Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The neovascular form of the age-related macular degeneration (AMD) causes most cases of severe blindness. Because vascular endothelial growth factor (VEGF) plays a leading role in this disorder, several inhibitors of this molecule are being used in its treatment. However, VEGF has important functions in vascular pathophysiology. It enhances the development of collateral vessels that may supply blood to areas whose arteries are severely affected by atherosclerotic lesions. Additionally, it may promote restoration of the damaged endothelium, a vessel layer that protects against the development of atherothrombosis, and it has hypotensive effects. In contrast, VEGF may stimulate the formation of microvessels inside the atherosclerotic plaque. These vessels may become disrupted and cause intraplaque hemorrhage, stimulating disease progression. VEGF also has a role in thrombus formation. The effects of anti-VEGF therapy may therefore compromise patient safety. When administered systemically to cancer patients, the main cardiovascular adverse effects of these compounds have been thrombosis, hemorrhage and hypertension. As patients with AMD constitute a high-risk population for cardiovascular events, the safety of new anti-VEGF therapies must be assessed. In this review we analyze the effects of VEGF on atherosclerosis and the cardiovascular safety of anti-VEGF therapies in AMD.
 ...
PMID:Cardiovascular risk and antiangiogenic therapy for age-related macular degeneration. 1942 62

Regular exercise is a healthy lifestyle choice with numerous benefits to general health. Ophthalmologists may face questions of the benefits or risks of exercise to eyes. Here the effects of acute exertion and regular physical activity on ocular physiology and disease are reviewed. Intraocular pressure is transiently reduced by dynamic exercise. For the great majority of patients exercise is beneficial to the eyes by reducing risk of central retinal vein occlusion and neovascular age-related macular degeneration, and by improving control of systemic hypertension and diabetes. Ophthalmologists should be advocates of regular exercise with appropriate eye protection.
 ...
PMID:Effects of exercise on ocular physiology and disease. 1942 63

Family physicians have an essential role in assessing, identifying, treating, and preventing or delaying vision loss in the aging population. Approximately one in 28 U.S. adults older than 40 years is visually impaired. Vision loss is associated with depression, social isolation, falls, and medication errors, and it can cause disturbing hallucinations. Adults older than 65 years should be screened for vision problems every one to two years, with attention to specific disorders, such as diabetic retinopathy, refractive error, cataracts, glaucoma, and age-related macular degeneration. Vision-related adverse effects of commonly used medications, such as amiodarone or phosphodiesterase inhibitors, should be considered when evaluating vision problems. Prompt recognition and management of sudden vision loss can be vision saving, as can treatment of diabetic retinopathy, refractive error, cataracts, glaucoma, and age-related macular degeneration. Aggressive medical management of diabetes, hypertension, and hyperlipidemia; encouraging smoking cessation; reducing ultraviolet light exposure; and appropriate response to medication adverse effects can preserve and protect vision in many older persons. Antioxidant and mineral supplements do not prevent age-related macular degeneration, but may play a role in slowing progression in those with advanced disease.
 ...
PMID:Vision loss in older persons. 1951 94

The (pro)renin receptor (PRR) is believed to potentiate the renin-angiotensin system (RAS), conferring to prorenin, a likely pathological role at tissue level. The PRR has been identified in the microvascular endothelial cells of the retina, in which it seems to be involved in pathological neovascularization processes. In the present study, we sought to explore PRR expression and prorenin action in human retinal pigment epithelium (RPE) cells, as well as its potential implication in extracellular matrix (ECM) turnover. Isolated RPE cells from donor human eyes as well as freshly isolated human retinas demonstrated expression of PRR at mRNA and protein levels. Moreover, we demonstrate that PRR expressed in the RPE cells is functional, as shown by prorenin-induced increases in Erk1/2 phosphorylation. PRR expression was also shown to be regulated by its main physiological agonist prorenin. We found evidence that the PRR may be involved in ECM-remodeling processes through a prorenin-induced upregulation of type I collagen. Immunostaining analysis of human retinas revealed higher PRR and type I collagen expression in the RPE of eye donors with dry age-related macular degeneration (AMD) and hypertension, supporting the in vitro findings using human-isolated RPE cells. Taken together, the present study demonstrates for the first time that the PRR is expressed in human RPE and suggests a molecular mechanism by which hypertension may exacerbate the pathology of dry AMD.
 ...
PMID:(Pro)renin receptor is expressed in human retinal pigment epithelium and participates in extracellular matrix remodeling. 1958 Aug 9

During the last 20 years, numerous clinical trials have examined the therapeutic usefulness of melatonin in different fields of medicine. The objective of this article is to review, in depth, the science regarding clinical trials performed to date. The efficacy of melatonin has been assessed as a treatment of ocular diseases, blood diseases, gastrointestinal tract diseases, cardiovascular diseases, diabetes, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, infectious diseases, neurological diseases, sleep disturbances, aging and depression. Melatonin has been also used as a complementary treatment in anaesthesia, hemodialysis, in vitro fertilization and neonatal care. The conclusion of the current review is that the use of melatonin as an adjuvant therapy seems to be well funded for macular degeneration, glaucoma, protection of the gastric mucosa, irritable bowel syndrome, arterial hypertension, diabetes, side effects of chemotherapy and radiation in cancer patients or hemodialysis in patients with renal insufficiency and, especially, for sleep disorders of circadian etiology (jet lag, delayed sleep phase syndrome, sleep deterioration associated with aging, etc.) as well as in those related with neurological degenerative diseases (Alzheimer, etc.,) or Smith-Magenis syndrome. The utility of melatonin in anesthetic procedures has been also confirmed. More clinical studies are required to clarify whether, as the preliminary data suggest, melatonin is useful for treatment of fibromyalgia, chronic fatigue syndrome, infectious diseases, neoplasias or neonatal care. Preliminary data regarding the utility of melatonin in the treatment of ulcerative colitis, Crohn's disease, rheumatoid arthritis are either ambiguous or negative. Although in a few cases melatonin seems to aggravate some conditions, the vast majority of studies document the very low toxicity of melatonin over a wide range of doses.
 ...
PMID:Clinical uses of melatonin: evaluation of human trials. 2042 9

Combretastatin A4 phosphate (CA4P) is the lead compound of a relatively new class of agents termed vascular disrupting agents that target existing tumor blood vessels. Rapid tumor blood flow shutdown has been demonstrated in preclinical models and patients by various techniques such as dynamic contrast-enhanced MRI, perfusion computed tomography and PET scans following CA4P infusion. CA4P typically induces rapid tumor necrosis in the center of the tumor and leaves a rim of viable cells in the periphery. In oncology, CA4P does not appear to be that active by itself, but may be more efficacious when combined with chemotherapy, antiangiogenic therapy and radiation therapy. Studies are currently underway, which combine CA4P with antiangiogenic agents. Side effects have included hypertension, tumor pain and occasional cardiovascular toxicity, without any significant myelosuppression or disabling systemic symptoms. The utility of CA4P for conditions other than cancer, which involves neovascularization such as macular degeneration, is also being explored.
 ...
PMID:Combretastatin A4 phosphate: a novel vascular disrupting agent. 2079 67

The age-related macular degeneration is the most common cause of severe decrease of the visual acuity in industrial countries. The epidemiological data published in last 30 years are very alarming. They document that the age-related macular degeneration is the most common cause of blindness in industrial countries in the population of patients older than 65 years. The signs of beginning disease may be diagnosed as early as in the patients older than 45 years. The disease is strictly age-related and its prevalence and incidence is markedly increasing according to the older age. The basic risk factors of the disease are smoking, untreated hypertension, atherosclerosis, cataract surgery, and appearance of the disease in the family. Among further possible risk factors we count diabetes mellitus and the light color of the iris. Equivocal is the negative influence of ultraviolet rays.
 ...
PMID:[Epidemiology of the age-related macular degeneration]. 2113 73

Intravenous injection of angiogenesis-inhibitor drugs is used widely to treat cancers. Associated renal complications primarily involve proteinuria and hypertension, and thrombotic microangiopathies also have been described. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy currently is used by ophthalmologists to treat neovascularization in age-related macular degeneration. However, there is some evidence that intravitreal anti-VEGF injections may result in systemic absorption, with the potential for injury in organs that are reliant on VEGF, such as the kidney. We report the first case to our knowledge of a patient who developed an acute decrease in kidney function, nonimmune microangiopathic hemolytic anemia with schistocytes, and thrombocytopenia after 4 intravitreal injections of ranibizumab. Light microscopy of a kidney biopsy specimen showed segmental duplications of glomerular basement membranes with endothelial swelling and several recanalized arteriolar thrombi. Because of the increasing use of intravitreal anti-VEGF agents, ophthalmologists and nephrologists should be aware of the associated risk of kidney disease. Early detection is crucial so that intravitreal injections can be stopped before severe kidney disease occurs.
 ...
PMID:Systemic and kidney toxicity of intraocular administration of vascular endothelial growth factor inhibitors. 2129 97

Long-term efficacy and safety profile of pegaptanib was evaluated for age-related macular degeneration (AMD) with choroidal neovascularization. Sixty-one AMD patients from phase II clinical trial were entered into an extended trial and followed up for more than 2 years. Pegaptanib sodium 0.3 mg was administered once every six weeks. Changes in visual acuity were evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. The number of responders and adverse events were monitored. The mean change in visual acuity decreased by 10.3 letters for up to 199 weeks (62-199 weeks; mean 140 weeks) during follow-up. There were 77.4% responders at the beginning (54 weeks since the beginning of phase II trial) and 56.6% at the end of the extended trial. Adverse events were found in 57 of 61 patients (93.4%); 36 of the events (59.0%) were due to a preparation procedure, while 12 adverse events (19.7%), including retinal hemorrhage (3 events; 4.9%), anterior chamber inflammation (2 events; 3.3%), macular degeneration, floaters, photopsia, retinal vessel aneurysm, vitreous hemorrhage, ocular hypertension, arteriosclerosis obliterans and hypertension (1 event; 1.6%, respectively) were associated with pegaptanib sodium. Thus, the majority of adverse events was at least in part a result of the preparation procedure for injection. Based on the long-term efficacy and tolerability data of this trial, pegaptanib sodium appears to be beneficial for preventing the worsening of visual acuity caused by age-related macular degeneration with choroidal neovascularization.
 ...
PMID:[Long-term efficacy and safety profile of pegaptanib sodium for age-related macular degeneration with choroidal neovascularization--evaluation of extended phase II clinical trial]. 2140 Sep 18

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.
 ...
PMID:How does hypertension affect your eyes? 2150 40


<< Previous 1 2 3 4 5 6 7 8 9 Next >>