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Cífková R, Harazny JM, Bruthans J, Wohlfahrt P, Krajčoviechová AH, Lánská V, Gelžinský J, Mateřánková M, Mareš Š, Filipovský J, Mayer O, Schmieder RE. Early vascular damage in retinal microcirculation in arterial hypertension: the Czech post-MONICA study. J Hypertens 2024; 42:557-563. [PMID: 38088414 PMCID: PMC10842650 DOI: 10.1097/hjh.0000000000003637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/11/2023] [Accepted: 11/07/2023] [Indexed: 02/01/2024]
Abstract
Retinal microcirculation reflects retinal perfusion abnormalities and retinal arterial structural changes at relatively early stages of various cardiovascular diseases. Wall-to-lumen ratio (WLR) may represent the earliest step in hypertension-mediated organ damage.Our objective was to compare functional and structural parameters of retinal microcirculation in a randomly selected urban population sample, in hypertensive and normotensive individuals. DESIGN AND METHOD A total of 398 randomly selected individuals from an urban population aged 25-65 years, residing in Pilsen, Czech Republic, were screened for major cardiovascular risk factors. Retinal microcirculation was assessed using scanning laser Doppler flowmetry, with data evaluable in 343 patients. Complete data were available for 342 individuals divided into four groups based on blood pressure and control status of hypertension: normotensive individuals ( n = 213), treated controlled hypertensive individuals ( n = 30), treated uncontrolled hypertensive individuals ( n = 26), and newly detected/untreated hypertensive individuals ( n = 73). RESULTS There was a tendency to higher wall thickness in treated but uncontrolled hypertensive patients (compared to normotensive and treated controlled hypertensive individuals). WLR was significantly increased in treated but uncontrolled hypertensive patients as well as in individuals with newly detected thus untreated hypertension or in patients with known but untreated hypertension. There was no difference in WLR in treated, controlled hypertensive patients compared with normotensive individuals. CONCLUSION Our results show that an increased WLR, reflecting early vascular damage, was found in newly detected individuals with hypertension and in untreated hypertensive patients, reflecting early hypertension-mediated vascular damage. Early initiation of hypertension treatment may be warranted.
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Affiliation(s)
- Renata Cífková
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital
- Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
| | - Joanna M. Harazny
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander- University, Erlangen-Nürnberg, Germany
- Department of Human Physiology and Pathophysiology, University of Warmia and Mazury, Olsztyn, Poland
| | - Jan Bruthans
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen
| | - Peter Wohlfahrt
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital
| | - Alena Hrubeš Krajčoviechová
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital
| | - Věra Lánská
- Medical Statistics Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Július Gelžinský
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen
| | - Markéta Mateřánková
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen
| | - Štěpán Mareš
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen
| | - Jan Filipovský
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen
| | - Otto Mayer
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen
| | - Roland E. Schmieder
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander- University, Erlangen-Nürnberg, Germany
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Cífková R, Bruthans J, Wohlfahrt P, Hrubeš Krajčoviechová A, Šulc P, Jozífová M, Eremiášová L, Pudil J, Linhart A, Widimský J, Filipovský J, Mayer O, Poledne R, Stávek P, Lánská V, Strilchuk L. Longitudinal Trends in Severe Dyslipidemia in the Czech Population: The Czech MONICA and Czech Post-MONICA Study. J Cardiovasc Dev Dis 2023; 10:328. [PMID: 37623341 PMCID: PMC10455799 DOI: 10.3390/jcdd10080328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Background: Severe hypercholesterolemia is associated with an increase in the risk of developing atherosclerotic cardiovascular disease. The aim of this analysis was to assess longitudinal trends in severe dyslipidemia (defined as total cholesterol > 8 mmol/L or LDL-cholesterol > 5 mmol/L) in a representative population sample of the Czech Republic and to analyze the longitudinal trends in the basic characteristics of individuals with severe dyslipidemia. Methods: Seven independent cross-sectional surveys were organized in the Czech Republic to screen for major cardiovascular risk factors (from 1985 to 2015-2018). A total of 20,443 randomly selected individuals aged 25-64 years were examined. Results: The overall prevalence of severe dyslipidemia was 6.6%, with a significant downward trend from the fifth survey onwards (2000/2001). Over the study period of 30+ years, the individuals with severe dyslipidemia became older, increased in BMI, and did not change their smoking habits. Total cholesterol and non-HDL-cholesterol decreased significantly in both sexes throughout the duration of the study. Conclusions: Despite a significant improvement in lipids in the Czech Republic from 1985, substantially contributing to the decline in cardiovascular mortality, the number of individuals with severe dyslipidemia remained high, and in most cases, they were newly detected during our screening examinations and were thus untreated.
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Affiliation(s)
- Renata Cífková
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
- Department of Medicine II, Charles University in Prague, First Faculty of Medicine, 128 08 Prague, Czech Republic; (L.E.); (J.P.); (A.L.)
| | - Jan Bruthans
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
| | - Peter Wohlfahrt
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
| | - Alena Hrubeš Krajčoviechová
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
| | - Pavel Šulc
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
| | - Marie Jozífová
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
| | - Lenka Eremiášová
- Department of Medicine II, Charles University in Prague, First Faculty of Medicine, 128 08 Prague, Czech Republic; (L.E.); (J.P.); (A.L.)
| | - Jan Pudil
- Department of Medicine II, Charles University in Prague, First Faculty of Medicine, 128 08 Prague, Czech Republic; (L.E.); (J.P.); (A.L.)
| | - Aleš Linhart
- Department of Medicine II, Charles University in Prague, First Faculty of Medicine, 128 08 Prague, Czech Republic; (L.E.); (J.P.); (A.L.)
| | - Jiří Widimský
- Department of Medicine III, Charles University in Prague, First Faculty of Medicine, 128 08 Prague, Czech Republic;
| | - Jan Filipovský
- Department of Medicine II, Faculty of Medicine, Charles University, 301 00 Pilsen, Czech Republic; (J.F.)
| | - Otto Mayer
- Department of Medicine II, Faculty of Medicine, Charles University, 301 00 Pilsen, Czech Republic; (J.F.)
| | - Rudolf Poledne
- Atherosclerosis Research Laboratory, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic (P.S.)
| | - Petr Stávek
- Atherosclerosis Research Laboratory, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic (P.S.)
| | - Věra Lánská
- Medical Statistics Unit, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic;
| | - Larysa Strilchuk
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, 140 59 Prague, Czech Republic; (J.B.); (P.W.); (A.H.K.); (P.Š.); (M.J.); (L.S.)
- Department of Therapy №1, Medical Diagnostics, Hematology and Transfusiology, Lviv Danylo Halytsky National Medical University, 79010 Lviv, Ukraine
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