Key result
Unattended BP yields ~7 mmHg lower systolic values than attended despite similar retinal arteriolar correlations.
Why the study?
Data evaluating the relationship between attended versus unattended BP and retinal arteriolar alterations were lacking.
Does unattended blood pressure measurement correlate differently with retinal microcirculation changes compared to attended blood pressure measurement?
Cross-Sectional (n=142)
Random order of measurements
No
Does unattended blood pressure measurement correlate differently with retinal microcirculation changes compared to attended blood pressure measurement?
Attended and unattended blood pressure measurements correlate similarly with structural changes in retinal arterioles, despite unattended BP values being significantly lower.
Answers are grounded in this paper and cite their sources.
Both BP methods correlate similarly with retinal changes despite value gaps; leaves open whether unattended measurement refines microvascular risk assessment.
Though the relationship between both “attended” and “unattended” BP and several forms of target organ damage have been evaluated, data on retinal arteriolar alterations are lacking. The aim of our study was to evaluate the relationship between “attended” or “unattended” BP values and retinal arteriolar changes in consecutive individuals undergoing a clinical evaluation and assessment of retinal fundus at an ESH Excellence Centre. An oscillometric device programmed to perform 3 BP measurements, at 1 min intervals and after 5 min of rest was used on all individuals to measure BP with the patient alone in the room (“unattended”) or in the presence of the physician (“attended”) in the same day in a random order. The retinal arteriole’s wall thickness (WT) was measured automatically by a localization algorithm as the difference between external (ED) and internal diameter (ID) by adaptive optics (RTX-1, Imagine Eyes, Orsay, Francia). Media-to-lumen ratio (WLR) of the retinal arterioles and cross-sectional area (WCSA) of the vascular wall were calculated. Results: One-hundred-forty-two patients were examined (mean age 57 ± 12 yrs, 48% female, mean BMI 26 ± 4). Among them, 60% had hypertension (84% treated) and 11% had type 2 diabetes mellitus. Unattended systolic BP (SBP) was lower as compared to attended SBP (129 ± 14.8. vs. 122.1 ± 13.6 mmHg, p < 0.0001). WLR was similarly correlated with unattended and attended SBP (r = 0.281, p < 0.0001 and r = 0.382, p < 0.0001) and with unattended and attended diastolic BP (r = 0.34, p < 0.001 and r = 0.29, p < 0.0001). The differences between correlations were not statistically significant (Steiger’s Z test). Conclusion: The measurement of “unattended” or “attended” BP provides different values, and unattended BP is lower as compared to attended BP. In this study a similar correlation was observed between attended and unattended BP values and structural changes of retinal arterioles.
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Paini et al. (2022) conducted a cross-sectional in Individuals undergoing clinical evaluation (n=142). Unattended blood pressure measurement vs. Attended blood pressure measurement was evaluated on Correlation between systolic blood pressure and retinal arteriole media-to-lumen ratio (WLR) (r = 0.281 (unattended) vs r = 0.382 (attended), p=<0.0001). Unattended blood pressure measurement yielded lower systolic values than attended measurement (122.1 vs 129 mmHg, p<0.0001), though both correlated similarly with retinal arteriolar changes.
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