Risk factors for hypertensive retinopathy in a Chinese population with hypertension: The Beijing Eye study

Prevalence of Risk Factors of Retinal Diseases among Patients in Madang Province, Papua New Guinea

PURPOSE

To explore the prevalence of risk factors of retinal diseases among patients seeking services from Madang Provincial Hospital Eye Clinic in Papua New Guinea.

MATERIALS AND METHODS

A hospital-based retrospective study was conducted at the only eye clinic serving the entire Madang province of Papua New Guinea. Purposive sampling was used to obtain data from patients' record cards at the eye clinic from January to June 2021. The data collected included gender, age, presenting visual acuity, blood pressure, blood sugar level, body mass index, smoking habits, and history of cataract surgery. The data was analyzed using the International Business Machines Corporation's Statistical Package for Social Sciences version 21. A p-value of <0.05 was considered statistically significant.

RESULTS

Two hundred and fifty-five (255) patients went through diabetes and hypertension screening during the period of the study (January to June 2021). The mean age of the patients was 53.14 ± 11.20 years and there were more males (56.86%) than females. Nearly half of the patients (43.6%) were either visually impaired or blind. More than half (52.6%) had diabetes mellitus. Majority of the patients (73.3%) were hypertensive and more than half (57.0%) of the patients had unhealthy body mass index (BMI <18.525 kg/m² or > 25 kg/m²). Overweight was significantly associated with hypertension (p < 0.001) and diabetes mellitus (p < 0.001). A few of them were smokers or had a history of cataract surgery (13.7% and 2.0%, respectively).

CONCLUSION

There is a high prevalence of diabetes, hypertension, and overweight among ophthalmic patients in Madang. It is important that measures are put in place to eliminate barriers to health care and to strengthen eye care services in Papua New Guinea.

Correlation between MTHFR gene polymorphism and homocysteine levels for prognosis in patients with pregnancy-induced hypertension

OBJECTIVE

This research was designed to probe into the correlation between MTHFR gene polymorphisms and homocysteine levels in regard to the prognosis of pregnancy-induced hypertension.

METHODS

A total of 180 patients with pregnancy-induced hypertension who were admitted in the gynecology and obstetrics department of our hospital were collected as the observation group, and 180 normal pregnant women were selected as the control group. The homocysteine (Hcy) level, polymorphism expression of methylenetetrahydrofolate reductase (MTHFR) gene C677T locus and A1298C locus and the correlation between the different gene loci, Hcy level and pregnancy outcome were observed.

RESULTS

The Hcy level in the observation group was 18.1±6.2 (100 mmol/L) which was higher than that in the control group (8.6±3.9 mmol/L) (P<0.001). The C677T polymorphism of the MTHFR gene, and the proportion of CC in the observation group was lower than that in the control group, while that of CT and TT in the observation group was significantly higher (P<0.001). The T allele in the observation group was higher than that in the control group, while the C allele was lower than that in the control group (P<0.001). Hcy of TT type in pregnancy-induced hypertension group was higher than that in CC and CT groups (P<0.05). The incidence of adverse pregnancy outcomes in pregnancy-induced hypertension patients was obviously higher than that in normal control group (P<0.01). The incidence of TT type adverse pregnancy outcomes in MTHFR gene C677T polymorphism in patients with gestational hypertension was significantly higher than that in CC and TC groups (P<0.01).

CONCLUSION

The Hcy level in pregnancy-induced hypertension patients and the proportion of CT and TT in the MTHFR gene C677T locus rose; having the TT-type increased the incidence of abnormal pregnancy, which may be related to the increase of Hcy level.

Clinical Characteristics and Factors Associated With Hypertension in 205 Hospitalized Children: A Single-Center Study in Southwest China

Objective: The aim of this study was to investigate the clinical characteristics and factors associated with pediatric hypertension and target organ damage (TOD). Methods: We retrospectively reviewed clinical data from 205 children with hypertension treated in our hospital from 2007 to 2018. The patients were classified based on the type of hypertension (primary, secondary) and presence of TOD (heart, brain, retina). Logistic regression analysis was performed to identify the factors independently associated with hypertension and TOD. Results: There were 107 males, 97 females, and one intersex in this study, with an age range of 0.1-17.9 years. Majority of cases (177, 86.3%) had secondary hypertension, while 13.7% had primary hypertension. The most frequent cause of secondary hypertension was renal disease (59.32%). Elevated serum creatinine level (odds ratio [OR] = 7.22, 95% confidence interval [95% CI] = 1.6-32.62, P = 0.01), blood urea nitrogen (OR = 6.33, 95% CI = 1.81-22.19, P = 0.004), serum uric acid level (OR = 3.66, 95% CI = 1.20-11.22, P = 0.023), and albuminuria (OR = 3.72, 95% CI = 1.50-9.26, P = 0.005) were independently associated with secondary hypertension. Elevated serum uric acid and blood urea nitrogen levels were associated with left ventricular hypertrophy (OR = 6.638, 95% CI = 1.349-32.657, P = 0.02) and hypertensive encephalopathy (OR = 4.384, 95% CI = 1.148-16.746, P = 0.031), respectively. Triglyceride level correlated with hypertensive retinopathy (P = 0.001). Conclusion: Pediatric hypertension was most often secondary, with renal disease as the leading cause. Elevated levels of serum uric acid, blood urea nitrogen, serum creatinine, and albuminuria may indicate secondary hypertension in childhood. Elevated serum uric acid, blood urea nitrogen, and triglyceride levels were associated with left ventricular hypertrophy, hypertensive encephalopathy, and hypertensive retinopathy, respectively.

Hyperglycemia Augments Endothelin-1-Induced Constriction of Human Retinal Venules

Purpose

Endothelin-1 (ET-1) is a potent vasoactive factor implicated in development of diabetic retinopathy, which is commonly associated with retinal edema and hyperglycemia. Although the vasomotor activity of venules contributes to the regulation of tissue fluid homeostasis, responses of human retinal venules to ET-1 under euglycemia and hyperglycemia remain unknown and the ET-1 receptor subtype corresponding to vasomotor function has not been determined. Herein, we addressed these issues by examining the reactivity of isolated human retinal venules to ET-1, and results from porcine retinal venules were compared.

Methods

Retinal tissues were obtained from patients undergoing enucleation. Human and porcine retinal venules were isolated and pressurized to assess diameter changes in response to ET-1 after exposure to 5 mM control glucose or 25 mM high glucose for 2 hours.

Results

Both human and porcine retinal venules exposed to control glucose developed similar basal tone and constricted comparably to ET-1 in a concentration-dependent manner. ET-1–induced constrictions of human and porcine retinal venules were abolished by ET_A receptor antagonist BQ123. During high glucose exposure, basal tone of human and porcine retinal venules was unaltered but ET-1–induced vasoconstrictions were enhanced.

Conclusions

ET-1 elicits comparable constriction of human and porcine retinal venules by activation of ET_A receptors. In vitro hyperglycemia augments human and porcine retinal venular responses to ET-1.

Translational Relevance

Similarities in vasoconstriction to ET-1 between human and porcine retinal venules support the latter as an effective model of the human retinal microcirculation to help identify vascular targets for the treatment of retinal complications in patients with diabetes.