aDepartment of Ophthalmology, National University Health System bSingapore Eye Research Institute, Singapore National Eye Centre cSaw Swee Hock School of Epidemiology and Public Health, National University of Singapore dDepartment of Medicine, National University Health System, Singapore, Singapore.
J Hypertens. 2013 Oct;31(10):2036-42. doi: 10.1097/HJH.0b013e328362c201.
OBJECTIVE(S): To examine the effect of blood pressure (BP) on retinal vascular fractal dimension (Df), a measure of microvascular network complexity and density in a multiethnic cohort.
A population-based study of 3876 Chinese, Malay and Indian participants in Singapore. Retinal Df was measured using a computer-based program from digital retinal photographs. Associations between retinal Df and mean arterial BP (MABP) in the whole cohort and in each racial group were analysed using linear regression analysis. Logistic regression was used to examine the association between retinal Df and hypertension status.
The mean retinal Df of the study population was 1.45 (standard deviation 0.03). After adjustment for age, sex, race, diabetes, BMI, cholesterol and creatinine levels, persons with smaller Df had higher MABP (mean difference MABP was 6.18 mmHg comparing lowest to highest Df quartiles, P<0.001). This was similar in Chinese, Malay and Indian persons [mean difference 6.40 (P<0.001), 4.72 (P=0.011) and 6.62 (P<0.001)mmHg, respectively]. Persons with smaller retinal Df were more likely to have uncontrolled treated or untreated hypertension [odds ratio 1.79 (P=0.003) and 2.60 (P=0.003), respectively, comparing lowest to highest Df quartiles] than those with no hypertension; this relationship was not seen comparing persons with controlled treated hypertension with no hypertension (odds ratio 1.01, P=0.972).
Hypertension was associated with a sparser retinal vascular network, which was similar across different racial/ethnic groups and most apparent in those with uncontrolled or untreated hypertension. These data suggest that microvascular remodelling can be quantified by measuring retinal vasculature.
在一个多民族队列中，研究血压（BP）对视网膜血管分形维数（Df）的影响，Df 是微血管网络复杂性和密度的度量。
这是一项在新加坡进行的基于人群的研究，共纳入 3876 名华裔、马来裔和印度裔参与者。使用基于计算机的程序从数字视网膜照片中测量视网膜 Df。使用线性回归分析分析整个队列和每个种族群体中视网膜 Df 与平均动脉压（MABP）之间的关系。使用逻辑回归分析检查视网膜 Df 与高血压状态之间的关系。
研究人群的平均视网膜 Df 为 1.45（标准差 0.03）。在校正年龄、性别、种族、糖尿病、BMI、胆固醇和肌酐水平后，Df 较小的人 MABP 较高（最低 Df 四分位数与最高 Df 四分位数相比，MABP 的平均差异为 6.18mmHg，P<0.001）。这种关联在华裔、马来裔和印度裔人群中是相似的[平均差异分别为 6.40（P<0.001）、4.72（P=0.011）和 6.62（P<0.001）mmHg]。Df 较小的人更有可能患有未经控制的治疗或未经治疗的高血压[与无高血压相比，比值比分别为 1.79（P=0.003）和 2.60（P=0.003）]；而在比较控制良好的治疗性高血压与无高血压时，这种关系并不明显（比值比 1.01，P=0.972）。
高血压与视网膜血管网络稀疏有关，这种关联在不同种族/民族群体中相似，在未经控制或未经治疗的高血压患者中最为明显。这些数据表明，通过测量视网膜血管，可以定量评估微血管重塑。
