Microvascular function and oxidative stress in adult individuals with early onset of cardiovascular disease

Abstract

the current study aims to investigate retinal vascular function and its relationship with systemic anti-oxidative defence capacity in normal individuals versus those with early hypertensive changes according to the current ESC/ESH guidelines. Retinal microvascular function was assessed in 201 participants by means of dynamic retinal vessel analysis. Blood pressure, lipid panel, oxidized (GSH) & reduced glutathione (GSSG) were also evaluated for each participant. individuals classed as grade 1 hypertension demonstrated higher retinal arterial baseline diameter fluctuation (p = 0.0012), maximum dilation percentage (p = 0.0007), time to maximum constriction (p = 0.0003) and lower arterial constriction slope (p = 0.0131). Individuals classed as high normal and grade 1 hypertension also demonstrated higher time to maximum dilation than individuals classed as optimal or normal. GSH levels correlated negatively with SBp, DBp and MBp values in all participants (p = 0.0010; p = 0.0350 and p = 0.0050) as well as with MBP values in high normal and grade 1 hypertension (p = 0.0290). The levels of GSSG correlated positively with SBp, DBp and MBp values in all participants (p = 0.0410; p = 0.0330 and, p = 0.0220). Our results point to the fact that microvascular alterations can be identifiable at BP values still considered within normal values and go in parallel with the changes observed in the level of oxidative stress.

Natural Drugs as a Treatment Strategy for Cardiovascular Disease through the Regulation of Oxidative Stress

“…Oxidative stress plays an important role in the regulation of the cardiovascular system and has become a new target for CVD prevention and treatment. Oxidative stress can cause severe functional damage to endothelial cells and cardiomyocytes [ 24 , 25 ]. In addition, oxidative stress is involved in the pathogenesis of hypertension, myocardial ischemia-reperfusion injury, atherosclerosis, and other associated diseases by regulating inflammation and stimulating vascular smooth muscle proliferation [ 26 – 28 ].…”

European Society of Cardiology/European Society of Hypertension versus the American College of Cardiology/American Heart Association guidelines on the cut-off values for early hypertension: a microvascular perspective

“…Our ESC/ESH grade 1 hypertension also exhibited abnormal retinal venous response to flicker. In previous studies, we have already documented that individuals with other categories of cardiovascular risk also exhibit abnormal retinal venous responses to flicker-induced provocation 14,16,31,32 . Structural retinal venular dilation has previously implicated as a strong prediction of adverse CVD events 33,34 .…”

“…Structural retinal venular dilation has previously implicated as a strong prediction of adverse CVD events 33,34 . Nevertheless, the abnormal functional retinal venous responses, as measured by DVA, are still to be confirmed as signs of endothelial dysfunction in their own right or as epiphenomena of retinal arterial dysfunction 14,17 . In this particular context, our observed retinal venular dysfunctionality could reflect a compensatory adaptation following sustained arterial dilation during flicker.…”

“…SBP as well as diastolic DBP measurements were calculated for the day-time (6 am to 10 pm) and night-time (10 pm to 6 am) intervals. At least 80% of the programmed recordings were required for a diurnal curve to be considered in the present analysis 14,19 .…”

“…They were then also further classified into three other subcategories: "normal", "elevated" and "stage I" as recommended by the 2017 ACC/ AHA guidelines. Subjects classed as "optimal" according to the 2018 ESC/ESH guidelines were excluded and their values were included in our pool of "normal" data 14 .…”