title: Effect of antihypertensive treatment on retinal microvascular changes in hypertension.
abstract: 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.
authors.affiliation: Clinical Pharmacology, International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College, London, UK. a.hughes@imperial.ac.uk
authors.forename: Alun D
authors.initials: AD
authors.lastname: Hughes
authors.forename: Alice V
authors.initials: AV
authors.lastname: Stanton
authors.forename: Atif S
authors.initials: AS
authors.lastname: Jabbar
authors.forename: Neil
authors.initials: N
authors.lastname: Chapman
authors.forename: M Elena
authors.initials: ME
authors.lastname: Martinez-Perez
authors.forename: Simon A
authors.initials: SA
authors.lastname: McG Thom
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents; D017311:Amlodipine; D017706:Lisinopril