Key result
Narrower retinal arteriolar diameters and higher pulse wave velocity at baseline predicted higher systolic blood pressure after 4 years (β 0.6, p=0.026 and β 0.6, p<0.001, respectively).
Why the study?
High blood pressure is associated with subclinical vascular impairments as early as childhood, but the association of retinal microvascular diameters and pulse wave velocity with childhood blood pressure progression required assessment.
Do baseline retinal microvascular diameters and pulse wave velocity predict blood pressure progression in children?
Cohort (n=1,171)
Do baseline retinal microvascular diameters and pulse wave velocity predict blood pressure progression in children?
Effect estimate: β 0.6 (95% CI 0.072-1.164)
p-value: p=0.026
Retinal arteriolar diameter and pulse wave velocity independently predict blood pressure progression in childhood, highlighting a bidirectional relationship between vascular health and blood pressure.
Narrower retinal arterioles and stiffer arteries may flag higher future BP in children; leaves open whether screening alters trajectories.
BACKGROUND AND AIMS: Hypertension is a major risk factor for the development of cardiovascular disease (CVD) in adulthood. High blood pressure (BP) is associated with subclinical vascular impairments as early as childhood. We aimed to assess the association of retinal microvascular diameters and large artery pulse wave velocity (PWV) with progression of childhood BP. METHODS: In our prospective Basel cohort study, 1171 children aged 6-8 years were screened for BP, body mass index, retinal vessel diameters and PWV using standardized protocols. After 4 years, all parameters were assessed in 749 children using the same protocols. RESULTS: Children with narrower central retinal arteriolar diameters (CRAE) and higher PWV at baseline developed higher systolic BP after 4 years (β [95% CI] 0.6 [0.072 to 1.164] mmHg per 10 μm decrease, p = 0.026 and β [95% CI] 0.6 [0.331 to 0.838] mmHg per 0.1 m/s increase, p < 0.001, respectively). Children with increased systolic BP at baseline developed narrower CRAE and higher PWV at follow-up (β [95% CI] -3.3 [-4.43 to -2.09] μm per 10 mmHg increase, p < 0.001 and β [95% CI] 0.13 [0.10 to 0.16] m/s per 10 mmHg increase, p < 0.001, respectively). CONCLUSIONS: Retinal arteriolar diameter and PWV independently predict progression of childhood BP, while initial BP is linked to development of micro- and macrovascular impairments, describing a bivariate temporal relationship between vascular health and BP. Childhood may present a window of opportunity for initiation of primary prevention strategies for the treatment of high BP to help prevent manifestation of CVD later in life.
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Hauser et al. (2023) conducted a cohort in Blood pressure progression and vascular health (n=1,171). Narrower central retinal arteriolar diameters (CRAE) and higher pulse wave velocity (PWV) vs. Wider CRAE and lower PWV was evaluated on Progression of systolic blood pressure after 4 years (per 10 μm decrease in CRAE) (β 0.6, 95% CI 0.072-1.164, p=0.026). Narrower retinal arteriolar diameters and higher pulse wave velocity at baseline predicted higher systolic blood pressure after 4 years (β 0.6, p=0.026 and β 0.6, p<0.001, respectively).
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