Retinal arteriole-to-venule ratio changes and target organ disease evolution in newly diagnosed hypertensive patients at 1-year follow-up.
There is no agreement on the systematic exploration of the fundus oculi (FO) in hypertensive patients, and it is unknown whether the evolution of retinal microcirculatory alterations has prognostic value or not. The aim of this study was to investigate whether the evolution of the arteriole-to-venule ratio (AVR) in newly-diagnosed hypertensive patients is associated with better or worse evolution of target organ damage (TOD) during 1 year. A cohort of 133 patients with newly-diagnosed untreated hypertension was followed for 1 year. At baseline and follow-up, all patients underwent a physical examination, self-blood pressure measurement, ambulatory blood pressure monitoring, blood and urine analysis, electrocardiogram, and retinography. The endpoint was the favourable evolution of TOD and the total amount of TOD, according to the baseline AVR and the baseline and final difference of the AVR. A total of 133 patients were analyzed (mean age, 57 ± 10.7 years; 59% men). No differences were found in the decrease in blood pressure or antihypertensive treatment between quartiles of baseline AVR or baseline-final AVR difference. Patients with a difference between baseline and final AVR in the highest quartile (>0.0817) had a favorable evolution of left ventricular hypertrophy (odds ratio, 14.9; 95% confidence interval, 1.08-206.8) and the amount of TOD (odds ratio, 2.22; 95% confidence interval, 1.03-6.05). No favorable evolution was found of glomerular filtration rate. There is an association between the evolution of the AVR and the favorable evolution of TOD. Patients with greater increase of AVR have significantly better evolution of left ventricular hypertrophy and amount of TOD.
Research Unit, Institut d'Assistència Sanitària, IAS, Girona, Spain; CIBER of Epidemiology and Public Health, CIBERESP, Spain; Department of Medical Sciences, University of Girona, Girona, Spain.
Gabriel
G
Coll-de-Tuero
Artificial Vision and Pattern Recognition Group, VARPA, Department of Computing, University of A Coruña, Spain.
Sonia
S
González-Vázquez
Research Unit, Institut d'Assistència Sanitària, IAS, Girona, Spain.
Antonio
A
Rodríguez-Poncelas
CIBER of Epidemiology and Public Health, CIBERESP, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain.
María Antònia
MA
Barceló
Salt Healthcare Centre, ICS, Salt, Girona, Spain.
Joan
J
Barrot-de-la Puente
Artificial Vision and Pattern Recognition Group, VARPA, Department of Computing, University of A Coruña, Spain.
Manuel G
MG
Penedo
Internal Medicine Service, Hospital de Conxo, Santiago de Compostela, Spain.
Antonio
A
Pose-Reino
Internal Medicine Service, Hospital de Conxo, Santiago de Compostela, Spain.
Marta
M
Pena-Seijo
CIBER of Epidemiology and Public Health, CIBERESP, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain. Electronic address: marc.saez@udg.edu.
Marc
M
Saez
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D012171:Retinal Vessels / Q000000981:diagnostic imaging*; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain
D000959:Antihypertensive Agents
Retinography; evolution of target organ damage; left ventricular hypertrophy; subclinical cardiovascular disease