Ritt Martin, Harazny Joanna M, Ott Christian, Schlaich Markus P, Schneider Markus P, Michelson Georg, Schmieder Roland E
Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen, Germany.
J Hypertens. 2008 Jul;26(7):1427-34. doi: 10.1097/HJH.0b013e3282ffdc66.
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.
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.
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).
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.
小动脉壁腔比增加是心血管不良预后的一个预测指标。我们旨在分析未经治疗的原发性高血压患者的视网膜小动脉结构,并测试血压升高是否与视网膜小动脉壁腔比增加相关。
研究队列包括21名未经治疗的原发性高血压男性患者(平均年龄39.1±5.4岁)和29名未经治疗的血压正常男性(平均年龄36.7±5.9岁)。使用扫描激光多普勒血流仪在体内评估视网膜小动脉的壁腔比。
原发性高血压患者的视网膜小动脉壁腔比高于血压正常个体(0.36±0.1对0.28±0.1,P = 0.028)。研究组之间视网膜小动脉的壁横截面积无差异。生长指数表明两组之间视网膜小动脉平均壁横截面积差异的百分比为18%。收缩压(r = 0.360,P = 0.010)和舒张压(r = 0.536,P < 0.001)均与视网膜小动脉壁腔比相关。包括多种已知心血管危险因素的多元回归分析显示,血压与视网膜小动脉壁腔比增加独立相关(收缩压:β = 0.417,P = 0.012;舒张压:β = 0.548,P = 0.001)。
我们研究队列中视网膜血管小动脉结构的变化显示出与其他研究者先前在原发性高血压患者皮下小动脉中观察到的模式相似。血压是视网膜小动脉壁腔比的重要且独立的决定因素。