title: Ambulatory Aortic Stiffness Is Associated With Narrow Retinal Arteriolar Caliber in Hypertensives: The SAFAR Study.
abstract: BACKGROUND
  Arterial stiffness measured under static conditions reclassifies significantly cardiovascular (CV) risk and associates with narrower retinal arterioles. However, arterial stiffness exhibits circadian variation, thus single static stiffness recordings do not correspond to the "usual" 24 hr, awake, and asleep average arterial stiffness. We aimed to test the hypothesis that ambulatory 24 hr, awake, and asleep aortic (a) pulse wave velocity (PWV) associate with retinal vessel calibers, independently of confounders and of static arterial stiffness, in hypertensive individuals free from diabetes and CV disease.
  
  
  METHODS
  Digital retinal images were obtained (181 individuals, age: 53.9±10.7 years, 55.2% men) and retinal vessel calibers were measured with validated software to determine central retinal arteriolar and venular equivalents (CRAE and CRVE, respectively); ambulatory (24 hr, awake, asleep) and static office aPWV were estimated by Mobil-O-Graph; and static office carotid to femoral (cf) PWV by SphygmoCor.
  
  
  RESULTS
  Regression analysis performed in 320 gradable retinal images showed that, after adjustment for confounders: (i) ambulatory aPWV was significantly associated with narrower retinal arterioles but not with venules; (ii) asleep aPWV had stronger associations with CRAE than awake aPWV; (iii) both ambulatory aPWV and cfPWV were associated mutually independently with narrower retinal arterioles; aPWV introduction in the model of cfPWV, improved model's R2 (P = 0.012). Similar discriminatory ability of 24 hr aPWV and of cfPWV to detect the presence of retinal arteriolar narrowing was found.
  
  
  CONCLUSIONS
  Ambulatory aPWV, estimated by an operator-independent method, provides additional information to cfPWV regarding the associations of arterial stiffness with the retinal vessel calibers.
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece; eaiswpou@yahoo.gr.
authors: Evaggelia K
authors: EK
authors: Aissopou
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece;
authors: Antoniοs A
authors: AA
authors: Argyris
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece;
authors: Efthimia G
authors: EG
authors: Nasothimiou
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece;
authors: George D
authors: GD
authors: Konstantonis
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece;
authors: Kostas
authors: K
authors: Tampakis
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece;
authors: Nikolaos
authors: N
authors: Tentolouris
authors: 2nd Department of Ophthalmology, Attikon University Hospital, Athens, Greece;
authors: Miltiadis
authors: M
authors: Papathanassiou
authors: 2nd Department of Ophthalmology, Attikon University Hospital, Athens, Greece;
authors: Panagiotis G
authors: PG
authors: Theodossiadis
authors: Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece;
authors: Theodoros G
authors: TG
authors: Papaioannou
authors: Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands.
authors: Coen D A
authors: CD
authors: Stehouwer
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece;
authors: Petros P
authors: PP
authors: Sfikakis
authors: Hypertension Unit and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, Athens, Greece; Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands.
authors: Athanassios D
authors: AD
authors: Protogerou
mesh_terms: D000204:Activity Cycles; D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D001160:Arterioles / Q000473:pathology*; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010781:Photography; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012161:Retinal Artery / Q000473:pathology*; D059289:Vascular Stiffness
keywords: ambulatory arterial stiffness; arterial distensibility; blood pressure; hypertension; pulse wave velocity; retinal arterioles; retinal venules.