The association between endothelial dysfunction and hypertensive retinopathy in essential hypertension

Prevalence of hypertensive retinopathy and its associated factors among adult hypertensive patients attending at Comprehensive Specialized Hospitals in Northwest Ethiopia, 2024, a multicenter cross-sectional study

INTRODUCTION

Hypertensive retinopathy refers to changes in the retinal microvasculature resulting from elevated blood pressure, and the global burden ranges from 2 to 85%. However, there was no evidence on prevalence and associated factors of hypertensive retinopathy among adult hypertensive patients in the study area even in Ethiopia.

OBJECTIVE

The aim of this study was to investigate prevalence of hypertensive retinopathy and associated factors in adult hypertensive patients attending at Comprehensive Specialized Hospitals in Northwest Ethiopia in 2024.

METHODS

Multicenter hospital-based cross-sectional study was conducted in Northwest Ethiopia Comprehensive specialized hospitals from June, 07 to August, 07, 2024. A multistage sampling technique with an interval of 3 was applied to select 696 study participants. Data were collected through personal interviews, review of medical records and eye examinations. Data were entered into the Kobo Toolbox and then transferred to STATA version 17 for analysis. Bivariable and then multivariable binary logistic regression models were fitted to determine factors associated with hypertensive retinopathy. Variables with a P-value of less than 0.05 at multivariable analysis were considered statistically significant.

RESULT

A total of 696 (95.34%) participants were included in the study. The prevalence of hypertensive retinopathy was 57.47%(95%CI: 53.75, 61.10). Age > 74 years (AOR = 4.24, 95%CI = 1.54,11.64), heart disease(AOR = 5.38, 95%CI = 1.86,15.58), duration of hypertension > 5years (AOR = 12.66, 95%CI = 3.88,41.29), dyslipidemia (AOR = 3.44,95%CI = 1.59-7.45), uncontrolled current levels of hypertension (AOR = 40.03, 95%CI = 17.19,93.18), poor adherence of hypertensive medications (AOR = 1.84, 95%CI = 1.12,3.03) and diabetes (AOR = 3.56, 95%CI = 1.49,5.99) were positively associated with hypertensive retinopathy.

CONCLUSION

-The prevalence of hypertensive retinopathy is high among systemic hypertensive patients seen in Northwest Ethiopia comprehensive specialized hospitals and independently associated with older age, longer duration of hypertension, heart disease, diabetes, dyslipidemia, poor adherence of hypertension medications and uncontrolled hypertension. Early diagnosis and treatment of hypertension was recommended to prevent target organ complications.

Alteration of plasma von Willebrand factor in the treatment of retinal vein occlusion with cystoid macular edema

Retinal vein occlusion (RVO) is a major retinal disease caused by venous thrombosis. Although several studies have proposed an association between venous thrombosis and von Willebrand factor (VWF), the association between RVO and VWF remains unclear. We aimed to investigate the association between RVO and VWF and the alteration of VWF levels under anti-vascular endothelial growth factor (VEGF) treatment. We enrolled 55 patients with RVO involved cystoid macular edema. They received intravitreal injection of anti-VEGF drugs, either ranibizumab or aflibercept. We examined the clinical data and measured plasma VWF antigen and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity to identify variabilities during treatment. At baseline, there was no significant difference between the RVO group and age-matched controls in both VWF antigen and ADAMTS13 activity levels, but ADAMTS13 activity was significantly lower in central RVO than in branch RVO (P = 0.015). In branch RVO, VWF antigen was negatively correlated with central choroidal thickness (r = −0.51, P < 0.001). In branch RVO after anti-VEGF treatment, VWF antigen levels decreased significantly from 134% at baseline to 109% at 1 day (P = 0.002) and 107% at 1 month (P = 0.030) after treatment. In contrast, ADAMTS13 activity showed no significant difference during this period. In branch RVO at 1 month after treatment, VWF antigen was negatively correlated with central choroidal thickness (r = −0.47, P = 0.001). Our findings suggest an association between VWF and central choroidal thickness in patients with branch RVO, thus the measurement of VWF may be useful for evaluating disease activity and prognosis.

Tear And Serum Superoxide Dismutase And Catalase Activities In Hypertensive Retinopathy

The objective was to determine the changes in SOD and catalase activity, markers of oxidative stress/antioxidant balance in serum and tear of patients with hypertensive retinopathy and to identify whether there was a correlation between their levels and HR degree of hypertensive retinopathy (HR). Material and Methods — 90 hypertensive patients were divided in three groups, according to the Keith-Wagener classification: GI-36, GII-35 and GIII-19. SOD was assessed using the Dubinina and Matyushin method and catalase according to Koroliuk, both in modification of Gudumac V. The results were presented by median and interquartile range. The groups were compared using Kruskal-Wallis and Mann-Whitney nonparametric tests, and the Spearman correlation coefficient was calculated (SPSS 23.0). Results — Showed a statistically significant difference of SOD in serum (p=0.035) and tear (p=0.027) between groups. SOD decreased from GI until GIII in serum (-8%, p=0.032) and tear (-16%, p=0.031). In addition, it showed a weak significant negative correlation with the HR degree both in serum (r=-0.246, p=0.019) and tear (r=-0.284, p=0.007), while the correlation attested between serum and tear SOD levels was significant moderate and positive (r=0.336, p=0.001). It was noted a significant catalase elevation in the tear (p=0.033). In serum it was not correlated with HR degree, while in tear showed a significant weak strength, positive correlation (r=0.261, p=0.013). No correlations were found between serum and tear catalase levels. Conclusion — A progressive significant decrease in SOD levels and a tendency to increase of catalase activity was identified as HR advanced both in serum and in tear. The enhancement in the severity of HR was correlated with decreased SOD activity in tear and serum and increased catalase level in tear.

Long-term inhibition of UCHL1 decreases hypertension and retinopathy in spontaneously hypertensive rats

OBJECTIVE

To investigate the role of the deubiquitinase ubiquitin C-terminal hydrolase L1 (UCHL1) in hypertension and retinopathy in the spontaneously hypertensive rat (SHR).

METHODS

Wistar-Kyoto (WKY) rats and SHRs were administered the UCHL1 inhibitor LDN57444 (20 μg/kg/day) for 4 months. Pathological changes were detected with hematoxylin and eosin, immunofluorescence, and dihydroethidium staining. The mRNA and protein expression of UCHL1 were examined by real-time PCR and immunoblotting analysis.

RESULTS

At 6 months of age, SHRs showed significantly increased mRNA and protein levels of UCHL1 in the retina compared with WKY rats. Moreover, SHRs exhibited significantly increased central retinal thickness, inflammation, and reactive oxygen species production compared with WKY rats, and these effects were markedly attenuated by systemic administration of the UCHL1 inhibitor LDN57444. The beneficial effects of LDN57444 were possibly associated with reduced blood pressure and the inactivation of several signaling pathways.

CONCLUSION

UCHL1 is involved in hypertension and retinopathy in SHRs, suggesting that UCHL1 may be used as a potential therapeutic target for treating hypertensive retinopathy.

Study of ischemia modified albumin (IMA) as a biomarker in hypertensive retinopathy

Background

Hypertension (HTN) is one of the leading causes of morbidity and mortality worldwide. A prompt diagnosis and treatment of hypertensive retinopathy (HR), the leading complication of HTN is pivotal for a better visual outcome. Increased blood pressure on its own cannot fully clarify the development of retinal alterations, therefore an additional pathogenetic mechanism, such as oxidative stress, might be inquired.

The aim of the study was to evaluate the changes in the level of ischemia modified albumin (IMA) in the serum and tears of HR patients in order to establish the predictive value of IMA for the HR progression.

Methods

Serum and tear samples for the measurement of IMA were collected from 90 patients detected primarily with HR, who were not taking any antihypertensive or other drug that could influence the results of the study, divided according to the Keith-Wagener classification into GI – 36 patients with HR grade I, GII – 35 with HR grade II and GIII – 19 with HR grade III. Serum and tear IMA levels were assessed using the Co²⁺ binding method and expressed as median and interquartile range. Kruskal-Wallis and Mann-Whitney nonparametric tests were used to compare the groups and the Spearman correlation coefficient was calculated (SPSS 23.0), with p<0.05 being statistically significant.

Results

The groups showed a statistically significant difference in serum IMA (p=0.006), the values increasing in parallel with the progression of HR. The serum IMA level in GII increased compared to GI (+3%; 239.06 μM/L (IQR 75.58) vs 231.77 μM/L (IQR 104.09), p=1.00), as well as in GIII patients compared to GII (+17%; 277.67 μM/L (IQR 88.72) vs 239.06 μM/L (IQR 75.58), p=0.04). There were no differences in IMA content (p=0.160), between groups in the tears. No correlations were found between serum and tear IMA levels (p=0.134), but serum IMA showed a significant moderate strength, positive correlation with the degree of HR (r=0.307, p=0.003).

Conclusion

A progressive enhancement in serum IMA level as HR advanced was identified. Thereby, the results suggest the potential relevance of serum IMA as a sensitive and early biomarker useful for grading and optimal treatment of the patients with HR.

Could aortic arch calcification help in detection of hypertensive retinopathy?

OBJECTIVE

Hypertension-induced end-organ damage is one of the important determinants of morbidity and mortality in patients with hypertension. All types of hypertension-induced end-organ damages start with vascular damage. Vascular calcification is a marker of vascular damage and aortic arch calcification (AAC) is one of the easily identifiable types of vascular calcification. We hypothesized that AAC predicts retinopathy in hypertensive patients.

METHODS

Consecutive hypertensive patients without diabetes mellitus were included. Chest radiography in the posterior-anterior was used to assess the presence of AAC. All patients underwent ophthalmologic examination for retinopathy.

RESULTS

We included 495 hypertensive patients in this study. Of these, 306 (62%) had hypertensive retinopathy. Patients with hypertensive retinopathy had significantly higher prevalence of AAC as compared to the patients without hypertensive retinopathy (88% vs. 22%, P < 0.001). We found a strong and positive correlation between hypertensive retinopathy and AAC grades (r = 639, P < 0.001). Receiver operator characteristics curve analysis yielded a strong predictive ability of AAC for the presence of hypertensive retinopathy [area under curve = 0.814, 95% confidence interval (CI): 0.775-0.853, P < 0.0001]. In multivariate logistic regression analysis, presence of AAC [odds ratio (OR) 13.128; CI: 7.894-21.832] and serum glucose levels (OR 1.020; CI: 1.003-1.037) were strongly and independently associated with hypertensive retinopathy.

CONCLUSION

Presence of AAC on chest radiograph is strongly and independently associated with retinopathy in nondiabetic hypertensive patients. This simple, inexpensive and widely available tool may help in early detection of retinopathy in patients with hypertension.

Extracellular Vesicles in Comorbidities Associated with Ischaemic Heart Disease: Focus on Sex, an Overlooked Factor

Extracellular vesicles (EV) are emerging early markers of myocardial damage and key mediators of cardioprotection. Therefore, EV are becoming fascinating tools to prevent cardiovascular disease and feasible weapons to limit ischaemia/reperfusion injury. It is well known that metabolic syndrome negatively affects vascular and endothelial function, thus creating predisposition to ischemic diseases. Additionally, sex is known to significantly impact myocardial injury and cardioprotection. Therefore, actions able to reduce risk factors related to comorbidities in ischaemic diseases are required to prevent maladaptive ventricular remodelling, preserve cardiac function, and prevent the onset of heart failure. This implies that early diagnosis and personalised medicine, also related to sex differences, are mandatory for primary or secondary prevention. Here, we report the contribution of EV as biomarkers and/or therapeutic tools in comorbidities predisposing to cardiac ischaemic disease. Whenever possible, attention is dedicated to data linking EV to sex differences.

Glutathione-related antioxidant defense system in patients with hypertensive retinopathy

Objective: To analyze the glutathione antioxidant defense system changes in the tear and serum of patients with hypertensive retinopathy (HR) and to establish whether there is an interdependence between their levels and HR degree. Methods: 90 patients were split into three groups according to the Keith-Wagner-Barker grading of HR: GI-36 patients; GII-35 patients; GIII-19 patients. The concentration of reduced glutathione (GSH) and activities of glutathione peroxidase (GPx) and glutathione reductase (GR) in tear and serum were measured. Results were analyzed by ANOVA, followed by Bonferroni post hoc test. The Spearman correlation coefficient was calculated (p≤0.05 statistically significant). Results: In serum, the GSH level and GPx activity were not statistically changed between groups with HR degree advancement, unlike the GR activity that was statistically diminished (p=0.018). The values of the studied markers in the tear showed a decrease with the progression of the HR degree. Only serum GSH level correlated with the tear one (r=-0.361, p=0.000), while the enzymes activity did not. A correlation of GPx and GR activity (r=0.417, p=0.000) was identified in tear, while in serum - of GPx activity and GSH level (r=409, p=0.000). Tear GPx and GR levels correlated significantly but with low power with HR degree (r=0.299, p=0.004/ r=0.299, p=0.004). Conclusion: Statistically significant elevation in tear GPx and GR activity and a tendency of GSH level increase was revealed, being attested, and a direct correlation between GPx and GR activity, as well as of their activity with the HR degree. In serum, the GSH level and the GPx activity did not change accurately, while the GR activity diminished significantly, the identified decrease being correlated with the HR degree. Abbreviations: HR = hypertensive retinopathy, HTN = hypertension, GSH = reduced glutathione, GPx = glutathione peroxidase, GR = glutathione reductase, GGR = gamma-glutamyl transferase, ROSs = reactive species of oxygen, OS = oxidative stress.

Longitudinal changes in the thickness of the ganglion cell-inner plexiform layer in patients with hypertension: a 4-year prospective observational study

PURPOSE

Hypertension (HTN) is expected to accelerate age-related ganglion cell-inner plexiform layer thickness (GC-IPLs) reduction, but there is limited information on the reduction rate of GC-IPLs in HTN patients. We investigate longitudinal changes in the thickness of GC-IPL in patients with HTN.

METHODS

We performed a prospective, longitudinal and observational study design. Participants were divided into two groups: HTN group (49 eyes) and control group (56 eyes). After the initial visit, GC-IPLs were measured four times at 1-year intervals using spectral-domain optical coherence tomography. The GC-IPL reduction rate was estimated using a linear mixed model and compared between the two groups. Univariate and multivariate generalized linear mixed models were used to identify factors associated with reductions in GC-IPLs over time.

RESULTS

In a linear mixed model, the GC-IPL reduction rates for the HTN and control groups were -0.64 (p < 0.001) and -0.19 (p < 0.001) μm/year, respectively, and the interaction between group and follow-up duration was significant (p < 0.001). In the HTN group, all sectors exhibited significant reductions over time (all p < 0.001). Results from univariate and multivariate linear mixed model analyses revealed that age and IOP were significantly associated (p = 0.009 and 0.047, respectively) with reductions in GC-IPLs in HTN patients.

CONCLUSION

Patients with HTN exhibited a significant reduction in GC-IPLs compared to normal subjects. Additionally, age and IOP affected the reduction rate of GC-IPLs in HTN patients. In various ophthalmic diseases, physicians should consider the longitudinal effect of HTN on GC-IPLs.

Pharmacological correction of morphofunctional retinal injury using 11-amino acid fragment of darbepoetin in the experiment

Introduction: The retinoprotective effect of the 11-amino acid fragment of darbepoetin PRK-002 on the models of hypertensive retinal angiopathy and hypertensive neuroretinopathy in Wistar rats was investigated in comparison with carbamylated darbepoetin and sulodexide.

Materials and methods: The protective effects of the pharmacological agents were assessed using the following criteria: a semi-quantitative assessment of changes in the eye fundus when performing ophthalmoscopy, the retinal blood flow, the b/a coefficient, eNOs expression in retinal vessels, specific number of neuronal nuclei in the inner nuclear layer, and p53 expression in the retina.

Results and discussion: A pronounced protective effect, exceeding sulodexide at a dose of 150 LRU/kg and carbamylated darbepoetin at a dose of 300 μg/kg when correcting retinal angiopathy was observed in PRK-002 at a dose of 4 µg/kg, which expressed in adjustment of the retinal vessels’ calibers, removing retinal arterio-venous crossings, reaching the target levels of the retinal microcirculation, the b/a coefficient, and the restoration of eNOs expression in the endothelium of retinal vessels. PRK-002 at a dose of 4 µg/kg has a pronounced neuroprotective effect comparable to carbamylated darbepoetin at a dose of 300 µg/kg in correction of hypertensive neuroretinopathy, which expressed in the normalization of the fundus image, reaching the b/a target values, the specific number of neuronal nuclei in the inner nuclear layer, inhibition of p53 expression in the neurons of the inner nuclear and ganglionic layers.

Conclusion: The study revealed angio- and neuroprotective activity of the 11-amino acid fragment of darbepoetin PRK-002 in correction of retinal injury formed on the background of hypertension.

A comparative evaluation of the efficacy of dimethylaminoethanol derivative 7–16, C7070 and picamilon in correction of experimental hypertensive neuroretinopathy

Introduction. The efficacy of dimethylaminoethanol (DMAE) derivative 7–16, substance C7070 in comparison with picamylon in hypertensive neuroretinopathy model in white laboratory rats was evaluated.

Materials and methods. For measuring the blood pressure, a system of noninvasive blood pressure measurement in small animals NIBP200 was used. Ophthalmoscopy was performed by using Bx a Neitz ophthalmoscope (Japan) and Osher MaxField 78D lens, OI-78M model. Electroretinography (ERG) was recorded in response to a single stimulation. Biopotentials were presented graphically on the screen with the help of BIOPAC SYSTEMS MP-150 with ACQKNOWLEDGE 4.2 software (USA). To assess a degree of a functional retinal disorder, the b/a coefficient was used.

Results and discussion. The most pronounced protective effect on the model of hypertensive neuroretinopathy is demonstrated by C7070, which is expressed in the notable approximation to the normal eye fundus image and reaching the target values of the b/a coefficient. In the group with correction by DMAE derivative 7–16, a protective effect is observed, which exceeds picamilon, which is expressed in the elimination of soft and solid exudates, vein and venule plethora, vascular tortuosity, arterial spasm, Salus-Gunn I symptom, hemorrhages; the b/a increases significantly by 26% compared to the group without correction (p &lt; 0.05).

Conclusion. The eye fundus image and functional state of the retina are completely restored when correcting experimental hypertensive neuroretinopathy with C7070 in a dose of 50 mg/kg to laboratory rats and partially restored when correcting with DMAE derivative 7–16 in a dose of 25 mg/kg, which in both cases exceeds the protective effect of the reference drug picamilon on the model of hypertensive neuroretinopathy.

Serum uric acid concentration is associated with hypertensive retinopathy in hypertensive chinese adults

BACKGROUND

This cross sectional investigation included 12,966 subjects with hypertension, a cohort of the China Stroke Primary Prevention Trial (CSPPT), a randomized, multicenter clinical trial. This study aimed to explore the correlation between serum uric acid (SUA) concentration and hypertensive retinopathy in hypertensive adults.

METHODS

Diagnosis of hypertensive retinopathy was determined by non-mydriatic fundus photography and classified with Keith-Wagener-Barker (KWB) system. The correlation of SUA levels with hypertensive retinopathy prevalence and severity was assessed by statistical analysis.

RESULTS

9848 (75.95%) subjects were diagnosed with hypertensive retinopathy with the following retinopathy grade distribution: grade 1: 58.80%, grade 2: 14.81%, and grade 3-4: 2.34%. SUA levels were significantly associated with hypertensive retinopathy prevalence. Patients with hypertensive retinopathy had higher SUA levels than those without hypertensive retinopathy. Patients in the highest uric acid quartile had an odds ratio for hypertensive retinopathy of 1.21 compared to patients in the lowest uric acid quartile (OR = 1.21, 95% CI: 1.05-1.40, P = 0.008). When compared to the non-hyperuricemia group, those in the hyperuricemia group had an odds ratio for hypertensive retinopathy of 1.18(OR = 1.18, 95% CI: 1.05-1.33, P = 0.004). Every 1 mg/dl increase in uric acid concentration was significantly associated with a 6% higher odds of hypertensive retinopathy (OR = 1.06, 95% CI: 1.02-1.10, P = 0.002).

CONCLUSIONS

The prevalence of hypertensive retinopathy was high (75.95%) among hypertensives in our patients cohort. In addition, SUA concentration was significantly associated with hypertensive retinopathy.

Consideration of hypertensive retinopathy as an important end-organ damage in patients with hypertension

Longstanding and therapy-resistant hypertension may cause cerebral, renal, cardiac and retinal end-organ damage (EOD). Retinal hypertensive abnormalities are correlated with an increased risk of cardiovascular (CV) disease in general but are not included in CV risk assessment tools. Research into prevalence and determinants of retinal organ damage, such as hypertensive retinopathy (HR), is scarce. We evaluated the prevalence of HR and the association with other signs of EOD in patients with hypertension. A retrospective observational study was performed in all hypertensive patients referred by a general practitioner to the hypertension clinic at the Diakonessenhuis, Utrecht and Zeist, the Netherlands between 2011 and 2013. A screening of risk factors, albuminuria, left-ventricular hypertrophy (LVH) and retinal fundoscopy was performed. In all, 44% (123/280) of patients referred to the clinic were diagnosed with HR, while 15 and 11% were diagnosed with LVH and microalbuminuria, respectively. Patients with isolated HR consisted of 31% of all patients. When HR was added as a form of EOD, the percentage of patients with a treatment indication increased from 3 to 14%. Patients who were already on treatment goal exhibited a high prevalence of HR (28%), warranting treatment intensification. HR is prevalent in a third of hypertensive patients referred to our clinic, and isolated HR accounts for the majority of (end-) organ damages. Fundoscopy in the evaluation of hypertension might improve the indication for therapy. Furthermore, diagnosing HR could be helpful in selecting patients with hypertension on treatment goal in need of more aggressive treatment.

Vitamin D versus placebo in improvement of endothelial dysfunction: a meta-analysis of randomized clinical trials

AIMS

The possible effect of vitamin D administration in humans on endothelial dysfunction (ED) still remains undetermined. The current meta-analysis was performed to evaluate if vitamin D could improve ED.

METHODS

Randomized, double-blind, and placebo-controlled clinical trials were identified by systematic search of the PubMed, the Cochrane Library, the Web of Science and the Scopus data bases, as well as different reviews and clinical trials articles. A random effects model was used to calculate the pooled overall effect on flow-mediated dilation (FMD) linked to the vitamin D administration. Meta-regression and subgroup analyses were performed to evaluate the impact of study characteristics on the effect of vitamin D administration on FMD.

RESULTS

A total of eight studies with nine relevant study arms were identified. The obtained results of pooled analysis showed that vitamin D administration did not improve FMD (eight studies, 529 subjects; weighted mean difference (WMD): 0.96%, 95% CI: -1.24% to 2.06%; P = 0.09). This was probably due to significant heterogeneity in between included trials (I(2) = 84%, P < 0.00001). On the other hand, subgroup analysis demonstrated that vitamin D improved FMD in trials that lasted <16 weeks; if systolic blood pressure (SBP) was higher than 140 mmHg and in trials where diastolic blood pressure (DBP) was <80 mmHg.

CONCLUSION

Although the current evidence clearly demonstrates that in certain conditions vitamin D can improve ED, a larger number of clinical trials are needed to confirm this assumption to confirm or reject the final statement on this topic.

Diabetes retinopathy is a poor predictor for renal and cardiovascular outcomes in comparison with hypertensive retinopathy in patients with chronic kidney disease

AIMS

Chronic kidney disease (CKD) and retinopathy share the common pathophysiology of microvascular dysfunction. It is unclear whether the clinical significance of diabetic retinopathy (DMR) and hypertensive retinopathy (HTNR) differs in CKD patients.

METHODS

We included 684 nondialysis-dependent CKD stage 3-5 patients with diabetes or hypertension: 501 patients with diabetes and 183 with hypertension. The clinical significance of DMR and HTNR was evaluated in terms of the rate of renal function decline and composite of any cardiovascular event or death.

RESULTS

DMR was observed in 261 (52.1%) CKD patients with diabetes, and HTNR in 44 (24.0%) CKD patients with hypertension. In the diabetes group, the renal function decline rate was significantly steeper in patients with than in those without DMR (-7.4 ± 9.8mL/min/1.73m(2)/yr vs. -2.4 ± 7.6mL/min/1.73m(2)/yr; P<0.001). In multivariate analysis, DMR were independently associated with a rapid decline in renal function (β=-2.44; P=0.20). However, HTNR did not affect the renal function decline in CKD patients. The composite event-free survival rate was lower in patients with diabetes and DMR than in those without DMR (P=0.043). Patients with diabetes and DMR were independently associated with a 2.13-fold increased risk for composite events (P=0.010). HTNR was not associated with higher risk for composite events in CKD patients.

CONCLUSION

Coexistence of diabetes and DMR were independently associated with CKD progression and composite cardiovascular event/death, but the clinical significance of HTNR is less clear in CKD patients.

Salvianolic acid A inhibits endothelial dysfunction and vascular remodeling in spontaneously hypertensive rats

AIMS

Despite the numerous pharmacological agents available for hypertension therapy, hypertension-related microvascular remodeling is not resolved, eventually leading to end-organ damage. The aim of the present study was to investigate the protection of salvianolic acid A (SalA) against microvascular remodeling in vitro and in vivo.

MAIN METHODS

Spontaneously hypertensive rats (SHRs) were administered 2.5, 5 or 10 mg/kg SalA via intraperitoneal injection once a day for 4 weeks. The tail-cuff method was applied to monitor blood pressure; the microvascular structure of the retina was detected by hematoxylin-eosin and immunohistochemical staining; the function of mesenteric arteries was measured by DMT wire myography; endothelial cell proliferation was estimated using the Cell Counting Kit-8; endothelial cell migration was evaluated by wound healing and transwell assay; and endothelial cell integrity was detected by transendothelial electrical resistance and permeability assays.

KEY FINDINGS

Although no antihypertensive effects of SalA were observed, SalA attenuated the microvascular inward remodeling of the retina and improved microvascular function in the mesenteries in vivo. Further cell experiments confirmed the beneficial effects of SalA on the integrity of the endothelial monolayer in vitro.

SIGNIFICANCE

Salvianolic acid A inhibited endothelial dysfunction and vascular remodeling in spontaneously hypertensive rats. Therefore, salvianolic acid A could be a potential drug therapy to prevent further targeted organ damage induced by vascular remodeling.