Impaired endothelial function of the retinal vasculature in hypertensive patients

<p><b>Background and Purpose:</b> Arterial hypertension constitutes a central factor in the pathogenesis of stroke. We examined endothelial function of the retinal vasculature as a model of the cerebral circulation.</p> <p><b>Methods:</b> Thirty-eight young subjects (19 hypertensive and 19 normotensive) were treated with the AT1-receptor blocker candesartan cilexetil and placebo, each over 7 days. Retinal capillary flow and blood flow velocity in the central retinal artery were assessed with scanning laser Doppler flowmetry and pulsed Doppler ultrasound, respectively. NG-monomethyl-L-arginine (L-NMMA) was infused to inhibit nitric oxide (NO) synthesis. Diffuse luminance flicker was applied to stimulate NO release.</p> <p><b>Results:</b> In normotensive subjects, L-NMMA decreased retinal capillary flow by 8.2%±13% (P<0.05) and flickering light increased mean blood flow velocity in the central retinal artery by 19%±29% (P<0.01). In contrast, no significant change to these provocative tests was seen in hypertensive subjects. Treatment with candesartan cilexetil restored a normal pattern of reactivity in retinal capillaries (L-NMMA: decrease in perfusion by 10%±17%, P<0.05) and the central retinal artery (flicker: increase in mean blood flow velocity by 42%±31%, P<0.001) in hypertensive patients.</p> <p><b>Conclusions:</b> Endothelial function of the retinal vasculature is impaired in early essential hypertension but can be improved by AT1-receptor blockade.</p&gt

Metabolic syndrome in male population of the Warmia and Masuria region in Poland

Wstęp. Celem pracy była ocena częstości występowania zespołu metabolicznego (MS) według zaleceń IDF 2005 wśrod mężczyzn w wojewodztwie warmińsko-mazurskim. Materiał i metody. Zbadano 631 mężczyzn w wieku 19–82 lat. Dane zebrano między XII 2014 r. a XII 2016 r. Każdy z badanych wypełnił standaryzowany kwestionariusz. Dokonano pomiarow antropometrycznych. Zmierzono ciśnienie tętnicze. W surowicy 398 mężczyzn (wiek: 48 } 13) zbadano poziom glukozy i lipidogram. Analizy przeprowadzono dla czterech grup wiekowych: < 30, 30–47, 48–64, ≥ 65 lat. Wyodrębniono grupy: MS+ badani spełniali kryteria MS oraz MS- badani nie spełniali tych kryteriow. Wyniki. MS rozpoznano u 45,7% badanych. Zaobserwowano istotny wzrost częstości występowania MS w grupach wiekowych: < 30 lat 9,5%, 30–47 lat 38,1%, 48–64 lat 53,2%, ≥ 65 lat 65,8%. Częstość występowania kryteriow MS (n = 398) wyniosła: obwod talii (≥ 94 cm) u 254 badanych (63,8%); stężenie triglicerydow (≥ 150 mg/dl lub leczenie hipertriglicerydemii) u 146 (36,7%); HDL (< 40 mg/dl lub leczenie dyslipidemii) u 83 (20,9%); glukoza na czczo (≥ 100 mg/dl lub leczenie cukrzycy) w 173 (43,5%), podwyższone ciśnienie tętnicze (SBP > 130 mmHg lub DBP ≥ 85 mmHg lub leczenie nadciśnienia tętniczego) u 313 (78,6%). Wnioski. Częstość występowania MS wśrod populacji męskiej Warmii i Mazur wynosiła 45.75% i wykazywała istotny wzrost z wiekiem. Wyniki potwierdzają konieczność wczesnego wykrywania MS u mężczyzn w tym regionie Polski.  Background. The objective of the study was to evaluate the prevalence of metabolic syndrome (MS) in male population of the Warmia and Masuria region in Poland according to IDF 2005 recommendations. Material and methods. 631 men, aged 19–82 years (mean 47 } 14) were examined between Dec 2014 and Dec 2016. Standardized questionnaire was completed by the subjects. Anthropometric measurements were performed. Blood pressure was measured. Blood tests (serum fasting glucose, lipidogram) were performed in 398 men (age: 48 } 13years). Following age groups were identified: < 30YOA, 30–47YOA, 48–64YOA, ≥ 65YOA. Two groups of 398 men were defined: MS+ who fulfilled MS criteria, MS- who did not fulfill MS criteria. Results. MS was diagnosed in 45.7% of 398 men. There was a significant age-related increase in its prevalence: < 30years of age (YOA) 9.5%, 30–47YOA 38.1%, 48–64YOA 53.2%, ≥ 65YOA 65.8%. Prevalence of components of MS in study group (n = 398) was: waist circumference (≥ 94 cm) in 254 (63.8%); high triglycerides (≥ 150 mg/dl or hypertriglyceridemia treatment) in 146 (36.7%); low HDL (< 40 mg/dl or dyslipidemia treatment) in 83 (20.9%); fasting glucose (≥ 100 mg/dl or diabetes treatment) in 173 (43.5%); elevated blood pressure (SBP ≥ 130 mmHg or DBP ≥ 85 mmHg or treatment of hypertension) in 313 (78.6%). Conclusions. The prevalence of MS in male population of Warmia and Masuria was 45.7% with significant increase in age. The study confirms the necessity of early prevention of MS in that region of Poland.

The eye — a window to cardiovascular diseases

Microvascular alterations can parallel and even precede development of cardiovascular disease. Ocular bulb, due to transparent anatomical elements provides a unique opportunity to examine microcirculation non-invasively and in vivo by means of scanning laser Doppler flowmetry. This device enables to obtain both structural and functional parameters of retinal microvasculature. Alterations observed in retinal arterioles, i.e. lumen narrowing, increased wall-to-lumen ratio, rarefaction or reduced retinal capillary flow, have been independently associated with cardiometabolic diseases: hypertension, heart failure, coronary artery disease, stroke, chronic kidney disease and diabetes.Therefore, examination of easily accessible retinal microcirculation may provide novel insights into the mechanisms underlying various diseases, serve as a marker of target organ damage and add valuable information to cardiovascularrisk stratification