Angiotensin-converting enzyme gene and retinal arteriolar narrowing: The Funagata Study

Tanabe, Yusuke; Kawasaki, Ryo; Wang, J J; Wong, Tien Yin; Mitchell, Paul; Daimon, Makoto; Oizumi, Toshihide; Kato, Takeshi; Kawata, Satoshi; Kayama, Takamasa; Yamashita, Hidetoshi

doi:10.1038/jhh.2009.27

Cited by 13 publications

(6 citation statements)

References 24 publications

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“…31 Newer data also suggest that angiotensin-converting enzyme I/D gene polymorphism may be associated with subclinical structural arteriolar changes related to chronic hypertension among the Japanese. 32 Retinal vascular imaging Novel computer-based imaging analysis allows quantification of subtle hypertensive retinopathy changes. 33 Previous studies have already shown retinal arteriolar diameter is strongly and inversely associated with elevation of blood pressure, reflecting systemic peripheral vasoconstriction.…”

Section: Genetic Associationsmentioning

confidence: 99%

How does hypertension affect your eyes?

2011

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Hypertension has profound effects on various parts of the eye. Classically, elevated blood pressure results in a series of retinal microvascular changes called hypertensive retinopathy, comprising of generalized and focal retinal arteriolar narrowing, arteriovenous nicking, retinal hemorrhages, microaneurysms and, in severe cases, optic disc and macular edema. Studies have shown that mild hypertensive retinopathy signs are common and seen in nearly 10% of the general adult non-diabetic population. Hypertensive retinopathy signs are associated with other indicators of end-organ damage (for example, left ventricular hypertrophy, renal impairment) and may be a risk marker of future clinical events, such as stroke, congestive heart failure and cardiovascular mortality. Furthermore, hypertension is one of the major risk factors for development and progression of diabetic retinopathy, and control of blood pressure has been shown in large clinical trials to prevent visual loss from diabetic retinopathy. In addition, several retinal diseases such as retinal vascular occlusion (artery and vein occlusion), retinal arteriolar emboli, macroaneurysm, ischemic optic neuropathy and age-related macular degeneration may also be related to hypertension; however, there is as yet no evidence that treatment of hypertension prevents vision loss from these conditions. In management of patients with hypertension, physicians should be aware of the full spectrum of the relationship of blood pressure and the eye.

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Section: Genetic Associationsmentioning

confidence: 99%

How does hypertension affect your eyes?

2011

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“…167 The angiotensin-converting enzyme gene polymorphism has also been linked with retinal arteriolar narrowing. 168 Others studies have reported isolated genetic loci associated with retinal arteriolar calibre and hypertensive retinopathy signs. 169,170 Future genetic studies on hypertensive eye disease, including whole exome or genome studies and mendelian randomisation, may provide novel insights into the contribution of genetic mechanisms on the microcirculatory changes of hypertension and CVD.…”

Section: Genetic Risk Factorsmentioning

confidence: 99%

Hypertensive eye disease

Cheung

Biousse

Keane

et al. 2022

Nat Rev Dis Primers

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Hypertensive eye disease includes a spectrum of pathological changes, the most wellknown being hypertensive retinopathy. Other commonly involved parts of the eye in hypertension include the choroid and optic nerve, sometimes referred to as hypertensive choroidopathy and hypertensive optic neuropathy. Together, hypertensive eye disease develops in response to acute and/or chronic elevation of blood pressure. Major advances in research over the past three decades have greatly enhanced our understanding of the epidemiology, systemic associations and clinical implications of hypertensive eye disease, particularly hypertensive retinopathy. Traditionally diagnosed via a clinical funduscopic examination, but increasingly documented on digital retinal fundus photographs, hypertensive retinopathy has long been considered a marker of systemic target organ damage (e.g., kidney disease) elsewhere in the body.Epidemiological studies indicate that hypertensive retinopathy signs are commonly seen in the general adult population, are associated with subclinical measures of vascular disease and predict risk of incident clinical cardiovascular events. New technologies, including development of non-invasive optical coherence tomography angiography, artificial intelligence (AI), and mobile ocular imaging instruments, have allowed further assessment and understanding of the ocular manifestations of hypertension and increase the potential that ocular imaging could be used for hypertension management and cardiovascular risk stratification.

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“…In a relatively small study of 368 participants of the Funagata study, Tanabe et al . [60]. reported that retinal arteriolar diameter was significantly narrower in individuals with the deletion (D/D) genotype of the angiotensin‐converting enzyme (ACE) gene compared to individuals with insertion/deletion (I/D) or insertion (I/I) genotypes after multivariable adjustment.…”

Section: Genetic Influences On the Retinal Microcirculationmentioning

confidence: 99%

Genetic and Early Life Influences on the Human Retinal Microcirculation

Hughes¹

2011

Basic Clin Pharma Tox

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Abstract:The retinal fundus offers a rare opportunity to visualize the microcirculation in man using minimally invasive approaches. The purpose of this MiniReview is to summarize recent work on genetic and early life influences on the retinal microcirculation and to suggest how these observations may help inform our understanding of the human microcirculation in health and disease.The principal role of the circulation is to transport and allow exchange of materials with organs and tissues. The microcirculation, generally defined as small blood vessels with diameters less than a few hundred micrometres [1], is crucial to this function -indeed, Carl Wiggers commented 'in our zeal to interpret the importance of the heart and great vessels, it should never be forgotten that the more obvious phenomena of the circulation are but a means through which the real object of maintaining an adequate capillary flow is attained' (quoted Johnson [2]). Abnormalities of the microcirculation can precede macrovascular disease, and it is argued that microcirculatory dysfunction may play a key role in the pathogenesis of macrovascular disease [3].The purpose of this MiniReview is to summarize recent work on genetic and early life influences on the retinal microcirculation and to suggest how these observations may inform our understanding of the microcirculation in health and disease. As a consequence of the limited scope of this review, a number of important topics, for example, the effect on the retinal microcirculation of classical cardiovascular risk factors and systemic diseases, such as diabetes, hypertension, sepsis or autoimmune conditions, or retinal diseases such as retinopathy of prematurity, age-related macular degeneration and glaucoma, will not be discussed; these are well covered by recent reviews [4][5][6][7][8]. The Retinal MicrocirculationThe retinal fundus offers a relatively rare opportunity to visualize the microcirculation in man using non-invasive or minimally invasive approaches, and there is accumulating evidence that quantitative retinal assessment may help to predict cardiovascular disease [9,10]. A number of structural and functional imaging approaches exist, including laser Doppler flowmetry, optical coherence tomography, retinal oximetry and retinal photography, but with the exception of retinal photography, these approaches are generally used in small-scale studies. Using digital retinal photography, it is possible to take measurements on small blood vessels in the range 50-300 lm with the advantage that these blood vessels are displayed in a relatively planar two-dimensional network ( fig. 1) While studies of the retinal microcirculation do provide insight into microcirculatory function, it is important to remember that there is considerable specialization of the microcirculation within tissues and the retinal microcirculation is no exception. For example, the retinal microvasculature, unlike the choroidal circulation, is not innervated by the sympathetic nerves, and a variety of paracrine factors regul...

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Angiotensin-converting enzyme gene and retinal arteriolar narrowing: The Funagata Study

Cited by 13 publications

References 24 publications

How does hypertension affect your eyes?

How does hypertension affect your eyes?

Hypertensive eye disease

Genetic and Early Life Influences on the Human Retinal Microcirculation

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