Effect of antihypertensive treatment on retinal microvascular changes in hypertension.
OBJECTIVE
Hypertension causes arteriolar narrowing and rarefaction in the retinal circulation, but the extent to which these changes are reversible by antihypertensive treatment is not well studied. We compared the effect of antihypertensive treatment with a calcium-channel-blocker-based regimen and an angiotensin-converting-enzyme-inhibitor-based regimen on the retinal microvasculature.


METHODS
Twenty-five patients (17 men, age range 24-71 years) with untreated hypertension were randomized to treatment with an amlodipine-based (n = 12) or lisinopril-based (n = 13) regimen in a double-blind, prospective parallel limb trial for 52 weeks. Measurements of blood pressure and the retinal microvasculature were made at baseline and at the end of the study.


RESULTS
Both the amlodipine-based and lisinopril-based treatments reduced blood pressure to similar extents. Blood pressure reduction was associated with a reduction in arteriolar narrowing, a widening of arteriolar branch angle and an increase in arteriolar density. There were no significant differences between the two treatment regimens.


CONCLUSIONS
Antihypertensive treatment is associated with improvement in arteriolar narrowing and rarefaction. Improved microvascular structure may contribute to the beneficial effects of antihypertensive treatment in hypertension.
Hughes
Alun D
AD
Clinical Pharmacology, International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College, London, UK. a.hughes@imperial.ac.uk
Stanton
Alice V
AV
Jabbar
Atif S
AS
Chapman
Neil
N
Martinez-Perez
M Elena
ME
McG Thom
Simon A
SA
D000328:Adult; D017311:Amlodipine / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017706:Lisinopril / Q000008:administration & dosage*; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D012164:Retinal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D012171:Retinal Vessels / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D017311:Amlodipine; D017706:Lisinopril