What is the clinical evidence from this study?

Study design: Cohort. Population: Normal blood pressure or prehypertension (n=1900). Intervention: Retinal arteriolar narrowing vs. Wider retinal arteriolar diameters. Primary outcome: Incident hypertension (systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or use of antihypertensive medication) (OR 1.38, 95% CI 1.23 to 1.55).

December 28, 2005Open Access

Retinal Vessel Diameters and Risk of Hypertension

MIM. Kamran IkramWannan Medical College JWJacqueline C.M. WittemanBroad Institute JVJohannes R. VingerlingErasmus MC

Key Result

Each standard deviation decrease in retinal arteriolar diameter was associated with a 38% increased risk of incident hypertension (OR 1.38).

Study Design

Type

Cohort (n=1,900)

Multicenter

Structured PICO

Does retinal vessel narrowing predict the development of incident hypertension in adults ≥55 years of age?

Population

1,900 adults aged 55 years and older with normal blood pressure or prehypertension, followed for a mean of 6.6 years to assess incident hypertension.

Exposure

Retinal arteriolar and venular diameters measured on digitized images of 1 eye.

Outcome

Incident hypertension, defined as either systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or use of antihypertensive medication.

Both retinal arteriolar and venular narrowing independently predict the development of systemic hypertension in older adults.

Main Result

Odds Ratio: 1.38 (95% CI 1.23–1.55)

Limitations

Number of nonparticipants at follow-up could introduce bias
Photographs were not taken synchronized on the cardiac cycle, leading to variation in vessel diameter because of pulsatility

Abstract

Generalized retinal arteriolar narrowing is an important sign of systemic hypertension, and a lower arteriolar:venular diameter ratio predicts the risk of hypertension. We investigated whether this association was based on arteriolar or venular diameters or both. This study was based on the prospective population-based Rotterdam Study (1990-1993) and included 1900 participants (> or =55 years of age) of whom 739 persons had normal blood pressure (systolic or =140 mm Hg or diastolic blood pressure > or =90 mm Hg or use of antihypertensive medication. Adjusted for age, gender, follow-up time, body mass index, smoking, diabetes mellitus, total and high-density lipoprotein cholesterol, C-reactive protein, and intima-media thickness, arteriolar narrowing was associated with an increased risk of hypertension (odds ratio per SD: 1.38; 95% CI, 1.23 to 1.55); for venular narrowing this was less striking (OR: 1.17; 95% CI, 1.04 to 1.32). Each SD decrease in the arteriolar:venular diameter ratio significantly increased the risk of hypertension by 24%. To examine the effect of baseline blood pressure, we stratified persons into those with "normal blood pressure" or "prehypertension." Within these strata, arteriolar narrowing was still related to incident hypertension. These data show that both retinal arteriolar and venular narrowing may precede the development of systemic hypertension.

Ask AI

Helpful

Bookmark

View Full Paper