Examination of Large Artery Atherosclerosis could Reveal Small Artery Retinopathy in Untreated Middle-Aged Individuals

Abstract

Small arteries can be visualized in the ocular fundus, and findings of retinopathy based on Scheie classification are often applied to evaluate the impact of hypertension and atherosclerosis. However, the relationship between damage in the large and small arteries has not been investigated sufficiently, especially in the early stages. The present study investigated possible associations between large artery atherosclerosis and small artery retinopathy in untreated middle-aged individuals. Methods: Untreated middle-aged workers undergoing periodic health checkups (n 7,730, 45 8 years) were enrolled in this study. The absence or presence and extent of retinopathy were characterized by ophthalmologists as hypertensive (H0-4) and atherosclerotic grades (S0-4) based on Scheie classification. Large artery atherosclerosis was examined based on functional assessment of the cardio-ankle vascular index (CAVI) and morphological assessment of the carotid intima-media thickness (IMT) by ultrasound. Results: We found significant differences in CAVI and carotid IMT between individuals with and without hypertensive or atherosclerotic retinopathy. Multivariable regression analysis showed that the presence of hypertensive and atherosclerotic retinopathy was significantly associated with CAVI and carotid IMT. Logistic regression analysis with the endpoint of a hypertensive or atherosclerotic lesion revealed that CAVI and carotid IMT are independent determinants of retinopathy. Conclusions: CAVI and carotid IMT were significantly associated with the presence of retinopathy based on Scheie classification in untreated middle-aged subjects, implying that atherosclerotic examination in large arteries could reveal early-stage small artery retinopathy. changes that lead to primary organ damage 1-5). Hence, preventing the progressive processes of atherosclerosis is one of the most critical strategies in public health. Hypertension, dyslipidemia, diabetes mellitus, and smoking promoted atherosclerosis are established cardiovascular risk factors related to unhealthy Copyright©2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

Dietary astaxanthin-rich extract ameliorates atherosclerosis/retinopathy and restructures gut microbiome in apolipoprotein E-deficient mice fed on a high-fat diet

“…3 Epidemiology evidence also showed that large artery AS indicates small artery retinopathy in untreated middle-aged individuals and vice versa. 4 As demonstrated by our study, ASTE administration reduced AS-lesions in the aortic arch, thoracic aorta plaques, and the retinal fundus vascular. However, some studies concluded that supplementation with ASTE did not prevent atherogenesis or aortic damage in AS rabbits.…”

“…Moreover, microvascular disease, especially retinopathy, has been indicated as the most crucial complication of AS. 3,4 Traditionally, statin-based drugs were permitted to treat AS. 5 However, many of these are along with side effects, such as heart diseases and body immunity disorders.…”

Effect of Ginsenoside Rh1 on Proliferation, Apoptosis, and Oxidative Stress in Vascular Endothelial Cells by Regulation of the Nuclear Erythroid 2-related Factor-2/Heme Oxygenase-1 Signaling Pathway

“…Atherosclerosis (AS) is a leading cause of coronary heart disease. [1][2][3][4] Vascular endothelial cells (VECs) are a major cell type that reside in the arterial walls, and aberrant behaviors of VECs may contribute to the development of AS. 5 A previous study found that excessive reactive oxygen species (ROS) produced as a result of external stimulation leads to oxidative stress injury, which is the main cause of endothelial dysfunction.…”

The Relationships between Micro- and Macrovascular Damages: Their Functional and Morphological Aspects

“…1) 2,5) , and the findings of the Sugiura's study were consistent with this concept. Moreover, Sugiura et al found a close association of IMT (representing morphological vascular damage), rather than CAVI (representing functional vascular damage), with retinopathy 4) , and these findings suggest that the direct effect of risk factors on cardiovascular disease, rather than pulsatile microvasculopathy, is a major player for morphological microvascular damages in the early stages of atherosclerosis. However, in the pulsatile microvasculopathy, blood pressure itself is one of the major players 2,5) , and pulse wave velocity (PWV), which is a marker of functional vascular damage in macrocirculation, rather than blood pressure adjusted PWV, had a close association with the progression of retinopathy 6) .…”

“…In this issue, Sugiura et al examined the crosssectional associations of morphological/functional vascular damages in macrocirculation, which was assessed by the measurements of carotid intima-media thickness (IMT) and cardio-ankle vascular index (CAVI), with morphological vascular damages in microcirculation, which was assessed by the presence and extent of retinopathy, in subjects without the manifestations of atherosclerotic vascular damages 4) . They found a cross-sectional association of both morphological/functional vascular damages in macrocirculation with morphological vascular damages in microcirculation 4) .…”