Lens Opacities Clinical Trial
Official title:
Using Lens Opacities to Predict Salt Sensitivity Hypertension
Salt-sensitive hypertension (SSH) accounts for about the half of all Hypertension (HT) cases
.In SSH, Na+/K+-ATPase activity is impaired. Impaired Na+/K+-ATPase activity in the lens
epithelium results in cortical opacities in the peripheral equator of the lens.
This study analyzed 305 patients with hypertension aged between 40 and 80 years and 124
non-HT controls. A total of 163 patients with HT who were admitted to the emergency service
at least once with a minimum increase of 10% in their systolic and diastolic blood pressure
after consuming salted food met the eligible criteria for HT and were included in the SSH
group. A total of 142 patients who were previously diagnosed with HT but had no previous
history were considered non-SSH. Two researchers examined the presence of cortical lens
opacities biomicroscopically using the diffuse, direct, Scheimpflug, and retroillumination
from fundus methods.
The number of patients with hypertension (HT) worldwide is estimated to reach 1.56 billion by
2025.HT accounts for almost 50% of deaths due to stroke and coronary artery disease.
Salt-sensitive hypertension (SSH) accounts for about the half of all HT cases. Na+ /K+-ATPase
activity is impaired in patients with SSH . Impaired Na+ /K+-ATPase activity in the lens
epithelium results in cortical opacities in the peripheral equatorial region of the lens.A
definite diagnosis of salt sensitivity is difficult, expensive, and associated with low
patient compliance. Salt sensitivity is a risk factor for cardiovascular mortality and
morbidity regardless of blood pressure and for other diseases such as asthma, gastric
carcinoma, osteoporosis, and renal dysfunction. The present study is the first to investigate
the potential of using lens opacity to predict SSH.
The transparency of the whole lens is largely based on epithelial cell permeability and Na+
/K+-ATPase activity. Circulation is activated by Na+ /K+-ATPases, which are present at
20-fold normal concentrations, particularly in the equatorial than in the anterior epithelial
cells.
The mechanisms associated with SSH pathogenesis, such as signaling pathways involving Src
family kinase (SFK), endothelin, connexin, brain natriuretic peptide (BNP), aldosterone,
transient receptor protein V4 (TRPV4) ion channel, with-no-lysine kinase-Ste20-like
proline/alanine rich kinase/oxidative stress-responsive kinase 1 (WNK-SPAK/OSR1), and
Ras-related C3 botulinum toxin substrate (Rac1) , are important to the physiology of the lens
epithelium. Compelling studies suggest that inhibition of these pathways may facilitate
opacity.
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