Analysis of retinal arteriolar structure in never-treated patients with essential hypertension.
OBJECTIVE
Increased wall-to-lumen ratio of small arteries is a predictor of adverse cardiovascular prognosis. We aimed to analyze retinal arteriolar structure in never-treated patients with essential hypertension and to test whether elevated blood pressure is associated with an increased wall-to-lumen ratio of retinal arterioles.


METHODS
The study cohort comprised 21 untreated male patients with essential hypertension (mean age 39.1 +/- 5.4 years) and 29 untreated normotensive men (mean age 36.7 +/- 5.9 years). Wall-to-lumen ratio of retinal arterioles was assessed in vivo using scanning laser Doppler flowmetry.


RESULTS
Patients with essential hypertension had a higher wall-to-lumen ratio of retinal arterioles than normotensive individuals (0.36 +/- 0.1 vs. 0.28 +/- 0.1, P = 0.028). Wall cross-sectional area of retinal arterioles did not differ between the study groups. The growth index, indicating the percentage of difference in average wall cross-sectional area of retinal arterioles between both groups, was 18%. Both systolic (r = 0.360, P = 0.010) and diastolic (r = 0.536, P < 0.001) blood pressures were related to wall-to-lumen ratio of retinal arterioles. Multiple regression analysis including a variety of known cardiovascular risk factors revealed that blood pressure is independently associated with an increased wall-to-lumen ratio of retinal arterioles (systolic blood pressure: beta = 0.417, P = 0.012; diastolic blood pressure: beta = 0.548, P = 0.001).


CONCLUSIONS
The changes in arteriolar structure of retinal vessels in our study cohort revealed a similar pattern to that observed previously by other investigators in subcutaneous small arteries in essential hypertension. Blood pressure emerged as an important and independent determinant of wall-to-lumen ratio of retinal arterioles.
Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen, Germany.
Martin
M
Ritt
Joanna M
JM
Harazny
Christian
C
Ott
Markus P
MP
Schlaich
Markus P
MP
Schneider
Georg
G
Michelson
Roland E
RE
Schmieder
D000328:Adult; D001160:Arterioles / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D012039:Regional Blood Flow; D012160:Retina / Q000033:anatomy & histology / Q000503:physiopathology*; D012161:Retinal Artery / Q000503:physiopathology*