 patients with arterial hypertension and gout. 83% of the patients were men with a mean age of 55.4±12.3 years. Grade I arterial hypertension was detected in 43.7% of patients, grade II was in 36.9% and grade III was in 19.3%. The duration of arterial hypertension was 8 [4; 11] years. All the patients had chronic gouty arthritis. 30% of the patients had tophi. The duration of gout was 7 [2; 10] years. Markers of renal lesions, urine sediment and GFR calculation were assessed in all the patients. All the patients were performed a modern systems analysis of nephrological conditions based on comprehensive renoscintigraphy (SENS-CRS) which allows to make an in-depth differential analysis of the renal parenchyma and thus reveals abnormalities in the upper and lower urinary tract function with a minimum of radiation exposure of 0.6 mSv per patient.Results:Using the standard method of GFR calculation with CKD-EPI formula we found that 10 patients (11.3%) had no signs of CKD (GFR over 90 ml/min); 56 patients (64.5%) had I-II stage of CKD (GFR over 60 ml/min) 21 patients (24.2%) had III-IV stage of CKD (GFR less than 60 ml/min).The patients were divided into two groups for a differentiated assessment of urodynamics. Group I consisted of 66 patients with a GFR of more than 60 ml/min and Group II consisted of 21 patients with a GFR of less than 60 ml/min. The comparison of the two groups revealed abnormalities in urodynamics. In Group 1 arterial blood flow in the parenchyma (A 14.5±6.8 sec) was slowing down against the background of normal venous outflow (V 17.8%±9.2%). Concentration function of the kidneys was sufficient (Gren 17.6±5.2 o.e.). The total excretion rate of labeled urine from the two kidneys decreased to D = 56.5% ± 16.1% during its transition from the cortical to the cerebral layer of the renal parenchyma. The indixes of the relative urinary stasis in the renal calyx-pelvis system exceeded the standard ones on average by 2 times (KC 4.8 ± 3.2; KP 7.0 ± 4.2), which indicated stagnant disorders in the kidneys, hidden from conventional diagnostic methods. The patients in Group II had those abnormalities even more expressed (A 12.4±4.5 sec, V 12.8%±9.4%, D 51.9%±15.4%, KC 5.0±3.3; KP 9.5±5.2).16 patients under follow-up who had arterial hypertension with serum creatinine levels greater than 125 μmol/l were classified as a subgroup of patients at an increased risk of developing high stages of CKD. Stages I-II were previously diagnosed in the 16 patients according to the CKD-EPI formula and stage III CKD with a high risk of progression to stage IV CKD was diagnosed in one patient.A comparative analysis of the SENS-CRS data of the patients with arterial hypertension was performed between the above-mentioned 16 patients and the remaining 71 patients. The nonparametric Mann-Whitney method was used (p<0.05) for the purpose. The method was established only by the indicator D (%) of the rate of elimination of the radiopharmaceutical from the renal parenchyma. However, no significant differences were found either for the calculated GFR values, or for all other parameters of complex renoscintigraphyConclusion:After the gout diagnosis is made and confirmed by screening, it is important that patients with gout and hypertension should be included in the nephrologic monitoring system to control risk factors associated with the development or aggravation of CKD.The renocortical parameter D (%), used in the SENS-CRS technology, is a prognostically important preclinical marker of intrarenal congestion in the latent development of serious morphofunctional disorders in the renal parenchyma leading to the development of CKD or the aggravation of an existing stage of CKD.Disclosure of Interests:None declared.

scholarly journals Modern Aspects of Hypertensive Angioretinopathy

2019 ◽  
Vol 15 (4) ◽  
pp. 470-475
Author(s):  
L. K. Moshetova ◽  
I. V. Vorobyeva ◽  
A. Dgebuadze
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Retinal Disease ◽  
Early Death ◽  
Automated System ◽  
World Health ◽  
Hypertensive Retinopathy ◽  
Special Importance ◽  
Muscular Tissue

This literature review is devoted to modern problems of hypertensive retinopathy with arterial hypertension, as well as hypertensive retinopathy in combination diseases. The latest world studies were analyzed. Particular attention is paid to the clinical disease characteristics at the present stage with the analysis of the arterio-venous ratio, optic nerve edema (with high blood pressure figures) using an automated system, vector analysis, suggesting a new arteriovenous classification, called Web Integration (Wivern). The modern pathogenesis of hypertensive retinopathy, namely the ratio of proangiogenic and anti-angiogenic factors, the role of inflammation (C-reactive protein), the role of endothelin-1, endostatin, interleukin-8 (IL-8), and the main fibroblast growth factor (bFGF ), angiogenin and uric acid. The special importance of fundus registration is reflected with the help of the newest equipment at high figures of arterial pressure in patients with hypertensive retinopathy. It is known that according to the World Health Organization (WHO), mortality rate from cardiovascular diseases is 31 %. Hypertension is the main risk factor for coronary heart disease, myocardial infarction, heart failure, stroke, kidney disease and early death. Questions of eye blood flow in hypertensive angioretinopathy in patients with arterial hypertension (AH) are covered. Hypertensive retinopathy (HR) is a retinal disease that is caused by a prolonged increase blood pressure (BP) and leads to a decrease in vision. The data of pathophysiology are analyzed (arterial hypertension (AH) leads to thickening of the vessels of the inner membrane (intima), to thickening of the medial membrane (media) — hyperplasia of the muscular tissue followed by hyaline degeneration with the development of sclerotic changes). The questions of modern diagnostics with retinal morphological status evaluation (OCT), detection of eye fundus condition with newest fundus camers, pathogenetic aspects are discussed. This review will help to prevent the development of more severe forms of hypertensive retinopathy. This information will allow us to identify the most significant indicators in the early diagnosis of hypertension angioretinopathy.

scholarly journals Carbohydrate metabolism and transformation of pre-diabetes into type 2 diabetes mellitus depending on diagnostic methods in nondiabetic patients with hypertension and high cardiovascular risk

2012 ◽  
Vol 18 (2) ◽  
pp. 83-95
Author(s):  
V. V. Tolkacheva ◽  
S. V. Villevalde ◽  
ZH. D. Kobalava
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Glucose Tolerance ◽  
Arterial Hypertension ◽  
Diagnostic Criteria ◽  
Fasting Glucose ◽  
Diagnostic Methods ◽  
Oral Glucose ◽  
Newly Diagnosed ◽  
Hypertensive Patients

Objective. To assess the glycemia status and risk of progression to diabetes mellitus (DM) depending on diagnostic criteria (fasting glucose, 2-h glucose, glycated hemoglobin HbA1c and their combination) in hypertensive patients with high cardiovascular (CV) risk without known DM. Methods. 433 hypertensive patients with high CV risk were included in the study. Stratification of CV risk was done in accordance with national guidelines for the management of arterial hypertension (2010). Patients were divided into groups with noncomplicated (n = 201) and complicated (n = 232) arterial hypertension. Follow-up was 6 years. Fasting glucose, 2-h glucose during oral glucose tolerance test (OGTT) and HbA1c were assessed in all patients each 6 months. The patients were divided into groups with normoglycemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), its combination (IFG/IGT), isolated HbA1c 5,7-6,4 % and newly diagnosed DM (ADA2011). Results. Impaired glucose status was diagnosed in 82 % of patients with arterial hypertension and high CV risk according to fasting glucose, 2-h glucose, HbA1c diagnostic criteria. IFG was the most prevalent in patients with non-complicated arterial hypertension, and newly diagnosed DM — in complicated arterial hypertension. HbA1c used as an additional criterion of impaired glucose metabolism in addition to OGTT contributes to the better identification of newly diagnosed DM in high risk hypertensive patients for 10 %. Two-hour hyperglycemia has higher predictive value for diagnosing DM in patients with complicated arterial hypertension, thus imposing the obligatory OGTT assessment in this group of patients. OGTT is desirable, but non-obligatory in patients with non-complicated arterial hypertension. Conclusion. The assessment of HbA1c and fasting glucose/2-h postload glucose has independent and complementary importance and helps to identify patients with different pathogenetic mechanisms of glucose metabolism impairment. Prognostic value of HbA1c as a diagnostic criterion of risk progression to DM is comparable with fasting glucose/ 2-h postload glucose assessment.

scholarly journals Stress and arterial hypertension - from pathophysiology to pharmacology

2021 ◽  
pp. 66-66
Author(s):  
Nemanja Nenezic ◽  
Radomir Matunovic ◽  
Ognjen Gudelj ◽  
Ivica Djuric ◽  
Jasna Jancic ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Animal Studies ◽  
Strong Association ◽  
Antihypertensive Agents ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Hypertensive Retinopathy ◽  
Channel Blockers ◽  
Post Traumatic Stress ◽  
Converting Enzyme Inhibitors ◽  
Adrenergic Blockers

Arterial hypertension is the most massive chronic non-infectious disease of mankind nowadays. It may remain undiagnosed for years, provoking later complications, such as acute heart failure, cerebrovascular stroke, myocardial infarction, renal failure, hypertensive retinopathy, or sudden death. Primary arterial hypertension is more common, while secondary occurs in about 5-20% of cases. The recent studies have shown that stress may be a core factor in development of essential hypertension in some patients. For the patients suffering from post-traumatic stress disorder, stress is the dominant etiological factor that leads to the disease. It has been proven that chronic stress can affect blood pressure regulation and endocrine-metabolic functions through the limbic-hypothalamic centers, therefore it can affect the arterial hypertension development. The strong association between stress and arterial hypertension have been also confirmed in preclinical and animal studies. For the pharmacotherapy approach, the most important are beta-adrenergic blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors) and AT1-receptor blockers (sartans). As a second line treatment, calcium channel blockers, diuretics, alpha-adrenergic blockers, and central antihypertensive agents may be required. The anxiolytics, such as benzodiazepines, should be considered if chronic anxiety and psychosomatic disorders are present.

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