Objective: Retinal microcirculation reflects retinal perfusion abnormalities and retinal arterial structural changes at relatively early stages of various cardiovascular diseases. Wall-to-lumen ratio (WLR) may represent an early step in hypertension mediated organ damage. Our objective was to assess functional and structural parameters of retinal microcirculation in a randomly selected urban population sample, in hypertensive and normotensive individuals at baseline and after 7 years. Design and method: A total of 398 randomly selected individuals from an urban population aged 25 to 65 years, resident in Pilsen, Czech Republic, were screened for major cardiovascular risk factors in 2017. Retinal microcirculation was assessed using scanning laser Doppler flowmetry (SLDF), with data evaluable in 343 patients. In 2024, a follow-up study was organized, attended by 208 individuals of the original cohort. Results: Basic characteristics of normotensive and hypertensive individuals and their retinal parameters are shown in Table 1. Over the 7-years’ follow-up, out of the originally 131 normotensive individuals, 25 developed hypertension and antihypertensive medication was initiated in 15 of them. There was also a significant increase in antihypertensive medication in the originally hypertensive group, resulting in a significant decrease in BP. Treatment with lipid lowering drugs increased substantially in both groups, thus preventing deterioration in lipid profile. The incidence of diabetes more than doubled in both the groups. No major changes in retinal parameters were observed.Conclusions: Despite baseline differences in BP and CV risk profile between normotensive and hypertensive individuals, structural changes in retinal microcirculation did not develop over the follow-up period of 7 years in either group, which could be attributed to early initiation of drug treatment. The significant decrease in retinal vascular resistance (RVR) may suggest early functional improvement possibly preceding changes in vascular remodeling (e.g. WLR).
Cífková et al. (Fri,) studied this question.