Fuchs Sandra C, Pakter Helena M, Maestri Marcelo K, Beltrami-Moreira Marina, Gus Miguel, Moreira Leila B, Oliveira Manuel M, Fuchs Flavio D
Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, CEP 90035-003, Porto Alegre, RS, Brazil; Postgraduate Studies Program in Cardiology, School of Medicine, and Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, CEP 90035-003, Porto Alegre, RS, Brazil.
Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, CEP 90035-003, Porto Alegre, RS, Brazil.
PLoS One. 2015 Sep 16;10(9):e0136678. doi: 10.1371/journal.pone.0136678. eCollection 2015.
Retinal arterial narrowing is associated with higher office blood pressure (BP) and ambulatory blood pressure monitoring, and increased incidence of cardiovascular disease, but it is still unknown if the vessel caliber is associated with BP measured at the time of retinography acquisition.
Retinal arteriolar and venular calibers were measured by the microdensitometric method in 448 patients with hypertension. Participants underwent 24-hours ambulatory blood pressure (24-h ABP) monitoring simultaneously with the retinography acquisition. Association between arteriolar and venular calibers with increase of 10 mmHg in the mean 24-hours, daily, and nightly BP, and with BP measured at the time of retinography, was evaluated by ANOVA and multivariate analyses.
Mean 24-hours, daytime and nighttime systolic and diastolic BP were inversely associated with the arteriolar caliber, but not with the venular caliber. Arteriolar caliber decreased -0.8 (95% CI -1.4 to -0.2) μm per 10-mmHg increase in 24-hours mean systolic BP, adjusted for age, gender, fellow vessel, and duration of hypertension (P = 0.01). The corresponding decreasing in arteriolar caliber by 10 mmHg of increasing in mean diastolic BP was -1.1 μm (-2.0 to -0.2, P = 0.02). The decrease of arteriolar caliber by the same increasing of BP measured at the time of retinography was lower and not statistically significant, particularly for mean diastolic BP and outer arterioles calibers: -1.0 (-1.8 to -0.2) μm in the daytime BP average versus -0.3 (-0.9 to 0.3) at the moment of retinography acquisition.
These findings suggest that the caliber of arteriolar retinal vessels in patients with uncontrolled hypertension are not significantly influenced by blood pressure measured at the time of retinography acquisition.
视网膜动脉狭窄与较高的诊室血压(BP)和动态动态血压监测相关,且心血管疾病发病率增加,但血管管径是否与视网膜成像采集时测量的血压相关仍不清楚。
采用微密度测量法测量448例高血压患者的视网膜小动脉和小静脉管径。参与者在进行视网膜成像采集的同时接受24小时动态血压(24-h ABP)监测。通过方差分析和多变量分析评估小动脉和小静脉管径与24小时平均、每日和夜间血压升高10 mmHg以及与视网膜成像时测量的血压之间的关联。
24小时平均、白天和夜间的收缩压和舒张压与小动脉管径呈负相关,但与小静脉管径无关。在调整年龄、性别、对侧血管和高血压病程后,24小时平均收缩压每升高10 mmHg,小动脉管径减少-0.8(95%可信区间-1.4至-0.2)μm(P = 0.01)。平均舒张压升高10 mmHg时,小动脉管径相应减少-1.1 μm(-2.0至-0.2,P = 0.02)。视网膜成像时测量的相同血压升高导致的小动脉管径减少幅度较小且无统计学意义,尤其是平均舒张压和外层小动脉管径:白天平均血压时为-1.0(-1.8至-0.2)μm,而视网膜成像采集时为-0.3(-0.9至0.3)μm。
这些发现表明,未控制高血压患者的视网膜小动脉血管管径不受视网膜成像采集时测量的血压显著影响