Key result
In patients with COPD, higher systolic blood pressure was significantly associated with narrower retinal arterioles (β: -0.136, p<0.001), while pulmonary rehabilitation did not affect vessel diameters.
Why the study?
Although retinal vessel diameters are linked to cardiovascular health in population studies, it was unknown whether this applies to COPD patients or changes with pulmonary rehabilitation.
Does an exercise-based pulmonary rehabilitation program improve retinal vessel diameters in patients with COPD?
Observational (n=246)
No
Does an exercise-based pulmonary rehabilitation program improve retinal vessel diameters in patients with COPD?
Effect estimate: β: -0.136 (95% CI -0.210 to -0.062)
p-value: p=<0.001
Retinal vessel diameters in COPD patients are associated with systolic blood pressure and systemic inflammation, but do not change following an 8-week exercise-based pulmonary rehabilitation program.
SBP links to narrower retinal arterioles in COPD; leaves open whether rehabilitation or other interventions modify microvascular parameters.
Cardiovascular diseases are frequently present in chronic obstructive pulmonary disease (COPD). Population-based studies found associations between retinal vessel diameters and cardiovascular health, but it is unknown whether this also applies to COPD patients. Therefore, we measured retinal vessel diameters in COPD patients and aimed to determine the association with cardiovascular risk factors, lung function, and functional outcomes. In addition, we investigated whether an exercise-based pulmonary rehabilitation (PR) program would change retinal vessel diameters, as a proxy for improved microvascular health. Demographics and clinical characteristics, including pulmonary function, exercise capacity, blood pressure, blood measurements and level of systemic inflammation were obtained from 246 patients during routine assessment before and after PR. Retinal vessel diameters were measured from digital retinal images. Older age and higher systolic blood pressure were associated with narrower retinal arterioles (β: -0.224; p = 0.042 and β: -0.136; p < 0.001, respectively). Older age, higher systolic blood pressure and lower level of systemic inflammation were associated with narrower retinal venules (β: -0.654; -0.229; and -13.767, respectively; p < 0.05). No associations were found between retinal vessel diameters and lung function parameters or functional outcomes. After PR, no significant changes in retinal venular or arteriolar diameter were found. To conclude, retinal vessel diameters of COPD patients were significantly associated with systolic blood pressure and systemic inflammation, whilst there was no evidence for an association with lung function parameters, functional outcomes or other cardiovascular risk factors. Furthermore, an exercise-based PR program did not affect retinal vessel diameter.
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Vaes et al. (2020) conducted an observational in Chronic Obstructive Pulmonary Disease (COPD) (n=246). Higher systolic blood pressure vs. Lower systolic blood pressure was evaluated on Central retinal arteriolar equivalent (CRAE) (β: -0.136, 95% CI -0.210 to -0.062, p=<0.001). In patients with COPD, higher systolic blood pressure was significantly associated with narrower retinal arterioles (β: -0.136, p<0.001), while pulmonary rehabilitation did not affect vessel diameters.
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