The association between endothelial dysfunction and hypertensive retinopathy in essential hypertension.
BACKGROUND
Endothelial dysfunction, which is characterized by an imbalance between relaxing and contracting factors, procoagulant and anticoagulant substances, and between pro-inflammatory mediators, may play a particularly significant role in the pathogenesis of atherosclerosis. Numerous experimental and clinical reports suggest that a high von Willebrand factor (vWF) level reflects endothelial damage or dysfunction. Hypertensive retinopathy (HR) is a condition characterized by a spectrum of retinal vascular signs in people with elevated blood pressure. The pathophysiological mechanism of HR is not completely understood. Elevated blood pressure alone does not fully account for the extent of retinopathy. Endothelial dysfunction and mechanisms known to be involved in vascular lesions may be involved in the pathophysiological mechanism of HR. Therefore, this study was designed to answer the following questions: (i) Do vWf levels change in HR? and (ii) Is there any relation between degree of HR and vWf levels?


METHODS
This study included 80 hypertensive patients with HR. Group 1 comprised 40 patients with grade I HR, and group 2 comprised 40 patients with grade II HR. We selected 40 healthy subjects for the control group.


RESULTS
Level of vWf in group 2 was significantly higher than in group 1 (p=0.017) and the control group (p<0.001), and it was also higher in group 1 than in the control group (p<0.005). Also, vWf showed positive correlation with degree of HR in the hypertensive group (r=0.284, p=0.009).


CONCLUSIONS
Our study suggests that endothelial dysfunction, which is a mechanism known to be involved in vascular lesions, may promote the development of HR.
Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Mustafa
M
Karaca
Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Erkan
E
Coban
Department of Medical Biochemistry, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Sebahat
S
Ozdem
Department of Ophtalmology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Mustafa
M
Unal
Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey.
Ozan
O
Salim
Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey.
Orhan
O
Yucel
D001794:Blood Pressure; D004727:Endothelium / Q000378:metabolism / Q000503:physiopathology*; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D058437:Hypertensive Retinopathy / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019721:Ophthalmoscopes; D018709:Statistics, Nonparametric; D014421:Turkey; D014841:von Willebrand Factor / Q000378:metabolism*
D014841:von Willebrand Factor