Regression of Alterations in Retinal Microcirculation Following Treatment for Arterial Hypertension

Evaluation of early hypertension‐related alterations in retinal microcirculation has been subjective and poorly reproducible. The authors recently described a semiautomatic computerized system for evaluation of the calibre of retinal blood vessels that has shown very good reproducibility. In the study, this system was used to measure the calibres of retinal arterioles and veins, and their ratio, in a group of 51 hypertensive outpatients before and after 6 months of treatment with losartan or, if required for satisfactory blood pressure control, losartan plus hydrochlorothiazide. Mean retinal arteriole diameter increased from 0.0842±0.003 mm to 0.0847±0.003 mm (p=0.001). Arteriovenous ratio increased from 0.753±0.03 to 0.756±0.03 (p=0.005). This observation suggests regression of early hypertension‐related alterations in retinal microcirculation after 6 months of antihypertensive treatment.

[1]  Tien Yin Wong,et al.  A prospective cohort study of retinal arteriolar narrowing and mortality. , 2004, American journal of epidemiology.

[2]  R. Kronmal,et al.  Retinal microvascular abnormalities and blood pressure in older people: the Cardiovascular Health Study , 2002, The British journal of ophthalmology.

[3]  J. Laragh,et al.  Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. , 1992, Journal of the American College of Cardiology.

[4]  T. Kearns,et al.  Prognostic importance of ophthalmoscopic findings in essential hypertension. , 1966, Journal of the American Medical Association (JAMA).

[5]  R. Klein,et al.  Retinal vessel diameters and their associations with age and blood pressure. , 2003, Investigative ophthalmology & visual science.

[6]  K. Anderson,et al.  An updated coronary risk profile. A statement for health professionals. , 1991, Circulation.

[7]  R. Devereux Detection of Left Ventricular Hypertrophy by M‐Mode Echocardiography: Anatomic Validation, Standardization, and Comparison to Other Methods , 1987, Hypertension.

[8]  Antonio Mosquera González,et al.  ART-VENA: Retinal Vaseular Caliber Measurement , 2003, IbPRIA.

[9]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[10]  Tien Yin Wong,et al.  Retinal Arteriolar Diameter and Risk for Hypertension , 2004, Annals of Internal Medicine.

[11]  E. Schiffrin Remodeling of resistance arteries in essential hypertension and effects of antihypertensive treatment. , 2004, American journal of hypertension.

[12]  R. Klein,et al.  Retinal microvascular abnormalities and their relationship with hypertension, cardiovascular disease, and mortality. , 2001, Survey of ophthalmology.

[13]  R. Klein,et al.  Hypertensive Retinal Vessel Wall Signs in a General Older Population: The Blue Mountains Eye Study , 2003, Hypertension.

[14]  Robert M. Anderson,et al.  Prevention or delay of type 2 diabetes. , 2004, Diabetes care.

[15]  J. Shaw,et al.  Follow-up report on the diagnosis of diabetes mellitus. , 2003, Diabetes care.

[16]  W. A. Littler,et al.  USEFULNESS OF OPHTHALMOSCOPY IN MILD TO MODERATE HYPERTENSION , 1989, The Lancet.

[17]  N. M. Keith,et al.  Some Different Types Of Essential Hypertension: Their Course And Prognosis , 1939, The American journal of the medical sciences.

[18]  R. Klein,et al.  Methods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the Atherosclerosis Risk in Communities Study. , 1999, Ophthalmology.

[19]  J. Singh,et al.  Hypertensive retinopathy. , 1983, Indian journal of ophthalmology.

[20]  L. Hansson,et al.  Hypertensive retinal vascular changes: relationship to left ventricular hypertrophy and arteriolar changes before and after treatment. , 1992, Blood pressure.

[21]  R. Klein,et al.  Are retinal arteriolar abnormalities related to atherosclerosis?: The Atherosclerosis Risk in Communities Study. , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[22]  Giel Nijpels,et al.  Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study. , 2003, Archives of ophthalmology.

[23]  Antonio Pose-Reino,et al.  Computerized measurement of retinal blood vessel calibre: description, validation and use to determine the influence of ageing and hypertension , 2005, Journal of hypertension.

[24]  F. Magrini,et al.  Retinal microvascular changes and target organ damage in untreated essential hypertensives , 2004, Journal of hypertension.

[25]  Yutaka Imai,et al.  European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement , 2003, Journal of hypertension.

[26]  A. Dominiczak,et al.  2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) , 2007, European heart journal.

[27]  F. Magrini,et al.  Evaluation of target organ damage in arterial hypertension: which role for qualitative funduscopic examination? , 2001, Italian heart journal : official journal of the Italian Federation of Cardiology.

[28]  R. Klein,et al.  The prevalence and risk factors of retinal microvascular abnormalities in older persons: The Cardiovascular Health Study. , 2003, Ophthalmology.

[29]  Robert M. Anderson,et al.  5. Prevention or Delay of Type 2 Diabetes , 2016, Diabetes Care.

[30]  J. González-Juanatey,et al.  [Relation between left ventricular hypertrophy and retinal vascular changes in mild hypertension]. , 1997, Medicina clinica.

[31]  R. Klein,et al.  Retinal arteriolar diameters and elevated blood pressure: the Atherosclerosis Risk in Communities Study. , 1999, American journal of epidemiology.